Global Prevalence Of Infections Research Articles

Global prevalence of infections in newborns with respiratory complications: systematic review and meta-analysis.

Newborns as a vulnerable population are exposed to congenital and acquired infections during and after birth. There are several reports of the isolation and reporting of infectious agents (IAs) in early life of newborns with respiratory manifestations, and the present comprehensive study provides a snapshot of the current global situation of the prevalence of IAs in newborns with respiratory symptoms. A systematic search was conducted in main databases, including PubMed, Scopus, Web of science, and Google scholar. The pooled prevalence of infectious agents (IAs) in newborns was estimated using comprehensive meta-analysis software based on random effects model. Out of 44 inclusive studies (50 datasets) for IAs in newborns, the pooled prevalence was estimated to be 12.2% (95% CI: 6.40-22.0%) and the highest and lowest prevalence of IAs was related to the Brazil (78.2%, 95% CI: 31.0-96.6%), and UK (0.01%, 95% CI 0.01-0.01%) respectively. The high prevalence of IAs in newborns emphasizes considers the necessary measures to prevent respiratory infections.

Prevalence of Cryptosporidium and microsporidial infection in HIV-infected individuals.

Microsporidia and Cryptosporidium are obligate intracellular protozoa. These medically important species are recognized as opportunistic organisms in intestinal complications in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome patients. The current cross-sectional study was designed and conducted from August 2016 to August 2017 to determine intestinal Cryptosporidium and microsporidia spp. in HIV-infected individuals from the Behavioral Diseases Counseling Center, Tabriz, Iran, by modified acid-fast and modified trichrome staining and nested polymerase chain reaction (PCR) and real-time PCR. Of 100 HIV-infected persons, 21.0% (95% confidence interval [CI] 13.0 to 30.0) and 18.0% (95% CI 11.0 to 26.0) were identified as Cryptosporidium and microsporidia, respectively, by the microscopic method. Of these 100 HIV-infected persons, 18.0% (95% CI 11.0 to 26.0) and 14.0% (95% CI 7.0 to 22.0) were positive for Cryptosporidium and microsporidia, respectively, by the molecular method. The predominant species of microsporidia in patients was Enterocytozoon bieneusi (85.7% [95% CI 57.0 to 98.0]) and Encephalitozoon cuniculi (14.3% [95% CI 1.7 to 42.0]), which were found by quantitative real-time PCR and its high-resolution melting tool. As far as we know, this study is the first to estimate the prevalence of infection with Cryptosporidium and microsporidia among HIV-infected persons in northwest of Iran. The prevalence of intestinal microsporidiosis and cryptosporidiosis in this area in HIV-infected people was higher than the global prevalence of infection among immunocompromised patients. In addition to the need for further studies to prove protozoan pathogenicity in the aforementioned group, preventive measures should be considered.

Community carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae: a cross-sectional study of risk factors and comparative genomics of carriage and clinical isolates.

The global prevalence of infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) is increasing, and for Escherichia coli, observations indicate that this is partly driven by community-onset cases. The ESBL-E population structure in the community is scarcely described, and data on risk factors for carriage are conflicting. Here, we report the prevalence and population structure of fecal ESBL-producing E. coli and Klebsiella pneumoniae (ESBL-Ec/Kp) in a general adult population, examine risk factors, and compare carriage isolates with contemporary clinical isolates. Fecal samples obtained from 4,999 participants (54% women) ≥40 years in the seventh survey of the population-based Tromsø Study, Norway (2015, 2016), were screened for ESBL-Ec/Kp. In addition, we included 118 ESBL-Ec clinical isolates from the Norwegian surveillance program in 2014. All isolates were whole-genome sequenced. Risk factors associated with carriage were analyzed using multivariable logistic regression. ESBL-Ec gastrointestinal carriage prevalence was 3.3% [95% confidence interval (CI) 2.8%-3.9%, no sex difference] and 0.08% (0.02%-0.20%) for ESBL-Kp. For ESBL-Ec, travel to Asia was the only independent risk factor (adjusted odds ratio 3.46, 95% CI 2.18-5.49). E. coli ST131 was most prevalent in both collections. However, the ST131 proportion was significantly lower in carriage (24%) versus clinical isolates (58%, P < 0.001). Carriage isolates were genetically more diverse with a higher proportion of phylogroup A (26%) than clinical isolates (5%, P < 0.001), indicating that ESBL gene acquisition occurs in a variety of E. coli lineages colonizing the gut. STs commonly related to extraintestinal infections were more frequent in clinical isolates also carrying a higher prevalence of antimicrobial resistance, which could indicate clone-associated pathogenicity.IMPORTANCEESBL-Ec and ESBL-Kp are major pathogens in the global burden of antimicrobial resistance. However, there is a gap in knowledge concerning the bacterial population structure of human ESBL-Ec/Kp carriage isolates in the community. We have examined ESBL-Ec/Kp isolates from a population-based study and compared these to contemporary clinical isolates. The large genetic diversity of carriage isolates indicates frequent ESBL gene acquisition, while those causing invasive infections are more clone dependent and associated with a higher prevalence of antibiotic resistance. The knowledge of factors associated with ESBL carriage helps to identify patients at risk to combat the spread of resistant bacteria within the healthcare system. Particularly, previous travel to Asia stands out as a major risk factor for carriage and should be considered in selecting empirical antibiotic treatment in critically ill patients.

Fully resolved assembly of Cryptosporidium parvum.

Background Cryptosporidium parvum is an apicomplexan parasite commonly found across many host species with a global infection prevalence in human populations of 7.6%. Understanding its diversity and genomic makeup can help in fighting established infections and prohibiting further transmission. The basis of every genomic study is a high-quality reference genome that has continuity and completeness, thus enabling comprehensive comparative studies.FindingsHere, we provide a highly accurate and complete reference genome of Cryptosporidium parvum. The assembly is based on Oxford Nanopore reads and was improved using Illumina reads for error correction. We also outline how to evaluate and choose from different assembly methods based on 2 main approaches that can be applied to other Cryptosporidium species. The assembly encompasses 8 chromosomes and includes 13 telomeres that were resolved. Overall, the assembly shows a high completion rate with 98.4% single-copy BUSCO genes.ConclusionsThis high-quality reference genome of a zoonotic IIaA17G2R1 C. parvum subtype isolate provides the basis for subsequent comparative genomic studies across the Cryptosporidium clade. This will enable improved understanding of diversity, functional, and association studies.

Infection spreading and recovery in a square lattice.

We investigate spreading and recovery of disease in a square lattice, and, in particular, emphasize the role of the initial distribution of infected patches in the network on the progression of an endemic and initiation of a recovery process, if any, due to migration of both the susceptible and infected hosts. The disease starts in the lattice with three possible initial distribution patterns of infected and infection-free sites, viz., infected core patches (ICP), infected peripheral patches (IPP), and randomly distributed infected patches (RDIP). Our results show that infection spreads monotonically in the lattice with increasing migration without showing any sign of recovery in the ICP case. In the IPP case, it follows a similar monotonic progression with increasing migration; however, a self-organized healing process starts for higher migration, leading the lattice to full recovery at a critical rate of migration. Encouragingly, for the initial RDIP arrangement, chances of recovery are much higher with a lower rate of critical migration. An eigenvalue-based semianalytical study is made to determine the critical migration rate for realizing a stable infection-free lattice. The initial fraction of infected patches and the force of infection play significant roles in the self-organized recovery. They follow an exponential law, for the RDIP case, that governs the recovery process. For the frustrating case of ICP arrangement, we propose a random rewiring of links in the lattice allowing long-distance migratory paths that effectively initiate a recovery process. Global prevalence of infection thereby declines and progressively improves with the rewiring probability that follows a power law with the critical migration and leads to the birth of emergent infection-free networks.

Clinical Features of Febrile Urinary Tract Infection Caused by Extended-spectrum Beta-lactamase-producing Escherichia Coli in Children.

The global prevalence of infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has been increasing. In children, ESBL-producing E. coli manifest mostly as febrile urinary tract infections (fUTIs). This study aimed to elucidate the clinical features of fUTI resulting from ESBL-producing E. coli in Japanese patients. The clinical features of children with E. coli-related fUTI were retrospectively examined. These children underwent treatment at the National Hospital Organization Saitama Hospital, Japan, between May 2010 and April 2018. Urine specimens were obtained by either bladder catheterization or the clean-catch method. All children having positive urine cultures (≥104 colony-forming unit/mL for catheter specimens and ≥105 colony forming unit/mL for clean-catch specimens) and a fever of ≥38°C were considered to have fUTI. During the study period, 171 patients were diagnosed with E. coli-related fUTI. Among these, 17 (9.9%) fUTI cases were caused by ESBL-producing E. coli. A significant difference was noted in the median age of the populations having ESBL-producing E. coli and non-ESBL-producing E. coli infections (2 and 5 months, respectively); other characteristics were not significantly different between the two patient groups. ESBL-producing E. coli infections markedly increased in our hospital between 2013 and 2018. In the present study, young age was the only risk factor for fUTI caused by ESBL-producing E. coli identified in Japanese children.

Cystic echinococcosis and other helminth infections of wild boar in northeastern and northwestern regions of Tunisia

This study identified helminth species of wild boar (Sus scrofa) originating from northeastern and northwestern regions of Tunisia using 297 lungs, 297 livers, 264 intestinal tracts, 120 samples of muscle tissue (tongue, masseter, diaphragm, inter-costal) and 232 faecal samples derived from a total of 591 animals. Host gender was registered for the lung and liver wild boar group, which included 163 males and 134 females. All animals, excluding those used to retrieve muscular samples, were classified into three age classes, <2 (n = 212), 2-3 (n = 208) and ⩾4 years old (n = 141). Helminth fauna of the examined wild boar included 14 parasite species: one trematode (adult, Brachylaemus suis), three cestodes (metacestodes of Echinococcus granulosus, Taenia hydatigena cysticercus, adult, Hymenolepis diminuta), nine nematodes (adults of Metastrongylus apri, Metastrongylus pudendotectus, Ascarops strongylina, Globocephalus urosubulatus, Physocephalus sexalatus, Gnathostoma hispidum, Gongylonema pulchrum and eggs of Strongyloides ransoni and Capillaria spp.) and one acanthocephalan (adult, Macracanthorhynchus hirudinaceus). Trichinella larvae were not recovered from any of the 30 wild boar examined. Results showed a 73.5% global prevalence of infection with visceral helminths, 67.3% of which were lung and hepatic infections and 80.3% of helminths were recovered from the gastrointestinal tract. The most prevalent parasite was M. hirudinaceus (61.7%) while the highest intensity of infection was observed for Metastrongylus spp. The most prevalent cestode was E. granulosus (18.9%). This is the first detailed study on helminth infections of wild boar from a North African country.

Appropriate empiric antibiotic choices in health care associated urinary tract infections in urology departments in Europe from 2006 to 2015: A Bayesian analytical approach applied in a surveillance study.

BackgroundHealth care associated urinary tract infections (HAUTI) is a common complicating factor of urological practice. It is unclear what the appropriate empirical antibiotic choices are and how infection control policies (ICP) influence this. The aim of this study is to use probabilistic approaches towards the problem. That is to determine the chances of coverage of empirical antibiotic choices in HAUTIs and their annual trends in Europe. In addition, the impact of departmental self-reported compliance with catheter management and regulated usage of prophylactic antibiotics policies was tested. The estimated chances of coverage of antibiotics and further probabilistic calculations are carried out using the Global Prevalence of Infections in Urology (GPIU) annual surveillance study European data.MethodsGPIU is a multi-state annual prevalence study conducted in urology departments to detect patients with HAUTIs, using the Center for Disease Control (CDC) definitions and antimicrobial resistance (AMR). In this analysis; the European cohort from 2005 to 2015 was used. The estimated chance of coverage for each antibiotic choice in HAUTIs was calculated using the Bayesian Weighted Incidence Syndromic Antibiogram (WISCA) approach. Annual trend of the overall cohort and number of appropriate antibiotic choices were estimated. Departments were compared according to their self-reported compliance to ICPs to determine if there was an impact on chances of coverage and appropriate antibiotic choices.ResultsWe estimated that in most study years less than half of the single agent antibiotics and all combination options were appropriate for empirical treatment of HAUTIs. Departments with compliance to both ICPs were estimated to have 66%(2006) to 44% (2015) more antibiotic choices compared to departments with complete lack of compliance to the ICPs. In our estimates departments with adherence to a single policy was not superior to departments with complete lack of adherence to ICPs.ConclusionsMost single agent choices had limited coverage for HAUTIs and combination choices had improved chance of coverage. Optimal antibiotic selection decision should be part of decision experiments and tested in local surveillance studies. Departments with self-reported compliance to ICPs have more antibiotic choices and details of the compliance should be evaluated in future studies. The analysis herein showed that over the 10-year course there was no clear time trend in the chances of coverage of antibiotics (Bayesian WISCA) in European urology departments.

Transurethral Resection of the Prostate: are We Following the Guidelines? - Outcomes from the Global Prevalence of Infections in Urology (GPIU) Study

Transurethral resection of the prostate (TURP) is one of the most common urological procedures. With the increasing rate of multiresistant infections including urosepsis, it is essential for all surgeons to adhere to the relevant international guidelines to prevent infectious complications. The aim of this prospective, multinational, multicentre study was to evaluate compliance with recommended infection control measures regarding TURP procedures. The study was performed as a side questionnaire to the annual Global Prevalence Study of Infections in Urology (GPIU) between 2006 and 2009. Patients that had undergone TURP were eligible. Baseline data about hospitals and patients were collected. The questionnaire contained questions regarding preoperative microbiological investigations, catheter care and performance of perioperative antibiotic prophylaxis. A total of 825 men were included from 138 participating centres from Africa, Asia, Europe and South America. Only 50.1% of the patients received perioperative antibiotic prophylaxis with a median duration of 3 days (interquartile range [IQR] = 1–7 days). Preoperative urine culture was taken in 59.2%. The catheter was replaced in 1 week prior to the surgery only in 38.3% of cases. Compliance with the recommended infection control measures regarding TURP were only moderate, despite high grade recommendations in relevant international Guidelines. Stronger guideline adherence is necessary to improve patient care decrease antibiotic consumption in line with antibiotic stewardship in surgical practices.

136 - Transurethral resection of the prostate: Are we following the guidelines? Outcomes from the Global Prevalence of Infections in Urology (GPIU) side study 2006-2009

136 - Transurethral resection of the prostate: Are we following the guidelines? Outcomes from the Global Prevalence of Infections in Urology (GPIU) side study 2006-2009

The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections.

The Global Prevalence of Infections in Urology (GPIU) study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI). Investigators registered data through a web-based application (http://gpiu.esiu.org/). Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years.

Antibiotic Resistance and Novel Antibiotics for the Treatment of Urinary Tract Infections

Surveillance data on antibiotic resistance need to be considered with respect to the origin of isolates, types of surveillance studies, and types of types of registered infections. Antibiotic resistance in gram-negative uropathogens has been investigated in both local and multinational studies. A compilation of worldwide studies for example showed resistance rates of gram-negative uropathogens against fluoroquinolones in 10% to 80%, against cephalosporines in 5% to 70% and against carbapenems in 0% to 35%. A specific surveillance study in the field of urology—the global prevalence of infections in urology (GPIU) study—is a point prevalence study with a global effort to create surveillance data in patients at various urological departments with health-care associated urogenital infections (HAUTIs). The GPIU study has been performed annually since 2003, with a total inclusion of 27,542 patients, thus far. Resistance rates of most uropathogens against all tested antibiotics were high, especially with multidrug resistance. A concerning finding was that the severity of HAUTI is also increasing—25% being urosepsis in recent years. In order to keep up with this alarming trend, novel antibiotics for the treatment of urinary tract infections need to be developed. Several strategies are currently employed: Beta-lactam/beta-lactamase inhibitor combinations are extended to cephalosporines and carbapenems. Novel fluroroquinolones have been developed, and so called siderophore antibiotics are being tested. Novel aminoglycosides and novel tetracyclines are also in the clinical development phases. Thus, several antibiotic substances are currently being developed, or in the late clinical phases of development.

Clinical and epidemiological evaluation of cases of hepatitis E in St. Petersburg

Hepatitis E - zoonotic disease that has received a nosological independence twenty years ago, when Russian scientist, Professor M. S. Balayan, identified the pathogen (hepatitis E). It was believed that the disease can manifest itself only in the acute form, and occur only in regions with subtropical and tropical climate conditions. The development and introduction of practicing of modern scientific research methods for detecting antibodies to activator change, to view the global prevalence of infection and present doubts on inabilities of transformation into a chronic form. The purpose of our research was to conduct a retrospective analysis of hospital cases of acute jaundice hepatitis E in St. Petersburg. Etiologic accessory to hepatitis E implemented by discovery in serum of patients a specific marker of infection hepatitis E- an anti-HEV. In the analysis of archive documentation for 2000-2014 from the patients which were hospitalized in the Clinical Infectious Diseases Hospital by S. P. Botkin only 15 patients were diagnosed with “acute hepatitis E”. Which indicates the presence of patients with acute hepatitis E infection among hospitalized in hospitals of the city of St. Petersburg are not endemic for this disease. The presence of cases of disease of the indigenous inhabitants of the city during the past years, which isn’t going beyond its limits, indicates the existence of “autochthonous” hepatitis E.

255 Infective complications after prostate biopsy: Outcome of the Global Prevalence of Infections in Urology (GPIU) prostate biopsy side study 2010 – 2013. A prospective, multinational, multicenter study

255 Infective complications after prostate biopsy: Outcome of the Global Prevalence of Infections in Urology (GPIU) prostate biopsy side study 2010 – 2013. A prospective, multinational, multicenter study

Filariasis serosurvey, New Caledonia, South Pacific, 2013.

BackgroundLymphatic filariasis (LF) is a major public health problem in the Pacific. As the global prevalence of infection was not known in New Caledonia (NC), a serosurvey study was conducted by determining the prevalence of circulating filarial antigens, as recommended by the World Health Organization.FindingsA cross sectional study on a 2 degree stratified sample was carried out from June to November 2013. Inclusion criteria were: individuals aged 2 to 80 y/o, who had been hospitalized or sought medical care for a non-infectious cause and who had been living in NC for more than 6 months. LF antigenic detection was performed using the immunocromatographic BinaxNOW filariasis card test (ICT).Among the 1,035 individuals tested, 7 were antigenic. The overall LF antigenic prevalence was 0.62% (CI 95% [0.60-0.63]).All patients were unrelated to each other; none of them presented clinical symptoms of LF.Four of the 7 ICT positive patients reported having travelled to LF endemic areas, 2 patients had never traveled outside NC and the last one had only traveled in non-endemic areas.For the 7 ICT positive patients, the research of microfilariae in blood smears and filarial DNA by PCR was negative.ConclusionThe prevalence of filarial antigenemia in NC is less than 1%, the threshold that defines the filarial endemic areas for WHO. Nevertheless, as two patients who had never travelled outside NC and one who had only travelled to non-endemic areas were antigenic, we cannot conclude that NC is totally free of LF.

High prevalence of co-infection with multiple Torque teno sus virus species in Italian pig herds.

Torque teno viruses (TTVs) are a large group of vertebrate-infecting small viruses with circular single-stranded DNA, classified in the Anelloviridae family. In swine, two genetically distinct species, Torque teno sus virus 1a (TTSuV1a) and 1b (TTSuV1b) are currently grouped into the genus Iotatorquevirus. More recently, a novel Torque teno sus virus species, named Torque teno sus virus k2b (TTSuVk2b), has been included with Torque teno sus virus k2a (TTSuVk2a) into the genus Kappatorquevirus. In the present study, TTSuV1 (TTSuV1a and TTSuV1b), TTSuVk2a and TTSuVk2b prevalence was evaluated in 721 serum samples of healthy pigs from Sardinian farms, insular Italy. This is the largest study to date on the presence of TTSuV in healthy pigs in Italy. The global prevalence of infection was 83.2% (600/721), being 62.3% (449/721), 60.6% (437/721), and 11.5% (83/721) the prevalence of TTSuV1, TTSuVk2a and TTSuVk2b, respectively. The rate of co-infection with two and/or three species was also calculated, and data show that co-infections were significantly more frequent than infections with single species, and that TTSuV1+TTSuVk2a double infection was the prevalent combination (35.4%). Quantitative results obtained using species-specific real time-qPCR evidenced the highest mean levels of viremia in the TTSuV1 subgroup, and the lowest in the TTSuVk2b subgroup. Interestingly, multiple infections with distinct TTSuV species seemed to significantly affect the DNA load and specifically, data highlighted that double infection with TTSuVk2a increased the viral titers of TTSuV1, likewise the co-infection with TTSuVk2b increased the titers of TTSuVk2a.

Perspective: prospects for development of vaccines against human helminth infections.

The global prevalence of infection with parasitic worms or helminths likely exceeds that of any other infection. One-third of the world's population is estimated to harbor infection with intestinal helminths (Trichuris trichuria, Ascaris lumbricoides, Strongyloides stercoralis, or hookworm) [1]; between 200 and 300 million people are believed to be infected with one of the three species of schistosomes (Schistosoma mansoni, Schistosoma haematobium, Schistosoma japonicum) [2], and> 150 million are infected with one of the pathogenic :filarial parasites (Wuchereria bancrofti, Brugia malayi, Onchocerca volvulus, Loa loa) [3, 4]. The burden of helminth infection rests largely on the population of the developing world, where many persons carry infection with more than one of these parasites [5]. While nematode infection uncommonly leads to severe acute illness or death, a growing body of evidence indicates that chronic infection leads to patterns of morbidity and economic hardship not generally appreciated. For example, while heavy and chronic hookworm infection is a well-rccogmced cause of anemia, recent intervention studies have revealed that one course of anthelmintic treatment of schoolchildren leads to a sustained improvement in growth [6] and in academic performance [7]. Blinding eye disease is responsible for only part of the adverse impact of onchocerciasis, with chronic skin disease leading to major reduction in quality of life and economic productivity [4]. Helminth infection differs in a number of important ways from most other infectious diseases differences that have a major impact on possible strategies for disease control. First, with few exceptions, helminths do not multiply within the human host but require passage through the environment and an arthropod vector or other invertebrate host (such as a snail) to reproduce and complete the life cycle. This offers the possibility of vector control or other environmental measures as means of disease control. Second, helminth infection may persist for years, an important consideration when control by chemotherapy or vector control is contemplated. For example, it is necessary to maintain onchocerciasis control programs using ivermectin (which is inactive against the adult worm) and vector control for 10-15 years (the life span of the adult worm). Third, the clinical effects of infection are not directly related