High Prevalence Of Infection Research Articles

Extended-spectrum β-lactamase- producing gram-negative bacterial infections in severely ill COVID-19 patients admitted in a national referral hospital, Kenya

BackgroundBacterial infections in COVID-19 patients, especially those caused by multidrug-resistant gram-negative strains, are associated with increased morbidity, hospital stay and mortality. However, there is limited data on the epidemiology of extended-spectrum β-lactamase (ESBL)-producing bacteria in COVID-19 patients. Here, we assessed the prevalence and the factors associated with ESBL-producing gram-negative bacterial (GNB) infections among severely ill COVID-19 patients admitted in Kenyatta National Hospital (KNH), Kenya.MethodsWe adopted a descriptive cross-sectional study design for patients admitted between October 2021 and February 2022, purposively recruiting 120 SARS-CoV- 2 infected participants based on clinical presentation. Demographics and clinical characteristics data were collected using structured questionnaires and case report forms. Clinical samples were collected and analyzed by standard microbiological methods in the KNH Microbiology laboratory and the Centre for Microbiology Research, Kenya Medical Research Institute.ResultsGNB infections prevalence was 40.8%, majorly caused by ESBL—producers (67.3%) predominated by Klebsiella pneumoniae (45.5%). Generally, 73% of the ESBL producers harboured our target ESBL genes, mainly CTX-M-type (59%, 17/29) in K. pneumoniae (76.9%, 20/26). GNB harbouring TEM-type (83%, 10/12) and SHV-type (100%, 7/7) genes showed ESBLs phenotypes and inhibitor resistance, mainly involving clavulanate, but most of them remained susceptible to tazobactam (60%, 6/10). SHV-type genes carrying ESBL producers showed resistance to both cefotaxime (CTX) and ceftazidime (CAZ) (K. pneumoniae), CAZ (E. coli) or CTX (E. cloacae complex and K. pneumoniae). About 87% (20/23) of isolates encoding CTX-M-type β-lactamases displayed CTX/ceftriaxone (CRO) resistance phenotype. About 42% of isolates with CTX-M-type β-lactamases only hydrolyzed ceftazidime (CAZ). Isolates with OXA-type β-lactamases were resistant to CTX, CAZ, CRO, cefepime and aztreonam. Patients with comorbidities were 10 times more likely to have an ESBL-producing GNB infection (aOR = 9.86, 95%CI 1.30 – 74.63, p = 0.003).ConclusionWe report a high prevalence of ESBL-GNB infections in severely ill COVID-19 patients, predominantly due to Klebsiella pneumoniae harbouring CTX-M type ESBL genes. The patient’s underlying comorbidities increased the risk of ESBL-producing GNB infection. In COVID-19 pandemic, enhanced systematic and continuous surveillance of ESBL-producing GNB, strict adherence to infection control measures and antimicrobial stewardship policies are warranted in the current study setting.

Gastro-intestinal parasites of urban rhesus macaques (Macaca mulatta) in the Kathmandu Valley, Nepal

Intestinal parasitic infections such as amoebiasis, ascariasis, hookworm infection, and trichuriasis are the most common infections among non-human primates (NHPs). There are always the possibilities of transmission these parasites between humans and NHPs. Multiple groups of rhesus macaques (Macaca mulatta) live in the urban area of Kathmandu Valley near human settlements, however the gastrointestinal (GI) parasitic infections in those macaques are understudied. This study aimed to explore the GI parasites in free-ranging macaques from Pashupatinath, Swayambhunath, Tripureshwor, Nilbarahi temples and a group of captive rhesus macaques in the Central Zoo, Kathmandu. Fecal samples were collected from the macaques between October 2021 to September 2022 and assessed for parasites by the both wet mount method and concentration technique. There is high prevalence of GI parasite infection; out of 121 fecal samples examined, 87.6% of samples were positive. Six species of protozoans and eight species of helminths were identified from the fecal samples including the first report of Iodamoeba butschlii in monkeys of Nepal. Among the protozoan parasites, Entamoeba coli (54.71%) showed the highest prevalence followed by Balantioides coli (44.33%), E. histolytica (19.81%), and Iodamoeba butschlii (10%). Among the helminths, Trichuris spp. (31.13%) and Strongyloides spp. (31.13%) showed the highest prevalence followed by Hookworm (24.52%), and Strongyle spp. (23.58%). The likelihood ratio test suggested that the prevalence differed significantly with the seasons for Iodamoeba butschlii, Giardia spp., Strongyles spp., Hookworm, and Trichostrongylus spp. The prevalence of E. histolytica, E. coli, Iodamoeba. butschlii, Trichuris spp., Trichostrongylus spp., and Unknown spp.1 differed with sampling localities. The high prevalence of GI parasites found in the macaques living in the densely urbanized Kathmandu presents a potential threat to humans and warrants further study as well as increased education of the public and management of the human-macaque interface in the urban landscape of the Valley.

Epidemiological and molecular updates on hookworm species in dogs from southern Italy

BackgroundThe zoonotic hookworms Ancylostoma caninum and Uncinaria stenocephala are widespread soil-transmitted helminths in dogs in Europe. Given the veterinary and public health importance of hookworms in dogs and the recent changes in the molecular epidemiology of some species, there is a need to continuously monitor the epidemiological and molecular prevalence of these parasites also at the “local” level. The present study aimed to update the epidemiological scenario of hookworm infections in both owned and stray dogs in southern Italy and to discriminate between different hookworm species (A. caninum and U. stenocephala) through molecular analyses. For this purpose, a retrospective analysis was performed over 10 years (2011–2021), including a total of 7008 owned dogs and 5642 stray dogs referred to our laboratory for copromicroscopic examinations. Moreover, 72 faecal samples, from dogs naturally infected by hookworms, were used to discriminate between A. caninum and U. stenocephala using two PCR protocols. Prior to molecular analyses, a subsample of 40/72 positive faecal samples was used for morphometric investigations on hookworm eggs.ResultsThe results of the ten-year retrospective analysis (2011–2021) showed an overall prevalence of hookworm infection of 9.16%, specifically 5.1% in owned dogs and 14.2% in stray dogs. Logistic regression showed a significant association between positivity to hookworms and the variable “puppies” both in stray (13.84%; OR = 2.4) and owned (7.07%; OR = 2.2) dogs. The results of molecular analyses showed that positivity was confirmed only in 21/72 samples, specifically, 6 samples using protocol A and 19 with protocol B. Sequencing revealed 15 samples positive to U. stenocephala and 6 to A. caninum.ConclusionsThe findings of this study showed a high prevalence of hookworm infections in dogs in southern Italy, updating the epidemiological scenario of the last decade. Moreover, the results of the study revealed the first identification of hookworm species in dogs in Italy by molecular studies, highlighting that U. stenocephala is more prevalent than A. caninum.

Co-infection with Neisseria mucosa in a patient with tuberculous otitis media

Tuberculous otitis media (TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal Neisseria. Thus, understanding the pathogenic mechanisms and clinical features of commensal Neisseria is important, considering its recent presentation as an infection-causing pathogen. Neisseria mucosa is a commensal inhabitant in humans and is generally considered non-pathogenic but can cause infection in rare cases. Here, we report an atypical secondary infection caused by Neisseria mucosa in an 81-year-old woman with TOM being treated for pulmonary tuberculosis. Direct purulent otorrhea smear microscopy revealed no acid-fast bacilli using Ziehl-Neelsen staining, whereas the phagocytosis of gram-negative cocci by white blood cells was confirmed using Gram staining. Otorrhea culture revealed the growth of N. mucosa. Subsequently, M. tuberculosis infection in the otorrhea was identified using a culture-based method. Vigilance is critical for the early detection of TOM to prevent further complications. This report raises awareness regarding TOM and provides insight into the pathogenicity of N. mucosa in otitis media.

Gastrointestinal Helminth Parasites of Pseudotolithus species from Lagos Lagoon, Lagos, Nigeria

The gastrointestinal helminth parasitic fauna of Pseudotolithus specimens, an economically important group of fishes fromLagos Lagoon, was examined to describe the effects of gastrointestinal helminth parasites on the state of health ofPseudotolithusspecies at Lagos Lagoon, Lagos, Nigeria. Fish specimens obtained from Makoko Fish Market were sacrificedfrom October 2019 to March 2020, and gastrointestinal helminth parasites were isolated. Pseudotolithus typhus (n = 76),Pseudotolithus elongatus(n = 104) and Pseudotolithus senegalensis(n = 120) were among the 300 fish specimens that wereanalysed. In total, 186 out of 300 fish specimens (62.0%) were found to have gastrointestinal helminth parasites after sixmonths of sample collection. Pseudotolithus senegalensis had the highest prevalence of infection, 76 (63.3%), followed by P.elongatus, 68 (65.4%) and P. typhus, 42 (55.3%), which had the lowest prevalence of infection. Five species of parasites,Capillaria sp., Echinocephalus sp., Orneoascaris sp., Diphyllobothrium latum, and Neochinorhyncus sp., were isolated.Neochinorhyncus and Orneoascarissp. had the highest prevalence among all Pseudotolithusspecies. The overall prevalenceof infection, 77 (41.4%), was recorded in Capillaria sp., while the least prevalence, 08 (4.3%), was from Echinocephalussp.The total prevalence for the present study is 62.0%. There was no significant difference in infection levels (P>0.05) betweenthe two sexes, suggesting that neither sex was reliably affected by the parasite. Pseudotolithus species show a highprevalence of gastrointestinal helminths with a heavy parasitic burden, which may compromise the productivity,marketability, palatability, and or death of fish.

Acceptability, feasibility and cost of point of care testing for sexually transmitted infections among South African adolescents where syndromic management is standard of care

BackgroundYoung people (YP) in southern Africa are at substantial risk of HIV and sexually transmitted infections (STIs). Despite the epidemiological and biological link between STIs and HIV transmission and acquisition, infections such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) remain widely undiagnosed. Syndromic STI management is the standard of care in low- and middle-income countries (LMICs) despite a high prevalence of asymptomatic infections. We conducted an observational study to explore the acceptability, feasibility, and cost of a STI test-and-treat service for YP in Cape Town.MethodsYP attending a mobile clinic (MC) and a youth centre clinic (YC) were offered STI screening. Urine testing for CT and NG using a 90-min molecular point-of-care (POC) test on the GeneXpert platform was conducted and treatment provided. Data were collated on demographics, sexual behaviour, presence of symptoms, uptake of same-day treatment, prevalence of CT/NG, and service acceptability.ResultsThree hundred sixty six participants were enrolled (median age 20, 83% female).57% (209/366) of participants tested positive for either CT (126/366, 34%) or NG (57/366, 16%) or co-infection (26/366, 7%).Clinical symptoms were a poor predictor of GeneXpert diagnosed CT or NG, with a sensitivity of 46.8% and 54.0% for CT and NG respectively. Although half of participants initially chose to receive same day results and treatment, only a third waited for results on the day. The majority of participants (91%) rated the service highly via a post-visit acceptability questionnaire.ConclusionCurable STIs are highly prevalent in this population. STI screening using POC testing was feasible and acceptability was high. The study provides further impetus for moving policy beyond syndromic management of STIs in South Africa.

Serological and Molecular Epidemiology of Chikungunya Virus Infection in Vietnam, 2017-2019.

Chikungunya fever is an acute febrile illness caused by the chikungunya virus (CHIKV), which is transmitted by Aedes mosquitoes. Since 1965, only a few studies with limited scope have been conducted on CHIKV in Vietnam. Thus, this study aimed to determine the seroprevalence and molecular epidemiology of CHIKV infection among febrile patients in Vietnam from 2017 to 2019. A total of 1063 serum samples from 31 provinces were collected and tested for anti-CHIKV IgM and IgG ELISA. The 50% focus reduction neutralization test (FRNT50) was used to confirm CHIKV-neutralizing antibodies. Quantitative real-time RT-PCR (RT-qPCR) was performed to confirm the presence of the CHIKV genome. The results showed that 15.9% (169/1063) of the patients had anti-CHIKV IgM antibodies, 20.1% (214/1063) had anti-CHIKV IgG antibodies, 10.4% (111/1063) had CHIKV-neutralizing antibodies, and 27.7% (130/469) of the samples were positive in RT-qPCR analysis. The E1 CHIKV genome sequences were detected among the positive RT-qPCR samples. Our identified sequences belonged to the East/Central/South/African (ECSA) genotype, which has been prevalent in Vietnam previously, suggesting CHIKV has been maintained and is endemic in Vietnam. This study demonstrates a high prevalence of CHIKV infection in Vietnam and calls for an annual surveillance program to understand its impact.

Epidemiological features of Leishmania infantum in dogs (Canis lupus familiaris) suggest a latent risk of visceral leishmaniasis in the metropolitan area of Bucaramanga, Santander, Eastern Colombia.

Visceral leishmaniasis (VL) is a disease caused by species of the Leishmania donovani complex that is mainly transmitted through the urban cycle involving dogs as the primary reservoir. In Colombia, the incidence of VL is increasing, along with the spread of potential vectors. This study aims to investigate the eco-epidemiological factors associated with Leishmania spp. infection in dogs from the Metropolitan Area of Bucaramanga (MAB), Santander, eastern Colombia, which is a region at risk for VL. We conducted molecular and serological surveillance of Leishmania spp. in 207 dogs from MAB to determine the epidemiological factors associated with infection. Subsequently, we carried out a molecular and serological analysis of phlebotomine and humans, respectively, in areas with a higher prevalence of infection, aiming to describe the main features associated with the transmission cycle. Out of the 207 dogs tested, 37 (17.8%, 95% CI=12.6-23.1%) were positive for the presence of Leishmania antibodies by the IFAT test, and only 9 (4.3%, 95% CI=1.55-7.15%) were positive for L. infantum by PCR. Multivariate analyses indicated that canine shelters and dogs with clinical signs commonly associated with canine VL had a higher prevalence of infection (P<0.05). In the entomological survey, 69 blood-fed female phlebotomine of the genus Lutzomyia were captured in canine shelters, among them, 55% were identified as Lutzomyia camposi, 29% as Lu. ovallesi, 7% as Lu. dubitans, 6% as Lu. torvida, and 3% as Lu. cayennensis. The identified meal sources of the phlebotomine included human, pig, avian, cattle, and porcupine (Coendou quichua) blood. However, no phlebotomine positive for Leishmania spp. were detected by molecular analyses. Finally, 14 humans who had frequent contact with L. infantum-positive dogs were analyzed through rK39 test, but none tested was positive for IgG/IgM antibodies. The molecular and serological analyses indicate the circulation of L. infantum in dogs from MAB, with canine shelters having the highest prevalence of infection. The entomological survey of canine shelters showed a significant diversity of phlebotomine without potential vectors of L. infantum, suggesting the presence of infection in dogs from these areas could take place in other locations or through other transmission routes. The circulation of L. infantum in multiple dogs from MAB suggests a latent risk of zoonotic transmission of VL in these cities.

Molecular prevalence of Sarcocystis spp. and Toxoplasma gondii in slaughtered equids in Northern Tunisia.

Sarcocystis spp. and Toxoplasma gondii are two apicomplexan protozoa that infect a broad range of vertebrates, however, little is known about the infection of equids with these parasites. A total of 184 slaughtered equids from slaughterhouses of Bizerte and Tunis located in Northern Tunisia, were examined for meat infections with Sarcocystis spp. and T. gondii by PCR. The prevalence of infections with Sarcocystis spp. and T. gondii were 38% (95% CI: 31-45) and 39.7% (95% CI: 32.6-46.7), respectively. The highest prevalence of infection with Sarcocystis spp. was observed in donkeys (48.6%; 95%CI: 37.3-60) followed by mules (32.8%; 95%CI: 21.3-44.3), and horses (28.3%; 95%CI: 15.2-41.2) (p = 0.04). Similarly, the highest prevalence of infection with T. gondii was also observed in donkeys (66.2%; 95%CI: 55.4-77), followed by mules (18.7%; 95%CI: 9.2-28.3), and horses (26.1%; 95%CI: 13.4-38.8) (p<0.001). The co-infection prevalence was estimated to 17.4% (95%CI: 11.9-22.9). Taking into consideration that humans can be infected following consumption of infected equid meat with T. gondii and/or some Sarcocystis species, it is importance to assess the risk of human infection. Thus, further studies are needed to better understand the epidemiology of these zoonoses.

High Prevalence of Gram-Negative Infections in Intensive Care Units Across Jordan

High Prevalence of Gram-Negative Infections in Intensive Care Units Across Jordan

The Prevalence of Trichuriasis in School-age Children in Asia: A Systematic Review

Introduction: Trichuris trichiura, hookworms, and Ascaris lumbricoides are known as soil-transmitted helminths that commonly infect humans. Transmission is more common in areas with poor personal hygiene and environmental sanitation. Objectives: The aim of this study was to determine available information on the prevalence of T. trichiura infection in school-age children in Asia. This information can be used for additional studies to evaluate the prevalence and risk factors for T. trichiura infection locally that can inform regional control programs and look at laboratory examination techniques to diagnose this parasite disease. Methods: Multiple databases (Web of Science, PubMed, ProQuest, Scopus, and Google Scholar) were searched for literature on the trichuriasis prevalence published from 2011 to January 2021. Results: A total of 13,836 studies were identified through database searches. The included studies represent 16 countries, with the highest number of study conducted in Yemen. Conclusions: The prevalence of trichuriasis in school-age children was found to vary widely by country. The Kato-Katz technique was commonly used to detect T. trichiura eggs in school-age children in Asia. Health sector should implement surveillance programs, particularly in countries with high infection prevalence. Educational programs aimed at improving personal hygiene and environmental sanitation to decrease trichuriasis transmission.

Prevalence and risk factors of M tuberculosis infection in young people across 14 communities in Zambia and South Africa.

From 2018-2021 the TB Reduction through Expanded Antiretroviral Treatment and TB Screening (TREATS) project took place in 21 Zambian and South African communities. The TREATS Incidence of TB Infection Cohort Study was conducted in adolescents and young people (AYP), aged 15-24 years in 14 communities. We describe the baseline prevalence and risk factors of Mycobacterium tuberculosis (M. tuberculosis) infection among this cohort and explore the quantitative QFT-Plus interferon gamma (IFN-γ) responses. A random sample of approximately 300 AYP per community were recruited and information on TB/HIV risk factors, TB symptoms and social mixing patterns collected. QuantiFERON TB Gold Plus assay (QFT-Plus) was used to detect M. tuberculosis infection, following manufacturer's instructions. Logistic regression was used to determine factors associated with infection. 5577 eligible AYP were invited to participate across both countries, with 4648 enrolled. QFT-Plus results were available for 4529: 2552(Zambia) and 1977(South Africa). Overall, 47.6% (2156/4529) AYP had positive QFT-Plus results, the prevalence of infection in South Africa being twice that in Zambia (64.7% (1280/1977) vs 34.3% (867/2552) p<0.001). Infection was associated with age, household contact with TB and alcohol in Zambia but showed no associations in South Africa. The antigen tube differential (TB2-TB1>0.6 IU/ml) of the assay at baseline showed no evidence of association with recent TB exposure. The high prevalence of infection in AYP warrants urgent action to address TB control, especially in South Africa. Further research is required to delineate antigen tube responses of the QFT-Plus assay more precisely to fully realise the benefit of the additional TB2 tube in high TB/HIV burden settings.

Epizootological monitoring studies of chicken heterakosis spreading on the territory of Poltava region

Poultry breeding is one of the most promising branches of agriculture. Serious losses to this industry are caused by invasion diseases, including chicken heterakosis, which is widespread throughout the world. Heterakises cause pathological changes in the caecum, where various forms of typhlitises and enterohepatitises develop, and at high prevalence of infection, especially in young animals, lead to their death. The causative agent of the disease, Heterakis gallinarum nematode, is a parasitic organism environmentally adapted to the climatic conditions of many geograph-ical zones, which contributes to its wide spreading. The purpose of the research was to investigate chicken heterakosis spreading based on the results of analyzing the reporting documentation of the State Food and Consumer Service in Poltava region during 2018–2023. The conducted monitoring studies have established that in the condi-tions of the investigated region, the share of heterakosis among contagious poultry diseases makes 7.62 %. Infective poultry diseases account for 8.57 %. At the same time, the share of invasion diseases among poultry virulent pathology reaches 83.81 %. The share of heterakosis among poultry invasion diseases was at the level of 8.33 %, where the share of protozoases was the largest (67.71 %). Nematodoses accounted for a smaller share (18.75 %). Cestodiases were most rarely detected in poultry (5.21 %). Among the protozoan, nematodous and cestodous poultry diseases on the territory of Poltava region, eimeriosis made the largest percentage (67.71 %). Among nematodoses, the share of ascariasis was 16.67 %, capillariasis – 2.08 %. Among cestodoses, drepanidoteniosis was detected, the share of which made 5.21 %. Analyzing the indicators of the prevalence of heterakosis infection found on the territory of poultry farms in Poltava region, it was found that chickens’ infestation rate with heterakosis pathogen ranged from 0.06 to 0.19 % with an average value of 0.1 %. The highest indicators of the prevalence of heterakosis infection were detected in 2019–0.19 %. During 2020–2022, the infestation rates of poultry with heterakises gradually decreased from 0.12 to 0.06 %. The results of monitoring studies point to the relevance of further investigating the epizootological peculiarities of chicken heterakosis on the territory of certain regions of Ukraine.

Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes.

Trafficking and exploitation for sex or labor affects millions of persons worldwide. To improve healthcare for these patients, in late 2018 new ICD-10 medical diagnosis codes were implemented in the US. These 13 codes include diagnosis of adult and child sexual exploitation, adult and child labor exploitation, and history of exploitation. Here we report on a database search of a large US health insurer that contained approximately 47.1 million patients and 0.9 million provider organizations, not limited to large medical systems. We reported on any diagnosis with the new codes between 2018-09-01 and 2022-09-01. The dataset was found to contain 5,262 instances of the ICD-10 codes. Regression analysis of the codes found a 5.8% increase in the uptake of these codes per year, representing a decline relative to 6.7% annual increase in the data. The codes were used by 1,810 different providers (0.19% of total) for 2,793 patients. Of the patients, 1,248 were recently trafficked, while the remainder had a personal history of exploitation. Of the recent cases, 86% experienced sexual exploitation, 14% labor exploitation and 0.8% both types. These patients were predominantly female (83%) with a median age of 20 (interquartile range: 15-35). The patients were characterized by persistently high prevalence of mental health conditions (including anxiety: 21%, post-traumatic stress disorder: 20%, major depression: 18%), sexually-transmitted infections, and high utilization of the emergency department (ED). The patients' first report of trafficking occurred most often outside of a hospital or emergency setting (55%), primarily during office and psychiatric visits.

High seroprevalence of antibodies against arboviruses in postpartum women in Salvador, Brazil

ObjectivesArboviruses represent a major challenge to public health in Brazil. Dengue (DENV) virus has been endemic for decades, and the introduction of Zika (2015) and Chikungunya (2014) viruses (CHIKV) has imposed a significant burden on the country. The present study aimed to investigate the seroprevalence of Zika virus (ZIKV), DENV and CHIKV in women in Salvador, Bahia-Brazil. MethodsCross-sectional study involving postpartum women admitted to a maternity hospital in Salvador, Brazil. Anti-ZIKV, anti-DENV and anti-CHIKV immunoglobulin G was measured by enzyme-linked immunosorbent assay. ResultsA total of 302 women were enrolled with a median age: 26 years, interquartile range (21-33). Most self-declared as mixed-race or black skin color (92.4%). The seroprevalence was 57% for ZIKV); 91.4% for DENV, and 7.6% for CHIKV. Most participants denied awareness of previous arboviral infection, although 67 (22.3%) reported a previous history of ZIKV infection, 34 (11.1%) DENV infection and 9 (3%) CHIKV infection. ConclusionOur data indicate a high prevalence of past ZIKV and DENV infections in the population studied. Most of the participants remain susceptible to future CHIKV infection, highlighting the need for preventive and educational interventions. Our results suggest the need for continuous epidemiological surveillance of arboviral diseases, particularly among women residing in at-risk regions.

Molecular and morphological studies on Contracaecum rudolphii A and C. rudolphii B in great cormorants (Phalacrocorax carbo sinensis) from Italy and Israel.

The distribution of parasites is shaped by a variety of factors, among which are the migratory movements of their hosts. Israel has a unique position to migratory routes of several bird species leaving Europe to winter in Africa, however, detailed studies on the parasite fauna of birds from this area are scarce. Our study investigates occurrence and distribution of sibling species among Contracaecum rudolphii complex in Phalacrocorax carbo sinensis from Italy and Israel, to acquire further information on the geographical range of these species to gain deeper knowledge on the ecology of these parasites and their bird host. A total of 2383 Contracaecum were collected from the gastric mucosa of 28 great cormorants (18 from Israel and 10 from Italy). A subsample was processed for morphological analyses in light and scanning electron microscopy (SEM), and for molecular analyses through amplification and sequencing of the ITS rDNA and the cox2 mtDNA, and through PCR-RFLP. All the 683 Contracaecum subjected to molecular identification belonged to C. rudolphii s.l., (300 C. rudolphii A and 383 C. rudolphii B). SEM micrographs provided, for the first time, details of taxonomic structures in male specimens from both sibling species, and the first SEM characterization of C. rudolphii B. This work presents the first data on the occurrence of sibling species of C. rudolphii in Israel and provides additional information on the distribution of C. rudolphii A and B in Italy, confirming the high prevalence and intensity of infection observed in Ph. carbo sinensis from other Italian areas.

Non-Mycobacteria Tuberculosis in Africa: A Literature Review.

Non-tuberculous mycobacteria (NTM) have been reported to cause pulmonary and extrapulmonary infections. These NTMs are often misdiagnosed as MTB due to their similar clinical presentations to tuberculosis, leading to inappropriate treatment and increased morbidity and mortality rates. This literature review aims to provide an overview of the prevalence, clinical manifestations, diagnosis, and management of NTM infections in Africa. A systematic search was performed using various electronic databases including PubMed, Scopus, and Web of Science. The search was limited to studies published in the English language from 2000 to 2021. The following keywords were used: "non-tuberculous mycobacteria", "NTM", "Africa", and "prevalence". Studies that focused solely on the Mycobacterium tuberculosis complex or those that did not report prevalence rates were excluded. Data extraction was performed on eligible studies. Overall, a total of 32 studies met the inclusion criteria and were included in this review. In our literature review, we identified a total of 32 studies that reported non-tuberculosis mycobacteria (NTM) in Africa. The majority of these studies were conducted in South Africa, followed by Ethiopia and Nigeria. The most commonly isolated NTM species were Mycobacterium avium complex (MAC), Mycobacterium fortuitum, and Mycobacterium abscessus. Many of the studies reported a high prevalence of NTM infections among HIV-positive individuals. Other risk factors for NTM infection included advanced age, chronic lung disease, and previous tuberculosis infection. In conclusion, this literature review highlights the significant burden of non-tuberculosis mycobacteria infections in Africa. The prevalence of these infections is high, and they are often misdiagnosed due to their similarity to tuberculosis. The lack of awareness and diagnostic tools for non-tuberculosis mycobacteria infections in Africa is a major concern that needs to be addressed urgently. It is crucial to improve laboratory capacity and develop appropriate diagnostic algorithms for these infections.

Anal cancer screening results from 18-to-34-year-old men who have sex with men living with HIV.

Men who have sex with men living with HIV (MSM LWH) are at highest risk for human papillomavirus (HPV)-associated anal cancer. There is no consensus on the optimal screening initiation age. This study aimed to assess the prevalence and severity of anal HPV disease among MSM LWH under the age of 35, which is a currently proposed screening age threshold. Between 2014 and 2020, 1255 18-to-34-year-old MSM LWH underwent anal cytology screening. 916 were co-tested for high-risk HPV (HR-HPV). 467 underwent high-resolution anoscopy (HRA) and biopsy. Cancer registry data were queried. Predictors of abnormal cytology (ie, ≥ASCUS) and histological high-grade squamous intraepithelial lesions (HSIL) were evaluated using unadjusted logistic regression models. Median age was 28 years (range, 18-34). 19% received at least one dose of HPV vaccine. Abnormal cytology rate was 65%. HR-HPV and HPV16 prevalence were 87% and 30%. Biopsy results were benign (10%), LSIL (43%) and HSIL (47%). No cases of prevalent or incident anal cancers were detected. Findings were similar between age subgroups (18-24, 25-29 and 30-34) except for a higher prevalence of AIN 3 in the 30-34 group (19%). Abnormal cytology was significantly associated with HR-HPV infection. Histological HSIL was associated with HR-HPV infection and cytological LSIL or worse. The absence of anal cancer in a large cohort of MSM LWH under the age of 35, despite high prevalence of anal HR-HPV infection and precancer, supports an age-based anal cancer screening strategy for MSM LWH.

Molecular and Metagenomic Analyses Reveal High Prevalence and Complexity of Viral Infections in French-American Hybrids and North American Grapes.

French-American hybrids and North American grape species play a significant role in Canada's grape and wine industry. Unfortunately, the occurrence of viruses and viral diseases among these locally important non-vinifera grapes remains understudied. We report here the results from a large-scale survey to assess the prevalence of 14 viruses among 533 composite samples representing 2665 vines from seven French-American hybrid wine grape cultivars, two North American juice grape cultivars (Concord and Niagara), and the table grape cultivar Sovereign coronation. Based on reverse transcription polymerase chain reaction (RT-PCR) assays, ten viruses were detected. Grapevine rupestris stem pitting-associated virus, grapevine leafroll-associated virus 3, grapevine Pinot gris virus and grapevine red blotch virus were detected with the highest frequency. As expected, mixed infections were common; 62% of the samples contained two or more viruses. Overall, hybrid wine grapes were infected with more viruses and a higher prevalence of individual viruses than juice and table grapes. To validate these findings and to refine the virome of these non-European grapes, high-throughput sequencing (HTS) analyses of five composite samples representing each category of grapevine cultivars was performed. Results from HTS agreed with those from RT-PCR. Importantly, Vidal, a widely grown white-wine grape with international recognition due to its use in the award-winning icewine, is host to 14 viruses, four of which comprise multiple and distinct genetic variants. This comprehensive survey represents the most extensive examination of viruses among French-American hybrids and North American grapes to date.

Impact of bronchoalveolar lavage on the management of immunocompromised hosts

BackgroundRespiratory infections are an important cause of morbidity and mortality in immunocompromised individuals. Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) is an important tool to detect infectious agents in immunocompromised patients with low respiratory tract infections (LRTI). Research QuestionBAL changes the management of immunocompromised patients with suspected LRTI. Study Design and MethodsImmunocompromised patients with a suspicion of LRTI underwent diagnostic BAL. The primary composite outcome consisted of pre-defined modifications in the management of the immunocompromised patients following BAL. We quantified the impact of bronchoscopy up to 30 days after the procedure. ResultsA total of 2666 visits from 1301 patients were included in the study and immunosuppression was classified as haematological (n = 1040; 544 patients), solid organ transplantation (n = 666; 107 patients) and other causes (n = 960; 650 patients). BAL led to a change in management in 52.36% (n = 1396) of all cases. This percentage, as well as the 30-day mortality differed significantly amongst the three groups. Age, C-reactive protein and aetiology of infection determined significantly the risk of 30-day mortality in all patients. In 1.89% (n = 50) of all cases, a combination of 2 respiratory viral agents was identified and 24.23% (n = 646) were diagnosed with a single respiratory viral agent. InterpretationBAL leads to changes in management in the majority of immunosuppressed patients. There is a high prevalence of multimicrobial infections and respiratory viral infections in immunocompromised patients with respiratory symptoms. Individual virus infection is associated with diverse risk of a negative outcome.