High Contamination Rate Research Articles

With spatial distribution, risk evaluation of heavy metals and microplastics to emphasize the composite mechanism in hyporheic sediments of Beiluo River

This study aimed to assess the hazardous impacts of heavy metals (HMs) enrichment on the surface of microplastics (MPs) in the hyporheic zone. The present work analyzed the spatial distribution and risk evaluation of HMs (V, Cr, Mn, Co, Ni, Cu, Zn, As, Cd, and Pb) and MPs and the mechanism of HMs enrichment on MPs in the sediments. The highest rates of contamination were for Cd, Pb, and As. The main types of MPs were fiber, blue, and a size smaller than 500 µm. The lower reaches of the Beiluo River had the most serious HMs and MPs pollution, especially BL-10 (HMs: CF-Cd, 41.91; EF-Cd, 50.87; Igeo-Cd, 4.80; RI, 1291; PN, 29.83; MPs: abundance, 890 ± 18 items/kg). Meanwhile, the principal component analysis showed that natural, industrial activities, and agricultural production and transportation were primary HMs sources in sediments, and Cd, Co, and Pb were the main enriched metals on the surface of MPs. More importantly, regarding the interaction mechanism of these composite pollutants, we concluded that electrostatic adsorption and biofilm mediation were the main mechanisms of the synergistic effect. Overall, our findings provide a theoretical basis for further research on the ecotoxicity of composite pollutants in aquatic environments.

Detecting changes in the performance of a clinical machine learning tool over time

Excessive use of blood cultures (BCs) in Emergency Departments (EDs) results in low yields and high contamination rates, associated with increased antibiotic use and unnecessary diagnostics. Our team previously developed and validated a machine learning model to predict BC outcomes and enhance diagnostic stewardship. While the model showed promising initial results, concerns over performance drift due to evolving patient demographics, clinical practices, and outcome rates warrant continual monitoring and evaluation of such models. A real-time evaluation of the model's performance was conducted between October 2021 and September 2022. The model was integrated into Amsterdam UMC's Electronic Health Record system, predicting BC outcomes for all adult patients with BC draws in real time. The model's performance was assessed monthly using metrics including the Area Under the Curve (AUC), Area Under the Precision-Recall Curve (AUPRC), and Brier scores. Statistical Process Control (SPC) charts were used to monitor variation over time. Across 3.035 unique adult patient visits, the model achieved an average AUC of 0.78, AUPRC of 0.41, and a Brier score of 0.10 for predicting the outcome of BCs drawn in the ED. While specific population characteristics changed over time, no statistical points outside the statistical control range were detected in the AUC, AUPRC, and Brier scores, indicating stable model performance. The average BC positivity rate during the study period was 13.4%. Despite significant changes in clinical practice, our BC stewardship tool exhibited stable performance, suggesting its robustness to changing environments. Using SPC charts for various metrics enables simple and effective monitoring of potential performance drift. The assessment of the variation of outcome rates and population changes may guide the specific interventions, such as intercept correction or recalibration, that may be needed to maintain a stable model performance over time. This study suggested no need to recalibrate or correct our BC stewardship tool. No funding to disclose.

Monitoring Prevalence and Persistence of Environmental Contamination by SARS-CoV-2 RNA in a Makeshift Hospital for Asymptomatic and Very Mild COVID-19 Patients.

Objective: To investigate the details of environmental contamination status by SARS-CoV-2 in a makeshift COVID-19 hospital. Methods: Environmental samples were collected from a makeshift hospital. The extent of contamination was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA from various samples. Results: There was a wide range of total collected samples contaminated with SARS-CoV-2 RNA, ranging from 8.47% to 100%. Results revealed that 70.00% of sewage from the bathroom and 48.19% of air samples were positive. The highest rate of contamination was found from the no-touch surfaces (73.07%) and the lowest from frequently touched surfaces (33.40%). The most contaminated objects were the top surfaces of patient cubic partitions (100%). The median Ct values among strongly positive samples were 33.38 (IQR, 31.69-35.07) and 33.24 (IQR, 31.33-34.34) for ORF1ab and N genes, respectively. SARS-CoV-2 relic RNA can be detected on indoor surfaces for up to 20days. Conclusion: The findings show a higher prevalence and persistence in detecting the presence of SARS-CoV-2 in the makeshift COVID-19 hospital setting. The contamination mode of droplet deposition may be more common than contaminated touches.

Contamination dynamics of personal protective equipment (PPE) by SARS-CoV-2 RNA in a makeshift hospital with COVID-19 positive occupants

Personal protective equipment (PPE) helps protect healthcare workers (HCWs) from infection and prevents cross-contamination. Knowledge of the contamination dynamics of PPE during the management of COVID-19 patients in a makeshift hospital is limited. To describe the rate of SARS-CoV-2 contamination in PPE and to assess the change of contamination at different time points. HCWs were followed up for up to 4 hours with hourly collection of swab samples from PPE surfaces in a makeshift COVID-19 hospital setting. Swabs were tested using quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA. SARS-CoV-2 was detected on 50.9% of the 1620 swabbed samples from 9 different sites of full-body PPE worn by HCWs. The proportion of sites contaminated with SARS-CoV-2 RNA varied from 10.6% to 95.6%. Viral RNA was most frequently detected from the sole of the outer foot cover (95.6%) and least frequently on the face shield (10.6%). The median Ct values among positive samples were 34.20 (IQR, 32.61-35.22) and 34.05 (IQR, 32.20-35.39) for ORF1ab and N genes, respectively. The highest rate of contamination with SARS-CoV-2 RNA for the PPE swab samples was found after 3 hours of use. The positive rate of outer surface of HEPA filters from air supply device was 82.1% during the full capacity period of the makeshift hospital. A higher rate of contamination was identified at 3 hours after the entrance to the COVID-19 patient care area. Virus-containing aerosols were trapped in the HEPA filter of air supply equipment, representing a potential protective factor against infection to HCWs.

Development of a novel pilot-scale tray bioreactor for solid-state fermentation aiming at process intensification

Solid-State Fermentation (SSF) processes have high contamination and low productivity rates, since it involves batch processes with multiple manual stages. In order to reduce handling in SSF processes, this research developed a pilot-scale tray bioreactor that enables process intensification by combining upstream operations and fermentation in a single equipment. Thus, a novel tray bioreactor was developed with an atomization system of spore suspension, nutrient solution, and cooling water above the fermentative medium. It also incorporates a sterilization system using steam. In order to validate the bioreactor, two case studies were conducted. In the first case study, the fungus Metarhizium anisopliae was cultivated on three types of agro-industrial residues. The conidia/mL obtained using the mixture of wheat bran and broken rice was (16.7±0.46)×108, which is statistically higher (α=0.05) than the fungus production of (8.59±1.60)×108 cultivated on the control (Type I Rice). In the second case study, lipases from M. anisopliae were produced on agro-industrial residues. The enzymatic activity average was 5.64±0.45U/mL based on 36 fermentations. The results have shown that the new tray bioreactor can produce the fungus and lipases in greater quantities than other systems reported in literature, while reducing handling, energy, costs, and process time.

Individual, corporate, and national wishcycling: Improving recycling in the U.S. by understanding its complexity

This review explores the phenomenon of ‘wishcycling’—a consequence of growing commitments to sustainable behaviors—and its impact on recycling contamination. While recycling rates have increased over the past six decades, high contamination rates have led to the closure of recycling programs and limited recycling of certain materials. Informational interventions as well as switching to a dual-stream recycling system would substantially reduce contamination. We discuss the role of individuals, corporations, and regulators in generating this problem. Further, we liken individual wishcycling to the recycling attitude of corporations and governments. We discuss policy options to address these issues.

Bacterial contamination of water sources for domestic use in JOS and environs

Purpose: The purpose of the study was to assess and examine water bodies in Jos, Plateau State for bacterial contamination. Methods: A total of ninety four (90) water samples were collected aseptically from different sources (stream, well, borehole, tap, dam, storage tanks and water vendors) from different locations and investigated for their bacterial contaminants using the Most Probable Number Technique (MPN). Structured questionnaires were used to obtain information on the location, depth, sanitary condition and closeness of the water sources to septic tanks. The bacterial isolates present in the water samples were identified based on their morphology and biochemical characteristics. Total bacterial count was determined using the pour plate technique and total coliform count was by the Most Probable Number (MPN) method. Results: From the T-Test result of the mean coliform count of all the seven different water sources investigated, storage tanks (ST) were found to be the least contaminated followed by Tap water (TW) while stream (STR) water had the highest rate of contamination with MPN index of 300/100 ml. However, borehole water 6 (BW6) was the least contaminated among all the samples collected with MPN index of 7/10 ml. The MPN index range from 7/100 ml to 300/100 ml in BH6 and STR7 respectively while the Total viable count ranged from 1.0 × 102 to 3.3 × 103. A total of seven different isolates were characterized and identified as Pseudomonas aeroginosa, Klebsiella pneumonia, Escherichia coli, Salmonella typhi, Proteus vulgaris, Staphylococcus aureus and Proteus mirabilis. The results obtained were analysed using SPSS Version 21. Conclusion: This study reveals that all the different water samples collected and investigated were contaminated with bacteria.

A Large-Scale Study into Protist-Animal Interactions Based on Public Genomic Data Using DNA Barcodes.

With the birth of next-generation sequencing (NGS) technology, genomic data in public databases have increased exponentially. Unfortunately, exogenous contamination or intracellular parasite sequences in assemblies could confuse genomic analysis. Meanwhile, they can provide a valuable resource for studies of host-microbe interactions. Here, we used a strategy based on DNA barcodes to scan protistan contamination in the GenBank WGS/TSA database. The results showed a total of 13,952 metazoan/animal assemblies in GenBank, where 17,036 contigs were found to be protistan contaminants in 1507 assemblies (10.8%), with even higher contamination rates in taxa of Cnidaria (150/281), Crustacea (237/480), and Mollusca (107/410). Taxonomic analysis of the protists derived from these contigs showed variations in abundance and evenness of protistan contamination across different metazoan taxa, reflecting host preferences of Apicomplexa, Ciliophora, Oomycota and Symbiodiniaceae for mammals and birds, Crustacea, insects, and Cnidaria, respectively. Finally, mitochondrial proteins COX1 and CYTB were predicted from these contigs, and the phylogenetic analysis corroborated the protistan origination and heterogeneous distribution of the contaminated contigs. Overall, in this study, we conducted a large-scale scan of protistan contaminant in genomic resources, and the protistan sequences detected will help uncover the protist diversity and relationships of these picoeukaryotes with Metazoa.

Blood culture contamination in a tertiary care hospital: a retrospective three-year study

BackgroundBloodstream infections (BSI) are a leading cause of morbidity and mortality in hospitalized patients worldwide. A blood culture is the primary tool for determining whether a patient has BSI and requires antimicrobial therapy, but it can result in an inappropriate outcome if the isolated microorganisms are deemed contaminants from the skin. Despite the development of medical equipment and technology, there is still a percentage of blood culture contamination. The aims of this study were to detect the blood culture contamination (BCC) rate in a tertiary care hospital in Palestine and to identify the departments with the highest rates along with the microorganisms isolated from the contaminated blood samples.MethodBlood cultures that were taken at An-Najah National University Hospital between January 2019 and December 2021 were evaluated retrospectively. Positive blood cultures were classified as either true positives or false positives based on laboratory results and clinical pictures. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. A p-value of less than 0.05 was considered statistically significant for all analyses.ResultsOut of 10,930 blood cultures performed in the microbiology laboratory from 2019 to 2021, 1479 (13.6%) were identified as positive blood cultures that showed microbial growth. Of these, 453 were blood culture contaminations, representing 4.17% of total blood cultures and 30.63% of the positive blood culture samples. The highest rate of contamination was in the hemodialysis unit (26.49%), followed by the emergency department (15.89%). Staphylococcus epidermidis was the most prevalent (49.2%), followed by Staphylococcus hominis (20.8%) and Staphylococcus haemolyticus (13.2%). The highest annual contamination rate was observed in 2019 (4.78%) followed by 2020 (3.95%) and the lowest was in 2021 (3.79%). The rate of BCC was decreasing, although it did not reach statistically significant levels (P value = 0.085).ConclusionThe rate of BCC is higher than recommended. The rates of BCC are different in different wards and over time. Continuous monitoring and performance improvement projects are needed to minimize blood culture contamination and unnecessary antibiotic use.

Pathogenic Bacteria and Their Antibiotic Resistance Patterns in Milk, Yoghurt and Milk Contact Surfaces in Debre Berhan Town, Ethiopia.

Bacterial contamination of milk is a primary culprit for causing foodborne illnesses, presenting a significant health hazard for millions of individuals around the globe. The level and variety of microorganisms present in raw milk determine its degree of contamination and the potential health risks it poses. A cross-sectional survey was conducted from February to August. A questionnaire was used to collect data on socio-demographic characteristics and hygiene practices from milk distributors and traders. Raw milk, yoghurt, swabs from milk containers and drinking cups were collected and processed for bacterial isolation and identification, antibiotic susceptibility testing, MDR screening and confirmation, ESBL screening and confirmation. Finally, all data were pooled and analyzed using SPSS software version 25. A total of 120 samples of fresh milk, yogurt and cotton swabs from milk containers and cups were collected. A total of 80 bacterial isolates were isolated from 120 samples. Among the bacteria isolated, S. aureus 17 (21.3%), E. coli 17 (21.3%), S. epidermidis 14 (17.5%), Klebsiella spp. 9 (11.3%) and Salmonella spp. 7 (8.8%) were detected most often. High rate of contamination was observed in fresh milk 23 (28.8%) and yogurt 23 (28.8%). All isolates were resistant to at least one antibiotic tested. Comparatively, high rates of resistance were observed in all isolates to the most commonly prescribed antibiotics in Ethiopia. However, lower rates of resistance have been observed for recently introduced antibiotics in Ethiopia. Of the isolates, 20 (25.0%) were resistant to eight or more antibiotics. While 16 (20.0%), 12 (15.0%), 9 (11.3%) isolates were resistant to two, three and five antibiotics, respectively. Of the bacteria isolated, 52/80 (65.0%) were MDR, 25/49 (51.0%) were screened for ESBL production, and 20/49 (40.8%) isolates were confirmed as ESBL producer. This study showed a high rate ofbacterial isolates along with MDR and ESBL-producing strains in raw milk, yoghurt, milk container swabs and drinking cup swab samples, associated with poor hygiene and sanitation practices.

Parasitic Contamination of Commonly Consumed Fresh Fruits Sold At Tiko and Limbe Municipality Markets, South West Region of Cameroon

The disease transmission potential and safety of fruits sold in the cities of Limbe and Tiko, Cameroon, for consumption was assessed with respect to their contamination by ova and cysts of parasites. In sub- aharan-Africa, protozoan parasites and soil transmitted helminths are the leading intestinal parasites causing significant morbidity and mortality. This explains the frequency and high prevalence of intestinal parasitic infections in this region affecting nearly all inhabitants at some point of their lives. Fresh fruits are one of the main components of a healthy diet. A total of 424 different fruit types were randomly collected with 210 samples in the rainy season and 214 samples in the dry season from both towns for parasitological examination using normal saline sedimentation and zinc sulphate flotation techniques. The results showed that out of the 424 samples examined, 97 were contaminated with parasites giving an overall contamination rate of 22.9%. The rainy season had a higher contamination rate 29.5% than the dry season 16.4%. Among the fruits, mangoes, plum, pear, pawpaw were the most frequently contaminated and apples and watermelon were the least contaminated. The protozoans detected include E. histolytica/E. dispar (29.4%) being the most frequent, followed by E. coli (11.8%), Giardia lamblia, (6.1%) and Isospora belli (2.4%) being the least. The helminthic parasites detected included Ascaris lumbricoides (12.4%) being the most prevalent while the others were E. vermicularis (8.8%), T. trichuria(5.9%), Trichostrongyloides specie(5.9%), Taenia specie, F. buski, Ancylostoma specie, F. hepatica and O. sinensis 2.9% each. Fruits are still a means by which parasites are transmitted in the population considering the vast variety detected on different fruits and the high contamination rate. Therefore, emphasis should be put on educating the population about the importance of washing their fruits thoroughly and more than once before consumption. Vendors should also be educated on the proper means to display fruits for purchase by consumers and limit the touching of fruits by different consumers before purchase.

Following 4 months of social distancing during COVID-19 Pandemic in Brazil did not change aspects of functioning in children and adolescents with developmental disabilities: A longitudinal study.

The COVID-19 pandemic and its demands of social distancing have created challenges in the lives of children/adolescents with developmental disabilities and their families, which would change aspects of children's functioning. The objetive of this study was to evaluate changes in some components of functioning of children/adolescents with disabilities following 4 months of social distancing during a period of high contamination rate in the year 2020 in Brazil. Participated 81 mothers of children/adolescents with disabilities, 3-17 years, most of them (80%) diagnosed with Down syndrome, cerebral palsy and autism spectrum disorder. Remote assessments of functioning' aspects including IPAQ, YC-PEM/ PEM-C, Social Support Scale and PedsQL V.4.0. Wilcoxon tests compared the measures, with significance level <0.05. No significant changes in participant's functioning were identified. Social adjustments required to facing the pandemic during two points in time in the midst of the pandemic did not change the evaluated aspects of functioning in our sample of Brazilian.

Parasitological assessment of some fruits and vegetables commonly sold in retail outlets in the Mfoundi Division of Cameroon

BackgroundFruits and vegetables are very important for human diet as they provide all the nutrients needed to be healthy with just a daily-recommended intake of 400 to 600 mg. However, they constitute one of the major sources of human infectious agents. Thus monitoring of the microbial contaminants of the fruits and vegetables is very crucial for human safety. MethodA cross sectional study was conducted on fruits and vegetables in four markets (Mfoundi, Mokolo, Huitième and Acacia) of the Yaoundé city from October 2020 to March 2021. In all, 528 samples were purchased (carrots, cucumbers, cabbages, lettuces, leeks, green beans, okra, celeries, pepper, green peppers and tomatoes) and processed for infective agents using the centrifugation methods (Formalin, distilled and saline water). Seventy-four (74) soil/water samples collected from the sale environment were analysed using the same technics. ResultsOverall, 149/528 (28.21%) were contaminated by at least one infective agent: 130 (24.62%) and 19 (3.6%) having one and two pathogen species respectively. Vegetables had high contamination rate (22.34%) than fruits (5.87%). Lettuce (52.08%), carrot (41.66%) and cabbage (35.41%), were the most contaminated while okra was the least (6.25%). Candida spp. (14.01%) and larva of Strongyloides stercoralis (7.76%) were more observed while Hookworms (1.13%) was the least. Frequency of Strongyloides stercoralis (p = 0.001) and Candida spp. (p = 0.01) were statistically high than other pathogens. Contamination rates were similar for washed (27.65%) and unwashed (28.78%) samples before sale. Candida spp. (p = 0.001), Strongyloides stercoralis (p = 0.01) and Entamoeba histolytica/dispar (p = 0.017) showed significant contamination rates by month. Contamination trends were high in the rainy season (42.6%) than the dry season (15.1%). Correlation between environment and products sold revealed same pathogens in both cases. ConclusionThe study highlights that the sale environment and products constitute potential source of microbial contamination. These data raised the concern of stakeholders about health risk related to vegetables and fruits sold in some local markets in Cameroon. Thus the necessity for them to development more appropriate policies on the surveillance of sale environment and on the management of these products during the different process phases by the population.

Monitoring of Microbial Contamination of Groundwater in the Upper Choluteca River Basin, Honduras

Water can act as a vector for several microbes with significant pathogenic potential for both humans and animals. Waterborne infections are a critical public health concern as they cause more than 3.4 million deaths annually. Total and thermotolerant coliforms and intestinal enterococci have traditionally been used to assess the quality and suitability of drinking water. The aim of this study was to evaluate the microbiological quality of groundwater from six sub-basins located in the upper Choluteca River basin in Honduras and to determine the E. coli phylogroups isolated in these samples. Our findings show high rates of fecal contamination, which suggests that the groundwater in the basin is unsafe for human consumption. Phylogroups B1 and D were the most frequent among 99 E. coli isolates, while C and F were the least frequent phylogroups. Measures must be taken to raise awareness about sanitation and good practices for the management of household waste as well as the waste generated by agro-industrial activity and livestock.

The impact of a blood-culture diagnostic stewardship intervention on utilization rates and antimicrobial stewardship

Background: Blood cultures are often ordered when an infection is suspected; however, they have a low yield in most cases. The overuse of blood culture is associated with high contamination rates, resulting in excess diagnostics, unnecessary antibiotics, longer hospital stays, and higher hospital costs. We evaluated the safety of a multifaceted intervention, which encompassed education and blood-culture restriction, and its impact on blood-culture utilization and antibiotic use in adult intensive care unit (ICU) patients. Methods: The study was performed between October 2020 and October 2021 in the 12 general medicine and specialty ICUs of a quaternary academic care center. The intervention, implemented in April 2021, included providing education to ICU and infectious disease physicians based on an algorithm adapted from the Johns Hopkins DISTRIBUTE study in addition to restricting blood-culture ordering on these units to these providers. The month of April 2021 was excluded as a washout period. Study outcomes comprised blood-culture utilization, blood-culture positivity, days of therapy (DOT), and length of therapy (LOT), which were compared across the study periods using IRR or the Pearson χ2 test, as appropriate. In addition, 30-day mortality and 30-day ICU readmission were evaluated utilizing multiple COX regression models. Results: In total, 6,303 patients (2,087 MICU, 3,636 SICU, and 580 both) were included in the study, with a median age of 65 years (IQR, 21). Most participants were male (57.5%), with a median length of stay of 175 hours (IQR, 186). After the intervention, blood-culture utilization rates decreased from 15.4% to 12.4% (IRR 0.80, 95% CI, 0.76–0.85) (Fig. 1). There was no difference in blood-culture positivity between the preintervention period (11.05%) and the postintervention period (11.64%; P = .459). Days of therapy decreased from 1,180 to 1,130 per 1,000 patient days (IRR, 0.96; 95% CI, 0.95–0.98), and the length of therapy decreased from 602 to 579 per 1,000 patient days (IRR, 0.96; 95% CI, 0.94–0.99) (Fig. 2). There was no difference in 30-day mortality (P = .241) nor 30-day ICU readmission (P = .888) across the study periods after adjusting for potential confounders (Table 1). Conclusions: Our multifaceted intervention decreased blood-culture and antimicrobial utilization in the ICUs without significantly affecting the positivity rate, mortality, or readmission. This study suggests that educating providers on appropriate blood-culture use along with restriction could safely improve healthcare outcomes. Further studies are warranted to validate our results across various institutions and to evaluate the impact of blood-culture optimization in non-ICU patients.Disclosures: None

Prevalence of Campylobacter spp. Among Broiler Carcasses at Industrial Slaughterhouses in Hamedan, Iran

Background &amp; Aims: Today, food-borne diseases are known as one of the most important public health concerns in many countries. Campylobacter is one of the most prevalent food-borne pathogens. Raw chicken meat has been reported as the main source of human campylobacteriosis. The present study was conducted to investigate the prevalence of Campylobacter species among broiler carcasses at industrial slaughterhouses in Hamedan province, west of Iran. Materials and Methods: Totally, 100 samples were collected using sterile swabs from chicken skin at the post-scalding stage. The samples were enriched in Brucella broth containing Campylobacter selective supplement and incubated at 42º C for 48-72 hours under microaerophilic conditions. The molecular detection and identification of Campylobacter species were performed by the polymerase chain reaction (PCR) using cadF and Hip primers for detecting Campylobacter species and Campylobacter jejuni, respectively. Results: The results of this study revealed that 81% and 31% of broiler carcasses were positive for the presence of Campylobacter species and C. jejuni, respectively. Conclusion: Due to the high contamination rate of chicken meat with this pathogen, precise hygienic control of poultry meat and an increase in consumer awareness seem necessary to decrease human campylobacteriosis.

Urinary tract infections older adults at Mohammed VI University Hospital of Oujda: case series

This is a 36 months retrospective study from 22 March 2016 to 11 May 2019. The study included urinary specimens of persons aged 65 years or over, hospitalized or consulting at the authors' hospital. Urines were processed according to the recommendations of the medical microbiology reference system and European Committee on Antimicrobial Susceptibility Testing. The authors collected 6552 requests for cytobacteriological examination of urine. Most of the specimens was collected in the middle stream (n=5503; 84%). Cultures were sterile in 49.77% of cases. Positive in 50.22% of cases. Among positive samples we had 53.41% polymorphic cultures, 32.75% urinary tract infection, and 13.82% urinary tract colonization. Gender distribution showed a sex ratio at 0.62. Gram-negative bacilli, with Escherichia coli as the main species, dominated the isolated bacteria. Resistance rates of E. coli strains that we isolated were 70% for amoxicillin, 36.31% for amoxicillin-clavulanate and 25% for ciprofloxacin. A high resistance rate was seen for third generation cephalosporins. Least resistance recorded to nitrofurantoin. ITU in the elderly is diverse and significantly different from that of younger patients, through its high contamination rate, difficulty in acquiring clinical information, high rate of asymptomatic bacteriuria, and high proportion of multidrug resistant bacteria.

Study of sewage wells’ contamination with intestinal bacteria in the city of Misurata, Libya

Groundwater pollution, and the same pollution with sewage water resulting from improperdisposal by correct scientific methods, is one of the most dangerous environmental disastersthat affect humans in particular and the environment in general, as groundwater is considered one of the most important water resources, especially in the dry and semi-arid surface areas. Study of the contamination of groundwater wells with E. coli bacteria in a number of ground wells, 70 wells in one of the regions in the city of Misurata. Samples were collected and measured TDS and grown on a special medium compact dry and incubated for 24 hours at 37 C and another 24 hours at a temperature of 44 C. The results showed that 27 wells (38.5%) out of 70 wells were contaminated with E. coli bacteria, andthis is an indication of the risk of spreading contamination with colon bacteria compared tothe sample size. From the foregoing, the study concluded that the high rate of contamination of well water with coliform bacteria is due to the lack of a system to treat black water and dispose of it in a random manner.

Diagnostic accuracy of Xpert MTB/RIF Ultra and culture assays to detect Mycobacterium Tuberculosis using OMNIgene-sputum processed stool among adult TB presumptive patients in Uganda.

Stool is a potential sample for diagnosing Mycobacterium tuberculosis (Mtb) in patients with difficulty in expectorating. However, high mycobacterial culture contamination rates and Xpert MTB/RIF Ultra test error rates on stool samples have limited its use. OMNIgene SPUTUM (OM-S) is a sample transport reagent with characteristics of sputum decontamination while maintaining viable Mtb. We evaluated the impact of OM-S on Mtb diagnostic yield from stool using smear microscopy, Xpert MTB/RIF Ultra, and culture among presumptive TB patients. Paired stool and expectorated sputum samples were collected from consecutive Ugandan adults undergoing diagnostic evaluation for pulmonary TB between June 2018 and June 2019. Stool was divided into 2 portions: one was homogenized in OM-S (OM-S stool) and the other in PBS (PBS stool) as control. Both sputum and processed stool were tested for Mtb using concentrated smear fluorescence microscopy (CFM), Xpert MTB/RIF Ultra (Xpert) and Mycobacteria Growth Indicator Tube (MGIT) culture. Sensitivity, specificity, and predictive values for each test were calculated against sputum MGIT culture as the reference standard. Of the 200 participants, 120 (60%) were male, 73 (37%) were HIV positive (median CD4 120 cells/uL (IQR 43-297)) and 128 (64%) had confirmed pulmonary TB by sputum MGIT culture. Seven (4%) OM-S stool Xpert samples reported errors while 47 (25%) and 103 (61%) were contaminated on OM-S stool MGIT and PBS stool MGIT, respectively. OM-S stool MGIT was able to accurately diagnose 56 of the contaminated PBS stool MGIT samples compared to only 5 of the contaminated OM-S stool MGIT samples diagnosed by PBS stool MGIT. Sensitivity (95% Confidence Interval, CI) 89% (83-94) for OM-S stool Xpert was higher compared to that of OM-S stool MGIT 60% (51-69) and PBS stool MGIT 42% (32-52). Specificity (95%CI) 91% (82-97) was also higher for OM-S stool Xpert compared to OM-S stool MGIT 64% (51-75) and PBS stool MGIT 26% (16-38). Stool processed with OM-S showed potential to improve Mtb diagnostic yield and reduce rates of indeterminate results when tested on Xpert and MGIT culture. The method may thus be of value in Mtb detection among patients with difficulty to expectorate.

Utility of Differential Time to Positivity in Diagnosing Central Line Associated Bloodstream Infections: A Systematic Review and Meta-Analysis.

Differential time to positivity (DTP), typically defined as pathogen growth at least two hours earlier from catheter vs paired peripheral blood cultures, is sometimes used to diagnose central line associated bloodstream infections (CLABSIs). Previous studies assessing DTP, however, have been small, provided conflicting results, and have not assessed heterogeneity across important subgroups. We conducted a systematic review of the diagnostic characteristics of DTP for CLABSI, using MEDLINE, Embase, Web of Science, CINAHL, LILACS, AMED and the Cochrane database. Studies were eligible for inclusion if they reported sensitivities, specificities, predictive values, likelihood ratios, or 2x2 tables of DTP for diagnosing CLABSI. Extracted data were analyzed by creating forest plots, performing bivariate model meta-analysis, and assessing quality using QUADAS-2. Our search identified 274 records of which 23 met criteria for meta-analysis. Among 2,526 suspected CLABSIs, DTP demonstrated a summary sensitivity of 81.3% (95% CI 72.8-87.7%), specificity of 91.8% (95% CI 84.5-95.8%), positive likelihood ratio of 9.89 (95% CI 5.14-19.00), and negative likelihood ratio of 0.20 (95% CI 0.14-0.30). Covariate analysis based on catheter duration, study design, and patient immune status demonstrated no significant differences. However, DTP performed worse for Staphylococcus aureus (low sensitivity but high specificity) and Candida (high sensitivity but low specificity) compared to other organisms. DTP performs well in ruling CLABSIs in or out. Obtaining paired catheter and peripheral blood cultures for DTP when the infectious source is unclear may prevent unnecessary line removal and diagnostic tests, although this needs to be balanced against potentially higher contamination rates from catheter cultures.