High-risk Group For Infection Research Articles

Bacterial Conjunctivitis: Current Aspects of Diagnosis and Therapy

Bacterial conjunctivitis is a leading cause of infectious conjunctivitis in children and second most common cause in adults. Although often self-limiting, it can lead to complications like corneal scarring and systemic infections in high-risk groups including newborns and immunocompromised patients. Thus, prompt diagnosis and treatment are essential for these vulnerable populations. Common bacterial causes are Staphylococcus aureus and Streptococcus pneumoniae in adults and Haemophilus influenzae and Moraxella catarrhalis in children. Clinical features alone do not reliably identify the causative pathogen. Microbiological testing is necessary for persistent or severe cases. Topical antibiotics like azithromycin or fluorochinolones are usually prescribed. However, gonococcal and chlamydial conjunctivitis warrant systemic antibiotics due to their potential for severe complications. Increasing antibiotic resistance might even necessitate tailored therapy based on antibiotic susceptibility profiles. Screening and treating pregnant women is an effective prevention strategy by reducing perinatal transmission (especially of gonococcal and chlamydial infections). In summary, while often self-limiting, potential complications and rising antibiotic resistance underscore the importance of timely diagnosis and treatment of bacterial conjunctivitis. Preventive measures including maternal screening are crucial public health initiatives to curb the risks associated with this common eye infection.

Microscopic and Molecular Investigation of Intestinal Microsporidia in HIV + /AIDS and Cancer Patients Undergoing Chemotherapy in Mazandaran Province, North of Iran.

The aim of this study was to identify Enterocytozoon bieneusi and Encephalitozoon spp. in fecal samples of HIV + /AIDS and cancer patients undergoing chemotherapy, and comparing the results to healthy individuals in Mazandaran province, north of Iran. Stool samples were collected from 50 HIV + /AIDS patients, 50 cancer patients, and 50 healthy samples referred to medical centers in north of Iran. Stool samples were kept in 2.5% potassium dichromate at 4°C, and stained by modified trichrome for light microscopy examination. The multiplex/nested-PCR targeted the small subunit ribosomal RNA (SSU rRNA) gene. To characterize genotypes, the nested PCR products sequencedby Bioneer Companyand was subjected to phylogenetic analyses. Ten of 50 samples (20%) of HIV + /AIDS patients, 5of50 samples (10%) of cancer patients, and 1 of healthy individuals (2%) were microscopically positive. From 50 HIV + / AIDS patients, E. bieneusi and Encephalitozoon spp. were detected in 10 (20%) and 6 (12%) cases, respectively. Furthermore, among cancer patients, 7 (14%) and 2 (4%) cases were E. bieneusi and Encephalitozoon spp., respectively. Out of 50 samples of healthy individuals, only 3 (6%)cases of E. bieneusi were observed. The genotypes D and M were detected among positive samples of E. bieneusi. E. bieneusi and then Encephalitozoon spp. are common intestinal microsporidia in HIV + /AIDS patients and cancer patients undergoing chemotherapy in Mazandaran province. E. bieneusi genotype D seems to be the predominant genotype in Mazandaran province.Due to the considerable prevalence of intestinal microsporidia, physicians are advised to pay more attention to this opportunistic infection in high-risk groups.

Coxiellosis in Livestock: Epidemiology, Public Health Significance, and Prevalence of Coxiella burnetii Infection in Ethiopia.

Coxiellosis is a zoonotic disease that is prevalent globally and can pose significant challenges, especially in less developed countries like Ethiopia. Coxiella burnetii is responsible for causing an infection called Q fever in humans and coxiellosis in ruminants. Pneumonia and endocarditis are the only signs that characterize the acute and chronic forms of Q fever, respectively. Ruminants exhibit symptoms such as abortion during the later stages of pregnancy, impaired fertility, perinatal death, premature delivery, and reduced birth weight. C. burnetii infection typically spreads among healthy cattle via tick bites and exposure to infected cattle or their bodily secretions. The primary source of human infection is through the ingestion of contaminated milk and milk products, but transmission through aerosols and dust generated during livestock operations is also common. Cattle, sheep, camels and goats are the primary sources of human infection, and the bacterium can be found in various bodily fluids of infected animals. Several factors, including host characteristics, environmental conditions, and management practices, can potentially affect the occurrence of C. burnetii infection in livestock, such as cattle, camels, sheep, and goats. Coxiellosis is prevalent in Ethiopia's pastoral and mixed cattle management systems, as individuals frequently interact with cattle and are therefore more prone to exposure to the C. burnetii bacterium. Vaccination and biosecurity measures are effective techniques for managing C. burnetii infection. Therefore, it is crucial to implement appropriate mitigation strategies, raise awareness about the spread of C. burnetii infection, and conduct further studies on C. burnetii infection in high-risk groups.

Open minds on the road to improvement

In the absence of resoundingly clear evidence-based guidelines, we must either choose the approach that is most comfortable for our practice, or we must generate the data to inform consensus statements or guidelines. neurogenic bladder clean intermittent catheterization urinary tract infection quality improvement Periprocedural antibiotics for urodynamic studies of pediatric neurogenic bladder, empiric or culture-guided? A retrospective cohort studyJournal of Pediatric UrologyPreviewUrodynamic studies are fundamental in the care of children with neurogenic bladder. Children with neurogenic bladder who perform clean intermittent catheterization (CIC) are considered a high-risk group for infection after urodynamic studies. Current guidelines are not uniform regarding the duration, type, the need of prophylactic antibiotic treatment or performance of urine culture before urodynamic studies. Full-Text PDF

Seroprevalence of Toxocariasis and Its Associated Risk Factors among Adult Population in Kavar District, Fars Province, South of Iran: A Cross-Sectional Community-Based Seroepidemiological Survey.

Toxocariasis as a common neglected disease is the culprit of infecting all age groups. The current cross-sectional study was designed to assess the seroprevalence of toxocariasis and risk factors associated with seropositivity of Toxocara infection among the general population of adults in the Kavar district, south of Iran. A total of 1060 participants with an age range of 35 to 70 years from the Kavar region entered the study. Manual ELISA was utilized to detect anti-Toxocara-specific antibodies in their serum samples. In addition, demographic information as well as risk factors related to toxocariasis was collected from individuals who participated in the survey. The mean age of the participants was 48.9 (±7.9) years old. Out of 1060 subjects, 532 (50.2%) were men, and 528 (49.8%) were women. The overall Toxocara seroprevalence was 5.8% (61/1060). The prevalence of Toxocara seropositive cases was significantly different between males and females (p = 0.023). The seropositive rate for Toxocara infection was also significantly higher in housewives (p = 0.003) and subjects with learning disabilities (p = 0.008). Multivariable logistic regression revealed that housewives (OR = 2.04, 95% CI: 1.18-3.51, p = 0.010) and subjects with learning disability (OR = 3.32, 95% CI: 1.29-8.52, p = 0.013) were at increased risk of Toxocara infection. The findings of the current study depicted a noticeable seroprevalence of Toxocara infection in the general population in the Kavar district, southern Iran. An increased risk of toxocariasis has been associated with learning disabilities and being a housewife. All of the toxocariasis-positive cases had contact with animals, at some point in their life. In perspective, it is necessary to raise awareness of this infection among the population while surveilling Toxocara infection in high-risk groups.

Preoperative Decolonization Appears to Reduce the Risk of Infection in High-Risk Groups Undergoing Total Hip Arthroplasty.

Periprosthetic infections represent a major challenge for doctors and patients. The aim of this study was therefore to determine whether the risk of infection can be positively influenced by preoperative decolonization of the skin and mucous membranes. In a retrospective analysis of 3082 patients who had undergone THA between 2014 and 2020, preoperative decolonization with octenidine dihydrochlorid was performed in the intervention group. In an interval of 30 days, soft tissue and prosthesis infections were detected, and an evaluation between the study groups was made by using a bilateral t-test regarding the presence of an early infection. The study groups were identical with regard to the ASA score, comorbidities, and risk factors. Patients treated preoperatively with the octenidine dihydrochloride protocol showed lower early infection rates. In the group of intermediate- and high-risk patients (ASA 3 and higher), there was generally a significantly increased risk. The risk of wound or joint infection within 30 days was 1.99% higher for patients with ASA 3 or higher than for patients with standard care (4.11% [13/316] vs. 2.02% [10/494]; p = 0.08, relative risk 2.03). Preoperative decolonization shows no effect on the risk of infection that increases with age, and a gender-specific effect could not be detected. Looking at the body mass index, it could be shown that sacropenia or obesity leads to increased infection rates. Preoperative decolonization led to lower infection rates in percentage terms, which, however, did not prove to be significant (BMI < 20 1.98% [5/252] vs. 1.31% [5/382], relative risk 1.43, BMI > 30 2.58% [5/194] vs. 1.20% [4/334], relative risk 2.15). In the spectrum of patients with diabetes, it could be shown that preoperative decolonization leads to a significantly lower risk of infection (infections without protocol 18.3% (15/82), infections with protocol 8.50% (13/153), relative risk 2.15, p = 0.04. Preoperative decolonization appears to show a benefit, especially for the high-risk groups, despite the fact that in this patient group there is a high potential for resulting complications.

Oral Paclovid Significantly Reduces Hospitalization and Mortality in Non-hospitalized Elderly Patients with COVID-19

The development of antiviral drugs against coronavirus has proceeded at an unprecedented pace. In December 2021, the US FDA has successively approved two oral drugs against coronavirus pneumonia (COVID-19), namely PAXLOVID™ (PF-07321332) developed by Pfizer and Molnupiravir developed by Merck by targeting papain-like protease (PLpro) and RNA-dependent RNA polymerase (RdRp), respectively. PLpro and RdRp are important for the normal life cycle of coronaviruses. Inhibition of their activities could impair the synthesis of viral RNA and aid therapeutic treatments. However, little is known about the real-world effectiveness of oral antivirals against the severe acute respiratory syndrome (SARS)-CoV-2 omicron (B.1.1.529) variant. Recent studies have shown that Paxlovid can lead to a marked reduction hospitalization or death among unvaccinated outpatients with early COVID-19, whereas it was found no significant benefit for patients aged 64 and younger. In comparison, Molnupiravir did not reduce the risk of hospitalization or death after infection in high-risk groups who had been vaccinated against the coronaviruses, but only accelerated their recovery.

Periprocedural antibiotics for urodynamic studies of pediatric neurogenic bladder, empiric or culture-guided? A retrospective cohort study

Urodynamic studies are fundamental in the care of children with neurogenic bladder. Children with neurogenic bladder who perform clean intermittent catheterization (CIC) are considered a high-risk group for infection after urodynamic studies. Current guidelines are not uniform regarding the duration, type, the need of prophylactic antibiotic treatment or performance of urine culture before urodynamic studies. To assess whether antibiotic prophylactic therapy before urodynamic studies should be empiric or culture-guided in children with neurogenic bladder who perform CIC. Urine samples were collected from children with neurogenic bladder who require CIC before undergoing a urodynamic study. Urine cultures were collected via sterile urethral catheterization one week before urodynamic studies between 2010 and 2018. Children with signs of urinary tract infection (UTI) or children with bladder augmentation were excluded. Resistance to commonly prescribed periprocedural antibiotic treatments was documented. The probability of antibiotic resistance according to sex, vesicoureteral reflux (VUR) status, consumption of prophylactic antibiotics, and self/caregiver performed CIC was determined by a χ2-test. A total of 278 urine cultures were collected from 185 children with neurogenic bladder. The median age was 8 years (IQR 5-12). The most common etiology for neurogenic bladder was spinal dysraphism (n=146, 77%). Bacterial growth was detected in 216 (78%) cultures, and the most commonly detected bacterial species was Escherichia. coli (n=155, 72%). Thirty-six (19%) children had VUR, and 14 of them received continuous prophylactic antibiotics. The probability of resistance to oral antibiotics was amoxicillin (22%), cephalexin (21%), cefuroxime (14%), ciprofloxacin (10%), nitrofurantoin (21%), and sulfamethoxazole/trimethoprim (SMX/TMP) (23%) (See "summary table") No significant differences were found by χ2-test in the probability of resistance to antibiotics according to sex, VUR status, continuous antibiotic prophylaxis or self/caregiver performed CIC. The study reveals high resistance level to commonly prescribed oral antibiotic treatments (20-30%). Several studies have challenged the need of routine urine cultures before urodynamic studies due to low risk of post-procedural infection. However, it should be mentioned that not all the patients participating in those studies were with neurogenic bladder or routinely performed CIC. Hence, in this specific group of children, routine urine cultures should not be abandoned. The limitations of the study are: Single-center, retrospective study with no data availability regarding the development of UTI after the urodynamic studies. Urine cultures of children with neurogenic bladder who require CIC demonstrate significant levels of resistance to commonly prescribed oral antibiotics. These findings support culture-guided periprocedural antibiotic prophylaxis.

Drug-Resistant Tuberculosis Types and Their Treatment Regimens Using First-Line, Second-Line Injectable, Third-Line, Fluoroquinolones, Aminoglycosides, Cyclic Polypeptides, Novel and Repurposed Anti-Tuberculosis Drugs

Drug-Resistant Tuberculosis (DR-TB) causes high mortality and morbidity rates globally. DR-TB and COVID-19 pandemic are posing a major risk to global public health and economic security, and are jeopardizing efforts in the control, prevention and elimination of TB globally. Mycobacterium tuberculosis (MTB) has continued to evolve resistance to anti-TB drugs. Different types of DR-TB have been defined and they include; mono drug-resistant TB, Multi Drug-Resistant TB (MDR-TB), poly drug-resistant TB, pre-Extensively Drug-Resistant TB (pre-XDR TB), Extensively Drug-Resistant TB (XDR-TB), Extremely Drug-Resistant TB (XXDR-TB), and Totally Drug-Resistant TB (TDR-TB). DR-TB is caused by several factors which include: non-adherence, poor compliance, low efficacy anti-TB drugs, delayed diagnosis, interrupted supply, stock-outs, inadequate infection control, HIV co-infection, spontaneous mutations, and chromosomal replication errors. Global TB targets have gone off-track and years of progress reversed due to DR-TB and the COVID-19 pandemic. Treatment failure, death and costs incurred are higher among patients suffering from DR-TB than among those with susceptible TB. For this reason, susceptible TB needs to be diagnosed quickly and treated effectively to prevent its progression to DR-TB. Treatment for susceptible TB requires the use of first-line anti-TB drugs; rifampicin, isoniazid, pyrazinamide, and ethambutol. While DR-TB is treated using the second- and third-line anti-TB drugs. Effective treatment of TB is dependent on: prompt and accurate diagnosis of TB and recognition of drug-resistance; adherence to treatment; robust contact tracing and prophylactic treatment of TB contacts; and screening for TB infection in high-risk groups.

Helminth Infections in Children.

Helminth Infections in Children.

Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report

BackgroundPatients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) are prone to complicate viral infection. Central nervous system (CNS) involvement caused by the viruses is rare but with poor prognosis. Hantavirus, which usually cause hemorrhagic fever with renal syndrome (HFRS), and none case has been reported about these infection in allo-HSCT patients.Case presentationIn August 2021, a 13-year-old male child developed intermittent fever and refractory hypotension after allo-HSCT. Magnetic resonance imaging of the head revealed abnormal signal foci in the left midbrain cerebral peduncle and bilateral thalamus. His family reported traces of mouse activity in the patient’s home kitchen. HFRS was suspected, but with no significant kidney damage. The specific immunoglobulin (Ig) G and M of hantavirus were negative. The metagenomic next-generation sequencing (mNGS) detected Seoul Orthohantavirus (SEOV) sequences directly in cerebrospinal fluid and blood.ConclusionsAllo-HSCT patients are a high-risk group for infection. Usually the causative agent of infection is difficult to determine, and sometimes the site of infection is concealed. This report highlights the importance of suspecting hantavirus infection in allo-HSCT patients with CNS symptoms despite the absence of renal syndromes. The mNGS is a powerful tool for detecting pathogens. CNS infection with Seoul orthohantavirus in transplant patients is rare but possible as demonstrated in this case. To the best of our knowledge, this is the first reported case employing mNGS to diagnose SEOV caused CNS infection in an allo-HSCT patient.

Features of the population immunity to SARS-CoV-2 development in staff members of medical organizations during the spread of COVID-19

Background. The ongoing COVID-19 pandemic generates the urgent need of monitoring the herd immunity among healthcare workers as a high-risk group for infection.&#x0D; Aim. Determining the level and structure of population immunity to SARS-CoV-2 in the medical workers during the second peak of COVID-19 from August to November 2020.&#x0D; Material and methods. The study involved 15,158 medical workers from 91 medical organizations of the Republic of Tatarstan. The age of the examined stuff members varied from 18 to 74 years, the average age was 45.480.1016 years, most of them were women (13 627, 89.870.258%). Testing for the presence of total antibodies (immunoglobulin classes G, A and M) to SARS- CoV-2 was performed once by the enhanced chemiluminescence method. Statistical processing was carried out by methods of variation statistics and correlation analysis according to the Pearson method using MS Excel and WinPepi.&#x0D; Results. Seroprevalence to SARS-CoV-2 in medical workers was 35.230.388%. An increase in seropositive individuals level from 27.440.265% in August to 57.910.499% in November and an increase in the average geometric mean titer of total antibodies (immunoglobulin classes A, M, G) from 84.43 in August to 101.09 in November 2020 were detected. The level of individuals with antibodies increased with age from 18 to 59 years and decreased in group of 6070 years. The largest proportion of seropositive to SARS-CoV-2 individuals was found among junior (42.011.384%) and middle grade (37.50.527%) medical staff of hospitals for patients with COVID-19, ambulance and emergency stations. Among the seropositive to the SARS-CoV-2 workers the proportion of asymptomatic forms of infection was 84.970.498%. According to the level of seroprevalence, municipal districts of the Republic of Tatarstan were divided into three groups: moderate 8.939.0; average 42.949.6, high level 53.164.4.&#x0D; Сonclusion. An increase in seroprevalence to SARS-CoV-2 was revealed among medical workers of the Republic of Tatarstan from August to November 2020 during the second peak of COVID-19.

Paravertebral abscess and bloodstream infection caused by Burkholderia pseudomallei after acupuncture: a case report

BackgroundVarious pathogenic bacterial infections caused by acupuncture have raised widespread concern, but paravertebral abscesses and bloodstream infections of Burkholderia pseudomallei (B.pseudomallei) after acupuncture have not been reported.Case presentationA 49-year-old man was admitted to hospital with recurrent back pain and fever for 1 month, along with the finding of undiagnosed diabetes. He was considered to have tuberculosis because of unrelieved high fever and pulmonary nodules. Bilateral blood culture suggested B.pseudomallei infection, MRI of the lumbar spine suggested paravertebral abscess, and the final diagnosis was paravertebral abscess and bloodstream infection after acupuncture combined with migrating lung infection. He was discharged after abscess debridement and intensive anti-infective therapy, but no further oral antibiotics were administered because of his poor adherence. More than 5 months later, he was readmitted with the urine culture findings of B.pseudomallei. No other abscess formation was observed and he received oral antibiotics for more than 3 months without recurrence.ConclusionsAcupuncture may lead to B.pseudomallei infection in high-risk groups, and inadequate treatment can lead to recurrent infections.

Status of socio-demographic and behavioral profile of younger and older HIV high risk groups in Chhattisgarh

ABSTRACTBackground:The prevention of new infections in high-risk groups is a major thrust in National AIDS Control Program. There is enough evidence that many epidemiological and behavioral determinants which make High Risk Group vulnerable to HIV transmission. The most effective means of controlling the spread of HIV is through the implementation of Targeted Interventions (TIs) efforts by which services are catered to them. Furthermore, stigma and marginalization are often linked to this population, which may lead to difficulties while accessing social and health services (SHS) due to behavioral, cultural and language barriers or lack of knowledge of the system. So, finding the sociodemographic & behavioral profile can give a breakthrough in improving the quality of life of HIV high risk groups.Material and Methods:A cross sectional study was conducted during September to December 2019 in two districts (i.e., Raipur & Durg) among HRGs of Chhattisgarh. Training cum sensitization of survey team e.g., peer educators, outreach workers, counselors, project managers prior to the survey was done for data collection.Results:A Total of 3963 HRGs were registered with TI NGOs, 3418 (86.2%) were screened. The mean age of study participants was 27.69 ± 6.1. Compliance of participation was 86.2%. HRGs were observed to have malnutrition (BMI <18.5 &> 25.0). 7 cases of Pulmonary TB were found among IDUs. Prevalence of diabetes and Hypertension was 1.2% and 1.1% respectively. Substance abuse (i.e., for Alcohol and Tobacco) was significantly higher among IDUs and FSWs.Conclusion:This study reinforces the fact that for accessing High Risk Groups and retrieval of relevant information can best be obtained by their care givers i.e., TI NGOs personnel. Also understanding the sociodemographic and behavioral profiles are central to designing targeted HIV prevention interventions for them.

“A brutal disadvantage for my wife [living with dementia] That has set us back years”: Results of a quantitative survey of caring relatives of people living with dementia during the Covid‐19 pandemic in Germany

BackgroundThe Covid‐19 pandemic poses a major challenge to the entire population. People living with dementia and their caring relatives, mostly older people, are considered a high risk group for infection with Covid‐19. As people living with dementia have a particular need for consistent daily routines and care, the restrictions during the pandemic presented relatives with new burden. Here, we investigated how caring relatives experienced the time during the Covid‐19 pandemic.MethodWe planned to conduct focus groups with different stakeholders in dementia care. Due to contact restrictions, we carried out a quantitative survey with a semi‐structured questionnaire as an alternative method of data collection. Questionnaires (n = 45) including open and closed questions were sent by post to the leaders of four self‐help groups for relatives of people living with dementia and then distributed to the members by the group leaders. We asked about the current health status of the respondents, the limitations during the Covid‐19 pandemic and changes in the care of people living with dementia.ResultA total of 23 questionnaires were completed and returned to us. Participants had a mean age of 70.4 years (range 51 to 88 years). The majority of participants were female (69.6%). More than half of the participants assessed their health status as less good or bad (56.5%). Compared to the health status before the Covid‐19 pandemic, more than one third of respondents felt their own health was deteriorating (39.1%). Feelings of isolation and social exclusion increased in 39.1% of the participants during Covid‐19 pandemic. Most participants suffered from limitations of social contacts and leisure activities. The temporary closure of day care facilities for people living with dementia was a particular burden for caring relatives.ConclusionThe majority of respondents experienced the Covid‐19 pandemic as burdensome with regard to their health and their care responsibilities. The statements of relatives underline the importance of maintaining clear structures in everyday life and in care of people living with dementia even in periods of crisis.

Extra Analysis of Health Care Policy for Patients with Corona Virus during COVID 19 and with Chronic Heart Failures and Roles of Nurses at Hospitals in Vietnam

The study aims to provide knowledge of self-care for patients with COVID 19 and with heart failures. In the United States, between 2011 and 2014, an estimated 6.5 million Americans over the age of 20 had chronic heart failure The estimated prevalence of heart failure in Asia ranges from 1.26% to 6.7%, in Southeast Asian countries from 4.5% to 6.7%. This study used Health education intervention that was carried out for 90 patients with chronic heart failure inpatient treatment at Cardiology Department - Nam Dinh General Hospital. The rate of heart failure in Korea was estimated at 1.53% in 2013. The frequency of heart failure in Korea is expected to double, from 1.60% in 2015 to 3.35% in 2040. By 2040, more than 1.7 million Koreans are expected to have heart failure .In Japan, an estimated 1.0 million patients have heart failure and the number of outpatients with left ventricular dysfunction is expected to gradually increase to 1.3 million by 2030 In China, 4.2 million people suffer from heart failure and 500,000 new cases are diagnosed each year). We perform method of one-group intervention study with before-after comparison. Health education intervention was carried out in 90 patients with chronic heart failure inpatient treatment at Cardiology Department - Nam Dinh General Hospital. Our results show that patients with cardiovascular disease need to be aware that they are a very high risk group for infection as well as serious complications that may occur if they are unfortunately infected with COVID-19. This research finding and recommended healthy foods to support for better health of patients with chronic heart failure in many developing countries. Last but not least, vital roles of nurses in Nam Dinh and Vietnam hospitals have been increasing in recent years in helping patients and help them to gain knowledge for self-care with COVID 19 and with heart failures and practice “Maintenance of care” of patients with chronic heart failure.

P-143: Breakthrough – a designated pharmacist in the hemato-oncology department improves both quality and sequence of drug treatment and reduces ADR in Multiple Myeloma patients during Covid-19 pandemic

BackgroundIn March 2020, COVID19 break out and since then the world has been facing a new reality. Multiple Myeloma patients due to their disease and chemotherapy were considered as a high-risk group for infection. Since then, in an attempt to avoid multiple exposures, encounters between patients and caregivers have diminished negatively affecting the sequence and quality of drug treatment.ObjectivesImproving Quality, Sequence of Drug Treatment and reducing adverse drug reactions(ADR) in MM patients during Covid-19 pandemic.MethodsThis study is part of a broader randomized controlled trial. It included 44 MM adult patients, who received chemotherapy or biological therapy at Carmel Medical Center in Isreal. Once they sign a consent form, they were randomized into two groups (23 Intervention, 21 Control). In the intervention group, the pharmacist examined the patient’s entire medical treatment and sent recommendations to the family physician and hematoocologist. On the day of the treatment, the pharmacist has met with the patient and provided him/her with a discharge counseling in addition to close supervision for 4 months during the treatment period. The control group was treated without increased pharmacological intervention. The data collection phase had ended one month after intervention period. The control group data was examined after the end of treatment to prevent ethical dilemmas. The variables that were examined are compliance, ADR and balancing medical incidences.ResultsIntervention group: it was found that 65.2% of the patients did not take their medication according to the manufacturer’s instructions, 8.7% took medication that were not registered in their medical file, 30.4% took medication at a different dose than recommended, 56% of patients had poor compliance to one or more prophylactic treatments. 90 recommendations were sent to the hemato-oncologist - 79 (87.7%) were accepted. 57 recommendations were sent to the family physicians and 40 (70%) of them were accepted. During the follow-up period, an improvement of 100% in adherence to the manufacturer’s instructions, 100% of the medications were registered in the patient’s file and the response to prophylactic treatment increased to 96%. Among the patients in the intervention group, there was an improvement in the indices of diabetes balance (13%), LDL (34%), vitamin D (30%) and GFR (34%). This is in comparison with an improvement of 4.7%, 9.5%, 23% and a 14% in the control group. During the follow-up period in the intervention group 7 cases of ADR were reported compared to 19 cases in the control group.ConclusionWe found that integrating of a designated pharmacist as part of the hemato-oncology department during the Covid-19 pandemic had high positive effect on the quality and sequence of drug treatment and reduced the incidence of ADR “Crisis is also an opportunity” – integrating a designated pharmacist should be considered even in routine days.

Effect of Vaginal Cleansing with Povidone Iodine Solution before Cesarean Section on Postoperative Endometritis Infection

Background: Cesarean section (CS) continues to be the surgical intervention most often performed in obstetrics, with a daily increasing frequency of use. The risk for all postpartum infections is increased in CS compared to vaginal delivery. Infectious complications developing in the aftermath of CS are one of the main causes of maternal morbidity. So, the aim of this study was to investigate the effect of vaginal cleansing with Povidone Iodine solution before cesarean section on postoperative Endometritis Infection . Design: A quasi- experimental design was utilized in this study. Setting: This study was conducted at the operating room of Obstetrics and Gynecologic Department in Beni-Seuf University Hospital from the period of May 2019 until August 2019. The study Subjects included 200 pregnant women undergoing elective cesarean delivery, who were selected by purposive sampling technique. then divided into control and study group 100 per each group. The study group receive vaginal cleansing before cesarean section by antiseptic iodine solution 10% and standard abdominal scrub. Control group receive standard abdominal scrub only. Tools was used of data collection included; 1st tool: Structured interview questionnaire was designed by the researchers and included demographic characteristics and data related to the participants’ clinical profile 2nd tool: Postpartum follow-up checklist to assess presence or absence of the post CS infectious morbidity such as; endometritis (lower abdomen pain and a smelly vaginal discharge), febrile morbidity, and incisional site infection.3rd tool: Numericаl rating scale (NRЅ). Study results: Shows there was statistically significant difference regards fever and a smelly vaginal discharge among both groups, while there was no statistically significant difference was found regards wound infection and lower abdomen pain. Conclusion: Preoperative vaginal cleansing using antiseptic iodine solution 10% was an effective practice for reducing post cesarean endometritis where overall post cesarean infectious morbidity rate was lower among study group compared to control those exposed to routine care alone; supporting the study hypothesis. Recommendations: Physicians and Nurses should be used antiseptic povidone-Iodine 10% or vaginal cleaning as regular practice before cesarean deliveries. Apply vaginal preparation with anti septic solution before C.S operation for high risk group for infection as premature rupture of membranes, diabetes, and anemia.

MO851INCIDENCE AND MORTALITY OF CORONAVIRUS DISEASE (COVID 19) IN HEMODIALYSIS PATIENTS

Background and AimsIn December 2019, an outbreak of coronavirus disease 2019 (covid 19) due to SARS Cov2 began in China and spread worldwide. Hemodialysis patients represent a unique group of patients, mostly elderly, imunocompromised, with numerous comorbidities. Patients with end stage renal disease are thought to be at increased risk of disease, severe disease and death from Covid 19 infection. In addition, dialysis centers are a suitable place for an outbreak of the epidemic. All of the above represents a group of hemodialysis patients particularly susceptible to infection and the development of serious disease.MethodWe reviewed data of all maintenance hemodialysis patients in hemodialysis centar of Zvezdara Hospital, Belgrade, Serbia. We include all patients with COVID 19 infection in period between April 1 2020 and January 10 2021.ResultsOf 232 patients undergoing hemodialysis, 68 (29,31%) were infected with Sars-Cov-2. 46 (67,64%) patients were males and 22 (32,35%) females. The age range of the patients was 35 to 87 years, the mean age was 65,25. The underlyind cause of terminal renal failure in 25 patients was hipertensiv nefroangiosklerosis, 14 diabetic nephropathy, 10 opstructiv nephropathy, 9 polycystic kidney disease, and 10 other cause of kidney failure. The average of hemodialysis duration was 70,70 months. The average durations of disease was 15 days. Mortality has been estimated at 33,82% (23 patients). Among patients who died 8 (34,78%) were females, and 15 (65,21%) males.ConclusionThe mortality among hemodialysis patients diagnosed with Covid 19 is high. Hemodialysis patients typically present with multiple comorbidities and are considered to be a high-risk group for infections. Hemodialysis patients with Covid-19 may have prolonged hospital stays and unfavorable prognoses and should be closely monitored.

Evidence of Hantavirus circulation among municipal street sweepers, southwest of Iran.

Hantaviruses are rodent-borne zoonosis pathogens that cause hemorrhagic fever with renal syndrome (HFRS) and Hantavirus cardiopulmonary syndrome (HCPS) in humans. Rodents spread the virus via their excretions. The outbreak of Hantaviruses pose a significant public health problem. The epidemiology and history of Hantaviruses in Iran is not clear and regardless of the data from the few available studies, little is known about its epidemiology in this country. Herein, we discuss the prevalence of IgG antibody against Hantavirus serotypes in 385 street sweepers from southwest of Iran. Serum samples were investigated, using Hantavirus Pool 1 "Eurasia" IgG kit and Pool 2 "America" ELISA IgG kit (Euroimmun, Germany) to detect IgG antibodies against Old and New World Hantaviruses. The results showed a specific IgG antibody in two samples (0.5%). Both of seropositive cases had specific IgG antibody against Old World Hantaviruses. The data of the current study along with the previous data, indicate the circulation of Hantaviruses in Iran. Hence, the risk of Hantavirus infection in high-risk groups should be considered as a serious health issue.