High Infection Research Articles

The Thermal Stability of Influenza Viruses in Milk

Highly pathogenic avian influenza viruses (HPAIVs) of the H5N1 subtype (clade 2.3.4.4b) have been detected in raw milk from infected cows. Several studies have examined the time and temperature parameters to ascertain whether influenza viruses in milk can be inactivated completely under commercial pasteurization conditions, yielding conflicting results. This study aimed to investigate whether milk could help protect influenza viruses from heat treatment. After heat treatment at 49 °C for one hour, the titer reduction of the influenza A/WSN/1933 (A/H1) virus in milk was approximately 1.6 log10TCID50/mL, which was significantly lower than that (3 log10TCID50/mL) observed in the Dulbecco’s Modified Eagle Medium (DMEM) control media. The influenza D/bovine/CHN/JY3002/2022 (D/Yama2019) virus in milk retained a high residual infectivity (4.68 × 103 log10TCID50/mL) after treatment at 53 °C; however, the virus in DMEM completely lost its infectivity under the same conditions. Moreover, the influenza A/chicken/CHN/Cangzhou03/2023 (A/H5) virus in DMEM could be inactivated completely using any of the three heat treatment methods: 63 °C for 30 min, 72 °C for 15 s, or 80 °C for 15 s. For the virus present in milk, only heat treatment at 80 °C for 15 s completely inactivated it. These results suggest that milk prevents influenza viruses from pasteurization inactivation.

Inactivation of Pseudovirus Expressing the D614G Spike Protein Mutation using Nitric Oxide‐Plasma Activated Water

AbstractVariants of concern (VOCs) of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) exhibit high infectivity due to mutations, particularly in the spike protein, that facilitate enhanced binding of virus to human angiotensin‐converting enzyme 2 (hACE2). The D614G mutation, situated in S1‐domain, promotes the open conformation of spike protein, augmenting its interaction with hACE2. Activated water neutralizes pathogens by damaging biological molecules; however, its effect on mutated SARS‐CoV‐2 or VOCs requires further exploration. Here, the efficacy of nitric oxide (NOx)‐plasma activated water (PAW) in inhibiting infections by SARS‐CoV‐2 pseudovirus expressing D614G‐mutated spike protein is investigated, which serves as a model for mutated SARS‐CoV‐2. Results demonstrated high prevalence of D614G mutation in SARS‐CoV‐2 and its VOCs. NOx‐PAW is non‐toxic to cells at high concentration, inhibiting infection by 71%. Moreover, NOx‐PAW induced structural changes in S1‐domain of spike protein, reducing its binding affinity and lowering clathrin‐mediated endocytosis‐related gene expression. Additionally, in silico analysis revealed NOx species in NOx‐PAW played key role in impairing S1‐domain function of the mutated SARS‐CoV‐2 pseudovirus by interacting directly with it. Collectively, these findings reveal the potent inactivation ability of PAW against mutated SARS‐CoV‐2 and suggest its potential application in combating emerging variants of SARS‐CoV‐2 and other viral threats.

Prevalence of surgical site infections in a tertiary care teaching hospital in Goa, India: a cross-sectional study

Background: Surgical site infections (SSIs) are a major category of healthcare-associated infections (HAIs), particularly in surgical settings. They lead to extended hospital stays, increased morbidity, and financial burden. The study was conducted in the surgical wards of Goa medical college, a tertiary care hospital, to assess the prevalence of SSIs and identify the key bacterial pathogens and associated risk factors. Methods: A cross-sectional, prospective study design was employed, involving 378 patients aged over 18 years admitted for surgical procedures. Data collection included daily follow-up for signs of infection, identification of bacterial pathogens, and analysis of potential risk factors such as age, type of surgery, duration of postoperative drain, length of hospital stays, and wound classification. Statistical analyses were conducted using SPSS software, with significance set at p<0.05. Results: The study identified an SSI prevalence of 12.69% among the participants, with Pseudomonas being the most common causative agent. Significant risk factors included extended postoperative drain duration, longer hospital stays, emergency surgical procedures, and surgeries involving contaminated or clean-contaminated wounds. Patients with prolonged postoperative drains had a markedly higher incidence of SSIs (63.63%). Conclusions: The findings reveal a considerable burden of SSIs in the studied setting, with high infection rates in patients undergoing prolonged drain usage, emergency surgeries, and surgeries on contaminated wounds. Strengthening infection prevention measures, particularly in high-risk cases, and enforcing strict adherence to hygiene and sterilization practices are critical. Enhanced infection surveillance programs and targeted interventions could help reduce SSI rates, improve patient outcomes, and minimize healthcare costs.

Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study

BackgroundThe World Health Organization has set ambitious goals to eliminate cervical cancer, necessitating evidence on increasing coverage and access to screening and treatment in high-burden areas. We implemented a pilot program to assess the feasibility of obtaining self-collected specimens for high-risk human papillomavirus (hr-HPV) testing in Nzulezo stilt village, a hard-to-reach community in Ghana, and inviting only hr-HPV-positive women to a central location for colposcopy and possible treatment. Subsequently, this study aimed to investigate the prevalence of hr-HPV infection and cervical lesions among the women and to explore factors potentially associated with hr-HPV infection among them.MethodsThis pilot community-based cross-sectional study utilized data from screening sessions held from 2 to 20 November 2021 with specimens collected by participants using Evalyn brushes. HPV DNA testing was performed using the Sansure MA-6000 platform, while visual inspection utilized the Enhanced Visual Assessment (EVA) mobile colposcope. Univariate and multivariable nominal logistic regression was employed to explore factors associated with hr-HPV positivity.ResultsAmong 100 women screened (mean age, 43.6 ± 14.5 years), the overall hr-HPV prevalence rate was 39.0% (95% CI, 29.4–49.3). The prevalence rates of hr-HPV genotypes were stratified as follows: HPV16–8.0% (95% CI, 3.5–15.2), HPV18–5.0% (95% CI, 1.6–11.2), and other genotype(s) – 31.0% (95% CI, 22.1–41.0). Single-genotype infections with HPV16 and HPV18 were found in 4.0% (95% CI, 1.1–9.9) and 3.0% (95% CI, 0.6–8.5) of women, respectively. Mixed infections were observed in 1.0% (95% CI, 0.0–5.4) for HPV16 + 18, 3.0% (95% CI, 0.6–8.5) for HPV16 + other type(s), and 1.0% (95% CI, 0.0–5.4) for HPV18 + other type(s). The prevalence of cervical lesions among hr-HPV-positive women screened via colposcopy was 11.4% (95% CI, 3.2–26.7). In the multivariable model, reliance on other sources for medical bill payment was associated with hr-HPV infection (aOR, 0.20; 95% CI, 0.04–0.93), whereas age was not (aOR, 1.02; 95% CI, 0.99–1.05).ConclusionsA high hr-HPV infection prevalence was recorded among the women. Utilizing technologies such as self-sampling, HPV DNA testing, and mobile colposcopy enables screening and treatment in remote and hard-to-reach communities where access to cervical cancer screening and treatment would otherwise be limited. Further research is warranted to assess the value and scalability of this approach in similar remote areas and its potential implementation in future programs.

Rhizosphere bacterial community is mainly determined by soil environmental factors, but the active bacterial diversity is mainly shaped by plant selection.

The assembly of the rhizosphere community, even the diazotroph community, is mainly shaped by soil environmental factors (including soil climate and physiochemical characteristics) and plant selection. To better understand the driving forces on the active overall and nitrogen-fixing bacterial community compositions, we characterized the communities of tobacco rhizosphere soil collected from three sampling sites with a large geographic scale (> 600km). The results indicate that the diversity and community composition of the overall bacterial and diazotroph communities are obviously differed according to the sampling sites. Still, no significant difference is found between the communities in rootzone and rhizosphere samples. Climate variables including mean annual precipitation (MAP) and mean annual temperature (MAT), soil physiochemical characteristics including available nitrogen (AN), available potassium (AK) and pH are main factors that affect the bacterial and diazotroph community structures in the three sampling sites. Furthermore, MAP and MAT, AN and available phosphorus (AP), total nitrogen (TN) and organic carbon (OC), AK and electrical conductivity (EC) showed similar effects, but pH showed independent effect on the composition of the overall bacteria and diazotroph communities. However, the alpha diversity indices of active overall and nitrogen-fixing bacteria in the rhizosphere are obviously higher than in the rootzone samples, and no significant differences are observed among different sampling sites. Proteobacteria is the predominant active phylum of all samples for overall and nitrogen-fixing bacteria. Escherichia-Shigella, Achromobacter, Streptomyces and Sphingomonas are the dominant active bacterial genera, and Bradyrhizobium, Skermanella and Extensimonas are dominant active nitrogen-fixing bacteria genera in rhizosphere. Furthermore, the high active abundance of Escherichia-Shigella but low abundance of Ralstonia in all three sampling sites indicate high root-knot nematode infection and low wilt disease endemic risk. These results indicate that soil environmental factors contribute more to the tobacco rhizosphere bacterial community assemblage, but the rhizosphere contributes more to the diversity of active overall bacteria and nitrogen-fixing bacteria in the community. Our study provides novel knowledge for the assemble of rhizosphere bacterial and active bacteria communities across a large geographical scale.

Seasonality influences skin bacterial community structure and anti-Bd function in two anuran species

Microorganisms on amphibian skin reduce disease susceptibility and play an important role in pathogen defense. We hypothesized that anuran skin bacterial communities would change in response to seasonal variation and host species. To test this hypothesis, we used 16S rRNA amplicon sequencing to identify cutaneous bacterial communities of two frogs from the Qinling Mountains of China, Pelophylax nigromaculatus and Nanorana quadranus. We matched the amplicon sequence variants (ASVs) of microbes exhibiting protective effects against the pathogen Batrachochytrium dendrobatidis (Bd), using a database containing over 1900 16S rRNA gene sequences from amphibian skin bacteria. The results showed that seasonal variation had a stronger effect than host species on the structure (alpha-diversity, beta-diversity, species composition and abundance, and biomarkers) and anti-Bd function of cutaneous bacterial communities. These communities were highly dynamic but varied similarly between hosts. Their structural similarities were more consistent at the phylum level, but markedly less so at finer taxonomic levels. The highest relative abundance of anti-Bd reads was observed in P. nigromaculatus during summer, but anti-Bd reads were present in both frog species during different seasons. Therefore, the protective function of cutaneous microbial communities appears to be continuous despite between-species differences in anti-Bd ASV abundance. This observation does not directly explain why Bd infections have not been recorded in the region, butprovides important insight on anuran pathogen defense mechanisms. Our findings also suggest that specific seasons can be periods of high infection risk, with major implications for research on amphibian ecology and conservation.

Bacterial communities in Asecodes hispinarum (Hymenoptera: Eulophidae) and its host Brontispa longissima (Coleoptera: Chrysomelidae), with comparison of Wolbachia dominance.

The endoparasitoid Asecodes hispinarum (Bouček) (Hymenoptera: Eulophidae) serves as an effective biological control agent against Brontispa longissima (Gestro) (Coleoptera: Chrysomelidae), a notorious palm pest. Endosymbionts found in parasitoids and their hosts have attracted significant attention due to their substantial influence on biocontrol efficacy. In this study, we employed 16S rRNA sequencing, polymerase chain reaction, and fluorescence in situ hybridization to assess the symbiotic bacteria composition, diversity, phylogeny, and localization in A. hispinarum and its host B. longissima. Our findings showed significant differences in the richness, diversity, and composition of symbiotic bacteria among different life stages of B. longissima. Notably, the bacterial richness, diversity, and composition of A. hispinarum was similar to that of B. longissima. Firmicutes and Proteobacteria were the dominant phyla, while Wolbachia was the dominant genera across the parasitoid and host. It was discovered for the first time that Wolbachia was present in A. hispinarum with a high infection rate at ≥ 96.67%. Notably, the Wolbachia strain in A. hispinarum was placed in supergroup A, whereas it was categorized under supergroup B in B. longissima. Furthermore, Wolbachia is concentrated in the abdomen of A. hispinarum, with particularly high levels observed in the ovipositors of female adults. These findings highlight the composition and diversity of symbiotic bacteria in both A. hispinarum and its host B. longissima, providing a foundation for the development of population regulation strategies targeting B. longissima.

Strong association between high burden of soil-transmitted helminthiasis and household transmission among Malaysian Negritos, urging anthelmintic treatment beyond children

The Orang Asli (OA), Malaysia’s indigenous minority, continue to experience ongoing soil-transmitted helminth (STH) infections despite efforts including the Resettlement Programme (RPS). This study explores STH epidemiology and associated risks of moderate-to-heavy infections among 259 indigenous Negritos across four states in Peninsular Malaysia. Stool samples, anthropometrics, haemoglobin levels (finger-prick) and sociodemographic and environmental-sanitation factors via pretested questionnaires were collected. Parasitological examinations (direct faecal smear, formol-ether concentration, and Kato-Katz techniques) were thoroughly performed. The study revealed a 63.3% overall STH prevalence, with Trichuris trichiura (57.9%) being the most common, followed by Ascaris lumbricoides (35.5%) and hookworm (8.9%). Moderate-to-heavy infections were observed in 39.3% for T. trichiura and 48.9% for A. lumbricoides, with mixed infections of these two species being the most prevalent (50.6%). The risk for moderate-to-heavy infection increased significantly if other household members were infected (P < 0.001). Adults and adolescents also showed high infection rates, with no significant differences with children’s groups. These findings emphasize the need for anthelmintic treatment across all age groups and strategize local policies targeting older groups of the OA community to control ongoing transmission and reduce the STH burden and protect the future well-being of OA children, who deserve a healthier future.

Gender differences in correlation of biochemical parameters with the severity of COVID pneumonia and the need for oxygen/mechanical support

Background:COVID-19 pandemic had caused a global medical, economic and social problems. High infection rate, heterogenous presentation, lack of previous data and no standardized treatment had led to a need for further analysis, in order to be prepared for any potential new pandemics. We analyzed any possible correlation between gender, laboratory findings and severity of disease with need for oxygen or mechanical ventilation support. Methods: 100 patients with confirmed SARS-CoV-2 virus infection enrolled. Baseline characteristics that included age, sex, smoking history, BMI, oxygen therapy or mechanical ventilation support need were recorded. Type and severity of radiological finding determined by chest CT scan. Results: Majority of our patients were over 61 years old (58.6%), male (57.6%), and had severe radiological finding (bilateral pneumonia 29.3%, ARDS 35.4%), with only 20.2% had not required any oxygen supplementation. Regarding gender and laboratory findings, men have shown statistically significant higher values of CRP, lymphocytes, LDH and ferritin (96.4 vs 87.1, p=0.014; 1.17 vs 0.84, p=0.048; 674.8 vs 609.1, p=0.031; 1263 vs 578.4, p=0.001, respectfully). Severe radiological finding had shown positive correlation with the need for HFNC and/or (N)IMV (p=0.021 and p=0.032. respectfully), as well as with higher values of WBC, LDH and ferritin (p=0.042, p=0.035 and p=0.017. respectfully). Conclusions: There is a difference between presentation of the disease, as well as analyzed laboratory markers between sexes. The difference is most likely multifactorial and should require further research in order to discover other risk and prognostic factors.

Efficacy of a gelling-fibre dressing and a gelling-fibre dressing with silver nanoparticles at controlling exudate and infection: a 4-week multicentre clinical evaluation.

Suprasorb Liquacel Pro (standard test dressing) and Suprasorb Liquacel Ag (test dressing with silver nanoparticles) are absorptive gelling-fibre dressings designed to manage wound exudate levels and promote moist wound healing, with the latter having additional antimicrobial properties. To assess the impact of the test dressing on healing, exudate levels and signs of infection. Patients with moderately-to-highly exuding hard-to-heal wounds of any type were dressed with the standard test dressing or the test dressing with silver nanoparticles if they showed covert or overt signs of local infection. Comparative data were collected at baseline and 4-week conclusion. Adverse events and patient and professional opinions were also reported and collated. There were 19 patients with lower-limb wounds of various types present for a mean of 26 months. At baseline, most wounds were deteriorating or static (68%), while at conclusion most were improving or healed (84%), with additional indicators of improved healing. The number of patients with moderate-to-high exudate levels decreased from 84% to 53%. The 15 patients using the test dressing with silver nanoparticles saw reductions in covert signs of infection from 93% to 80%, overt signs of infection from 33% to 13% and antibiotic use from 13% to 7%. On average, the test dressings were effective in managing and reducing the barriers to healing, including high exudate, infection and biofilm, and in restarting stalled healing.

T. Muris Infection Dynamics of a Fresh, Wild Isolate: Is the Established E Isolate Still Relevant?

For decades, parasitic worms such as Trichuris muris have been maintained in laboratory animals, providing insights into host-parasite interactions and host immune responses. The most used T. muris isolate is the E isolate, established in the laboratory in 1954. However, one concern with these model systems is the potential for laboratory-induced selection and therefore changes in host-parasite interactions. To address these concerns, we compare the E isolate with a recently isolated T. muris isolate (M isolate), established from wild house mice (Mus musculus domesticus, Isle of May, UK), in their capacity to infect laboratory mice. High dose infection of C57BL/6 mice revealed that significantly more parasites of the M isolate survived to the adult stage compared to the E isolate. Worm persistence was associated with heightened TNF-α and IL-10 secretion upon parasite-specific re-stimulation, and higher serum IgG1 and IgG2c levels, concomitant with an increase in T-bet+ and ICOS+ CD4+ T effector-memory cells. Differences in host response to the isolates were not as pronounced during low dose infection. Our study highlights the need for regular evaluation of lab-maintained parasite isolates against freshly isolated parasites to understand whether the established lab strains remain relevant model systems for our understanding of parasitic infections.

Formulation of Asiatic acid-loaded polymeric chitosan-based hydrogel for effective MRSA infection control and enhanced wound healing in zebrafish models

BackgroundWound healing relies on a controlled inflammatory process vital for tissue regeneration. Chronic wounds, characterized by persistent inflammation and high infection risk, pose significant challenges in healthcare. Hydrogel dressings offer promise in wound care; however, the understanding of their role in managing inflammation and infection remains unclear. This study aimed to elucidate these processes and assess the efficacy of Asiatic acid (AA)-infused hydrogels in reducing inflammation and preventing infection. The unique properties of AA suggest its potential to modulate inflammation, promote tissue regeneration, and inhibit microbial colonization, thereby paving the way for specialized dressings that optimize healing outcomes. MethodsThe investigation encompassed the antibacterial, anti-biofilm, antioxidant activity, and biocompatibility of AA using a fibroblast cell line. A hydrogel incorporating AA was developed and characterized through scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), contact angle analysis, tensile testing, swelling capacity, and thermal stability assessments. Biodegradability was evaluated via enzymatic degradation, alongside controlled drug release and antibacterial efficacy against MRSA. In vivo studies using a zebrafish model examined wound healing and immune response. ResultsResults confirmed AA's potent antibacterial activity against MRSA and its effectiveness in disrupting mature biofilms. Additionally, AA exhibited strong antioxidant activity and biocompatibility. Morphological analysis revealed a pore structure conducive to wound healing, and the hydrogel demonstrated enhanced tensile strength, swelling properties, and thermal stability. In vivo, the AA-infused hydrogel accelerated wound closure, re-epithelialization, and immune response, supporting its potential for advanced wound care applications. In conclusion, the AA-infused chitosan hydrogel emerges as a promising candidate for advanced wound care therapies.

Effect of natural ventilation on aerosol transmission and infection risk in a minibus

High passenger density, prolonged exposure, and close interpersonal distance create a high infection risk (IR) in minibuses. While improving natural ventilation induced by turbulent airflows is essential for controlling IR in minibuses, comprehensive studies on its effectiveness are lacking. To address this, we conducted computational fluid dynamics simulations studies coupling indoor–outdoor turbulent airflows to examine the impact of window opening locations, window opening sizes, and initial droplet diameters (dp) on the ventilation airflow and dispersion of pathogen-laden droplets. Results show that the surrounding turbulent flow patterns create higher surface pressure at bus rear than bus front, which is a key factor influencing bus ventilation. When all windows are closed, ventilation is primarily provided by skylights at bus rooftops. Ventilation through only two skylights resulted in an air change rate per hour (ACH) of 17.55 h−1, leading to high IR of passengers. In contrast, fully opening front and rear windows increases ACH by 27.28-fold to 478.79 h−1, significantly reducing IR by 1–2 orders of magnitude compared to skylight ventilation. Expanding window opening sizes can effectively enhance ventilation when both front and rear windows open (attributed to the pumping effect), while is ineffective when only front windows open. To reduce IR in minibuses, we recommend opening multiple windows at the bus front and rear. Even if the total opening area of the front and rear windows is only two-thirds of that of the front window, its ACH is 2.8 times more than only opening front windows.

Molecular Pathogenesis of Human Papillomavirus: Insights into Viral Oncoproteins and Host Integration

Human Papillomavirus (HPV) is a major cause of death from cervical cancer and other anogenital cancers throughout the world. Pathogenicity of HPV is governed by intricate interplay of HPV and host cells mediated primarily by its oncoproteins E6 and E7. These oncoproteins disrupt critical pathways, including those involving tumor suppressors p53 and retinoblastoma (Rb) to induce unregulated cell proliferation and evasion of apoptosis. These mechanisms have been studied in order to develop the different diagnostic tools, such as HPV DNA testing and genotyping, and there are emerging techniques based on E6/E7 mRNA detection and high throughput sequencing. In addition, therapeutic strategies have advanced with the vaccines showing ability to prevent high risk HPV infection and ongoing research to developing targeted therapies to disrupt viral oncoprotein function. New diagnostic and therapeutic approaches to HPV research encompassing an expanding clinical landscape hold promise to reduce incidence of HPV associated malignancies and improve patient outcomes. This review summarizes the molecular pathogenesis of HPV with respect to host cells and discusses its implications for diagnostics and therapeutics, including the need for further development in this area.

Could Pistachio (Pistacia vera) Be a Suitable Alternative Crop for Olive-Growing Mediterranean Areas Affected by Xylella fastidiosa subsp. pauca ST53?

In the olive-growing areas of Apulia (southern Italy) where Xylella fastidiosa has caused enormous damage, there is a need to identify alternative crops. These could include pistachio (Pistacia vera L.), but it is critical to define the impact of the bacterium on this crop and what are the main phytosanitary threats for this species in the areas where the bacterium is now endemic. Therefore, we started evaluating infections caused by X. fastidiosa, the fungus Neofusicoccum mediterraneum, and other pathogens on four pistachio cultivars ('Kerman', 'Aegina', 'Lost Hills', and 'Napoletana') grown in areas where X. fastidiosa has been present for a long time. X. fastidiosa was detected only in one orchard (incidence: 18% 'Napoletana' and 55% 'Kerman') out of six surveyed orchards, with low bacterium concentration (1.67 to 5.98 × 103 CFU ml-1) and no symptoms. N. mediterraneum was retrieved in three orchards just on the cultivar Kerman but with high incidence (up to 30%) and infection level quantified as molecular severity (6.82 to 7.43); no other pathogens were detected. The N. mediterraneum representative isolates characterized in this study showed similarity with Spanish and Portuguese isolates. A confocal microscope analysis for this host-pathogen association suggested no differences in plant response to fungal aggression between the cultivars Kerman and Aegina, but just lack of latent inoculum in 'Aegina' plants, pointing to a possible nursery origin of the infection. Waiting for additional targeted experiments to clearly define host response of pistachio cultivars to Xylella spp., this study also points at N. mediterraneum as a potential threat to this tree crop new for the area.

RELATIONSHIP BETWEEN BASIC SANITATION AND THE INCIDENCE OF INFECTIOUS DISEASES IN THE HEALTH MACROREGIONS OF THE STATE OF MARANHÃO

Basic sanitation is crucial for quality of life, as the lack of this service can spread infectious diseases due to lack of hygiene and access to drinking water. Data from 2019 indicate that 86.9% of the population of Maranhão does not have sewage collection, resulting in more than 38 thousand hospitalizations due to waterborne diseases. This study aims to investigate the relationship between basic sanitation and the incidence of infectious diseases in Maranhão, highlighting the need for more effective sanitation plans. This is a descriptive study and uses a quantitative approach, collecting secondary data from DATASUS on the sanitation situation and infectious diseases in the health macro-regions of Maranhão. The information was extracted through a specific process on the website, covering the period from 2014 to 2017. The data were organized in Excel spreadsheets for analysis and visualization. The results reveal that 55.98% of families in the northern macro-region of Maranhão lack adequate sanitation, while the eastern and southern regions have 29.44% and 14.57%, respectively. Schistosomiasis, a disease transmitted by contaminated water, had the most cases in the northern region of the state. The data indicate that regions with inadequate sanitation have high infection rates, demonstrating a correlation between the lack of sewage and the increase in diseases such as amoebiasis and schistosomiasis. The study concludes that the macro-regions analyzed show a clear proportional relationship between inadequate sanitation and the incidence of infections, reinforcing the urgency of interventions in the area of ​​sanitation to improve the health of the population.

High rates of Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis co-infection in people with HIV: a systematic review and meta-analysis.

People living with HIV (PWH) experience a disproportionate burden of sexually transmitted infections (STIs), leading to more severe health outcomes and increasing the risk of HIV transmission. The presence of untreated STIs can accelerate HIV disease progression, while HIV infection can complicate STI diagnosis and treatment. Despite this interconnectedness, comprehensive data on the global prevalence of specific STIs among PWH remain limited. This systematic review aims to synthesize existing data to provide a more accurate picture of the prevalence of co-infection with Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis or Trichomonas vaginalis in PWH, while also identifying critical knowledge gaps and informing future research priorities. We searched databases for eligible studies reporting the prevalence of Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis among PWH, published from January 1, 2000, to February 1, 2023. From 22,290 identified articles, 127 independent studies meeting the inclusion criteria were included in this meta-analysis. The overall global co-infection prevalence of Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis in PWH, was 4.8% (95%CI: 4.7-5.0%), 0.8% (95%CI: 0.6-0.9%), 2.5% (95%CI: 2.2-2.7%), and 3.0% (95%CI: 2.7-3.3%), respectively. The global prevalence of these four STIs in PWH is high, especially in Africa and Southeast Asia and in MSM and TGW populations. Based on the subgroup analyses, we further found that there was a high prevalence of Treponema pallidum and Chlamydia trachomatis in Southeast Asia and a high infection of Trichomonas vaginalis in the whole of Africa. Treponema pallidum infection was more common in males than females, and Chlamydia trachomatis and Trichomonas vaginalis infections were more common in females than males. Besides, high infection rates of Treponema pallidum, Neisseria gonorrhoeae, and Chlamydia trachomatis were detected in men who have sex with men (MSM) + transgender women (TGW), while high infection rates of Trichomonas vaginalis were found in sex workers and pregnant women. The study confirmed high prevalence of four sexually transmitted pathogens in PWH, noting regional, gender, and subpopulation-specific differences. It offered insights for targeted interventions and healthcare strategies. The research underscored the necessity for enhanced data collection and expanded screening/treatment for vulnerable populations and regions.

Seroprevalence and associated factors of toxoplasmosis in female children and adolescents in Germany

Abstract Background Toxoplasmosis is a parasitic disease that causes a high burden of disease worldwide. Infections occur mainly through the consumption of undercooked meat or the ingestion of contaminated cat feces from the environment. In Germany, seroprevalence in adults is exceptionally high by international comparison (50%), which could be due to the frequent consumption of raw pork products. Comparable analyses for children and adolescents are missing but are needed to estimate the public health problem and to suggest countermeasures. Methods As part of the second wave of the representative German Health Interview and Examination Survey for Children and Adolescents (2014-2017), serum of 1,453 girls aged 3 to 17 years was tested for the presence of T. gondii IgG antibodies using enzyme linked fluorescence assay (ELFA). We calculated overall and stratified seroprevalence and used multivariable logistic regression models based on Directed Acyclic Graphs to identify associated factors. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) are being reported. Results Overall, 94 out of 1,453 girls tested positive for T. gondii resulting in a seroprevalence of 6.3% (95% CI: 4.7-8.0). With each year of life, the chance of being seropositive increased significantly by 1.2 (95% CI 1.1-1.3). A low social status (aOr 2.7; 95% CI 1.3-5.9) and living in rural (aOR 2.6; 95% CI 1.1-5.7) or urban (aOR 2.2; 95% CI 1.1-4.4) areas were found to be associated with seropositivity. No regional distribution patterns or differences between vegetarians and non-vegetarians were seen. Conclusions Six out of 100 girls become infected with T. gondii during the first 18 years of life. Independent risk factors identified in our study have also been associated with seropositivity in other countries. Meat consumption appears to have a reduced impact on the risk of infection in children and adolescents compared to adults, calling for different prevention strategies in this population. Key messages • Toxoplasmosis causes a high infection pressure for girls and young women in Germany. • Transmission pathways might differ between age groups with more environmentally associated infections in children and adolescents.

Antibiotic use and resistance: knowledge, attitudes and practices in Italian healthcare workers

Abstract Background Antimicrobial resistance (AMR) is one of the most significant public health challenges globally. The misuse or incorrect use of antibiotics has led to the emergence of resistant bacteria, making it increasingly difficult to treat infections. This study aims to identify knowledge, attitudes, and practices among Italian healthcare workers (HWs) - medical doctors (MDs) and nurses - regarding antibiotics, antibiotic use, and antibiotic resistance. Methods Cross-sectional study; a validated questionnaire from the European Centre for Disease Prevention and Control was distributed via web survey starting from April 2024 to a voluntary sample of healthcare workers employed in Italy. Descriptive analysis and multivariable logistic regression were performed to investigate predictors of knowledge regarding antibiotic use and AMR. Ethical approval was obtained from the local ethics committee. Results So far, 154 HWs were enrolled, of which 132 were nurses (85.7%). The average level of knowledge regarding AMR and antibiotic use was 6.8/7 (± 0.2) for MDs and 6.1/7 (± 0.2) for nurses, with an overall score, among HWs of 6.19 (± 0.99), compared to a European average of 6.35. The multivariable analysis highlighted that the medical profession reported higher knowledge regarding prudent antibiotic use and AMR (aOR 6.90; 95% CI 1.83-26.01, p-value = 0.004), while concerning professional practice, the unavailability and difficulty of access to guidelines seemed to increase the risk of reporting inadequate knowledge (aOR 2.04; 95% CI 1.01-4.13, p-value = 0.046). Conclusions Our preliminary results provide an insight into the importance of structuring and actively disseminating procedures/protocols and guidelines to deepen the issues of AMR and prudent antibiotic use. Also, there appears to be a need to enhance the delivery of refresher courses targeting HWs, with particular attention to settings at high infection transmission risk. EU funding: Project no. PE00000007, INF-ACT. Key messages • Although a higher knowledge about prudent antibiotic use and AMR, more efforts are needed to increase access to guidelines. • Constant updating of knowledge and practices is necessary to face the challenges of antibiotic resistance in public health.

High infection prevalence in patients who develop severe acute kidney injury during heart failure hospital admission

Abstract Background Acute kidney injury (AKI) is common in acute HF and associated with poor prognosis. (1-3) The cause of AKI is often unknown. Purpose The aim of this analysis was to analyse the data for patients with a severe AKI which developed during a HF admission and identify potential triggers in the preceding 7 days (e.g., infection, hypotension, contrast agents.). Methods Data between January 2022 to March 2023 was obtained from that submitted by our centre to the mandatory National HF Audit which collects data from every patient admitted with acute HF. For this analysis, baseline renal function was retrospectively collected from electronic patient records, and chronic kidney disease and AKI were subsequently defined, as per KDIGO guidelines(4), using baseline and admission measurements. Electronic patient records were reviewed for all patients who developed AKI stage 2/3 ≥48 hours after admission. Data collected during the week prior to their AKI included any radioiodine contrast exposure, temperature ≥ 38⁰C, antibiotics, CRP &amp;gt;100mg/L and periods of sustained hypotension. Results Of the 843 HF hospital admissions between January 2022 and March 2023, 507 (60.1%) were not associated with AKI [inpatient (IP) mortality 5.9%], 237 (28.1%) had an AKI stage 1 [IP mortality 17.3%], 51 (6.0%) had an AKI stage 2 [IP mortality 25.5%] and 48 (5.7%) had an AKI stage 3 [IP mortality 33.3%]. The age, diabetic status and ejection fraction of patients was similar across AKI stages. Of these, 64 patients developed their AKI stage 2 (n=30) or 3 (n=34) on or after their second day of HF hospital admission. 22 (34.3%) of these patients died during this admission, and 37 (57.8%) had died after a median follow-up of 217.5 days (IQR 24-331.75) (Table 1). 71.9% had evidence of an infection (defined by a temperature spike ≥38⁰C, received antibiotics, OR CRP &amp;gt;100mg/dL) in the week prior to developing their AKI (Table 2). 39% of patients had received a contrast agent in the preceding week, and 39% had experienced persistent hypotension in the preceding 48 hours. 25% had 2 of these potential triggers, 17.2% had 3. Six patients (9.4%) had no apparent identifiable triggers. 25% had not had renal function checked for 48h prior to AKI. Conclusion The most frequent identifiable potential trigger for severe AKI was infection in 72%, followed by contrast agent (39%) and hypotension (39%). Many patients had multiple triggers. Over-diuresis in isolation was not identified as a trigger for AKI in this cohort. Severe AKI 2/3 is a marker of extreme mortality risk and identifies patients in need of intensive monitoring. Lack of daily bloods in one quarter of patients led to a delay in AKI alert. Close observation for all acute HF patients including daily bloods and early identification and treatment of infection plus judicious and least use of contrast is needed to reduce the high mortality rates in this population.