High Infection Research Articles

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.

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 >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 >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.

Comparative safety outcomes of leadless versus transvenous cardiac pacemaker: a systematic review and meta-analysis

Abstract Introduction Leadless Cardiac Pacemakers (LCP) have emerged as a promising alternative to Transvenous Pacemakers (TVP) for managing bradyarrhythmias, especially in cases where TVP options are limited, such as venous access issues in haemodialysis patients or high infection risk individuals. However, long-term safety data, including mortality and hospitalisation rates, are lacking, hindering informed clinical adoption decisions. Purpose This systematic review and meta-analysis compares safety endpoints of LCP with TVP. Methods A systematic search of PubMed, Medline, Embase, Scopus, Web of Sciences, and gray literature was conducted following PRISMA guidelines from release of the Micra LCP to market until May 15, 2023. Meta-analysis was performed using RevMan 5.4. Results Twenty-four studies including data from 33,450 patients (12,802 LCP, 20,648 TVP) were evaluated. The mean age of the population was 77.5 ± 10.6 years, with a mean left ventricular ejection fraction (LVEF) of 58.6 % ± 6.7. Follow-up durations ranged from 6 to 36 months. Compared to TVP, the LCP was associated with significantly fewer overall complications, major complications, acute, mid-term complications, hospitalisations, re-interventions, and device dislodgements (p<0.05). Mortality, tricuspid regurgitation, pacemaker-induced cardiomyopathy, and heart failure hospitalisation rates did not significantly differ. Although LCP showed higher cardiac injury risk, no significant difference in cardiac tamponade rates was observed (Figure 2). LCP exhibited increased vascular-related complications but decreased lung injury, endocarditis, device, and pocket-related issues. Conclusion In the largest review of LCPs, we report that LCP is associated with significantly lower rates of overall complications compared to conventional TVP. This knowledge is critically important as more LCPs enter clinical practice and serves as a baseline against which future data can be evaluated. Nevertheless, proper skill training may help to mitigate the risk of vascular and cardiac injury. These findings underscore the importance of conducting randomized controlled trials to comprehensively evaluate the safety of LCP compared to TVP.Cardiac complication

Knowledge, Attitude and Practice of Nurses and Midwives towards Hepatitis B Infection and Control Measures in Alban Gaded Hospital, Khartoum, Sudan

Purpose: Infection with the hepatitis B virus (HBV) causes severe morbidity and death, burdening world health. Nurses and midwives, among other healthcare professionals, are more likely to contract the illness. Few studies have looked at the knowledge, attitude, and practices (KAP) of healthcare professionals in Sudan with regard to HBV infection, despite the fact that diverse components of KAP have an impact on health-related behaviors. This study's objective was to assess the knowledge, attitude, and practice (KAP) level of nurses and midwives concerning HBV viral infection in, Khartoum, Sudan.  Methods: In the Sudanese state of Khartoum, a public hospital (Alban Gaded Hospital) underwent a cross-sectional descriptive hospital-based study. To assess KAP's understanding of nurses and midwives about HBV infection. Self-administered questionnaires were used and approved by the supervisor for distribution to the population chosen for the study. The data was handed over to the Medical Director whom personally ensured the questionnaires were signed and filled by the Healthcare workers (HCWs) of the chosen criteria at the field. A member of group (23:B) took care of the supervision aside with the medical director, and made sure the data was collected as needed. The data at hand were subjected to statistical analysis using SPSS version 24.0 (Statistical Package for Social Sciences).  Results: 95 samples out of 99 were collected. According to participants’ knowledge: 67.95% have good knowledge about HBV, while 32.05% lack basic knowledge about it. The participants’ attitude towards HBV is above average showing 60.3% safe attitude. Lastly, the study shows excellent practice of the participants’ behavior towards HBV safety measures with a score of 92.3% safe practice. From the hospital, a total of 95 out of 99 nurses and midwives took part in the study. Two thirds of the respondents practiced safety, and the majority of respondents had a positive attitude about HBV preventative measures. More than half of the respondents (58.2%) had an average level of understanding. A minor but serious score of (12.6%) was noticed of the individuals, dealing with patients without wearing gloves. More over half of the nurses and midwives were not vaccinated against HBV; more than 50% of participants had incorrect ideas regarding the symptoms and route of HBV infection and all 95 participants voted (NO) for ever being infected by HBV.  Conclusion: In Alban Gaded hospital, the majority of the nurses and midwives were aware of HBV infection. But a sizeable majority of the participants lacked the necessary understanding of early immunization after birth. The study found a probability of high risk infection due to exposure under the poor level of HBV vaccine coverage rate. Moreover a clear point of limitation was noticed in Table 4 third question, where it asks whether you are or ever was infected by HBV. All the participants denied, showing a sense of partiality. Further occupational exposure prevention measures, training programs on HBV infection, including post-exposure prophylaxis, and increasing the vaccination rate of all HCWS are also strongly encouraged.

First report of potato pink rot caused by Phytophthora erythroseptica in Colorado.

Pink rot, caused by the oomycete Phytophthora erythroseptica, is a serious disease that may cause substantial losses to potato growers. In 2023, high infection rates of pink rot were noticed in the San Luis Valley (SLV), Colorado around harvest time and in storage with several growers losing complete storage pins to pink rot. In September 2023, tubers with pink rot symptoms were collected from two grower fields of Russet Norkotah (~2-3% infection) and Canela Russet (~5% infection) near the San Luis Valley Research Center at harvest time. Infected tubers showed dark discoloration on the surface at the stem end. Upon cutting, affected tissue developed salmon pink color about 20-30 min later (Fig. 1). DNA was extracted from two symptomatic tubers from each cultivar and healthy tubers using DNeasy PowerSoil Pro Kit (Qiagen, MD, USA) according to the manufacturer's instructions. The conventional PCR and qPCR assays developed by Cullen et al. (2007) were used to detect P. erythroseptica. In the conventional PCR, the primer pair Pery2F1/R1 produced expected bands of 135bp from symptomatic tubers but not from the healthy tubers. The symptomatic tubers were positive in the qPCR using the primer-probe set 99F, 177R, and 133T (Cullen et al., 2007). P. erythroseptica was isolated by culturing specimens of infected tissues on PARP selective media (Jeffers and Martin, 1986). A week later colonies of white color grew on the media. These colonies were confirmed to be of P. erythroseptica by PCR as mentioned above. The colonies of two isolates were transferred to water agar media, then three days later a mycelium tip was excised and cultured on PDA media for single isolation. On PDA media the colonies showed chrysanthemum pattern. Four days later DNA was extracted from the two isolates, RN296-1 and Canela-2, and tested positive for P. erythroseptica by the above-mentioned PCR. PDA agar plugs of two isolates were used to inoculate surface sterilized potato tubers. The isolate SLV-2023-Canela2 was inoculated on tubers of Russet Norkotah and Reveille Russet, 10 each, while10 tubers of Russet Norkotah were inoculated with the isolate SLV-2023-RN296-1. Ten tubers of Russet Norkotah were inoculated by sterilized plugs of PDA for negative controls. Tubers were left at room temperature for a week. All tubers of Russet Norkotah inoculated with SLV-2023-Canela2 and RN296-4 developed pink rot symptoms and tested positive for P. erythroseptica by PCR, while only 9 tubers of Reveille Russet inoculated with SLV-2023-Canela2 developed symptoms and were positive to P. erythroseptica by PCR. No symptoms were observed on the mock inoculated tubers and no P. erythroseptica was detected by the PCR. P. erythroseptica was isolated again from Russet Norkotah tubers inoculated with RN296-1 on PDA media and tested positive for P. erythroseptica by PCR one week later. To further confirm the identity, the ITS region was amplified using the primers ITS-1 and ITS-4 (White et al., 1990) from DNA extracted from inoculated Russet Norkotah tubers with SLV-2023-Canela2 isolate. PCR product was purified using QIAquick Gel Extraction Kit (Qiagen, MD, USA)and cloned using TOPO TA Cloning Kit for Sequencing (Invitrogen, MD, USA). Four clones were submitted for sequencing. The 846 nt sequence of the ITS was submitted to the GenBank (accession number PP587391) shared 99.76% identity with the P. erythroseptica strain BBA 62683 (KJ755119). P. erythroseptica was identified previously using morphological tools from tubers with symptoms resembling pink rot collected in the SLV (Tyler et al., 2002). However, in that report neither Koch's Postulates, nor molecular identification were conducted, hence, the current study presents the first molecular report of pink rot in the SLV, Colorado. Rapidly changing climate and increased temperature around harvest time may lead to an increase in the incidence of pink rot, hence effective management strategies need to be developed and implemented.

Synthesis and characterization of silver nanoparticles and their promising antimicrobial effects

Silver nanoparticles have garnered significant interest due to their unique properties, such as small size, high specific surface area, and high reactivity, making them valuable in various industries, including medicine, healthcare, consumer products, and food. The synthesis of silver nanoparticles has been extensively studied, with numerous methods reported, including physical, chemical, and biological routes. These synthesis methods can influence the antibacterial properties of silver nanoparticles, which is critical in hospital settings where pathogen exposure and antibiotic resistance are prevalent concerns. Notably, hospital environments face high infection risks from pathogens like Staphylococcus aureus and Pseudomonas aeruginosa, necessitating new antibacterial agents. This study aims to evaluate the antibacterial effects of synthesized silver nanoparticles against the pathogenic microorganisms S. aureus, P. aeruginosa, and Escherichia coli. The Silver nanoparticles were characterized using UV–vis spectroscopy, Dynamic Light Scattering (DLS), Field Emission Scanning Electron Microscopy (FESEM), and Transmission Electron Microscopy (TEM). The nanoparticles had an average size of 52 nm and exhibited an absorption peak at 430 nm. Both S. aureus and P. aeruginosa demonstrated zones of inhibition when exposed to the silver nanoparticles, indicating their potent antibacterial activity. This study highlights the potential of silver nanoparticles as effective antibacterial agents in the healthcare industry, particularly in combating hospital-acquired infections.

Impacts of testing and immunity acquired through vaccination and infection on covid-19 cases in Massachusetts elementary and secondary students

BackgroundDuring the 2021–22 academic year, Massachusetts supported several in-school testing programs to facilitate in-person learning. Additionally, COVID-19 vaccines became available to all school-aged children and many were infected with SARS-CoV-2. There are limited studies evaluating the impacts of these testing programs on SARS-CoV-2 cases in elementary and secondary school settings. The aim of this state-wide, retrospective cohort study was to assess the impact of testing programs and immunity on SARS-CoV-2 case rates in elementary and secondary students.MethodsCommunity-level vaccination and cumulative incidence rates were combined with data about participation in and results of in-school testing programs (test-to-stay, pooled surveillance testing). School-level impacts of surveillance testing programs on SARS-CoV-2 cases in students were estimated using generalized estimating equations within a target trial emulation approach stratified by school type (elementary/middle/high). Impacts of immunity and vaccination were estimated using random effects linear regression.ResultsHere we show that among N = 652,353 students at 2141 schools participating in in-school testing programs, surveillance testing is associated with a small but measurable decrease in in-school positivity rates. During delta, pooled testing positivity rates are higher in communities with higher cumulative incidence of infection. During omicron, when immunity from prior infection became more prevalent, the effect reversed, such that communities with lower burden of infection during the earlier phases of the pandemic had higher infection rates.ConclusionsTesting programs are an effective strategy for supporting in-person learning. Fluctuating levels of immunity acquired via natural infection or vaccination are a major determinant of SARS-CoV-2 cases in schools.

Wireless, Programmable, and Refillable Hydrogel Bioelectronics for Enhanced Diabetic Wound Healing.

Diabetic wounds, characterized by complex pathogenesis and high infection rates, pose significant challenges in treatment due to prolonged recovery times and high recurrence rates, often leading to severe complications such as amputation and death. Traditional dry dressing treatments fail to address the unique microenvironment of diabetic wounds and tend to cause secondary damage due to frequent replacement. In this study, an electronic-embedding, drug-loading hydrogel bioelectronics is reported for accelerating diabetic wound healing using a combination of programmable pharmaceutical and electrostimulative approaches. Encapsulated in stretchable and biocompatible materials, this device is capable of multiple drug refilling and accelerated drug release modulated by on-board electronics. In vivo experiments on diabetic model rats confirm the device's effectiveness in promoting wound healing. This innovative approach implies the potential for improving diabetic wound management using a combination of physical, material, and pharmaceutical interventions.

Influenza Virus Genomic Mutations, Host Barrier and Cross-Species Transmission

Abstract: Influenza is a global epidemic infectious disease that causes a significant number of illnesses and deaths annually. Influenza exhibits high variability and infectivity, constantly jumping from birds to mammals. Genomic mutations of the influenza virus are a central mechanism leading to viral variation and antigenic evolution. These are crucial in facilitating the virus to cross species barriers and cause human infection. This review summarizes the types of genomic mutations in the influenza virus, their roles and mechanisms in crossing species barriers, and analyzes the impact of these mutations on human health.

Lineage-specific pathogenicity, immune evasion, and virological features of SARS-CoV-2 BA.2.86/JN.1 and EG.5.1/HK.3.

SARS-CoV-2 JN.1 with an additional L455S mutation on spike when compared with its parental variant BA.2.86 has outcompeted all earlier variants to become the dominant circulating variant. Recent studies investigated the immune resistance of SARS-CoV-2 JN.1 but additional factors are speculated to contribute to its global dominance, which remain elusive until today. Here, we find that SARS-CoV-2 JN.1 has a higher infectivity than BA.2.86 in differentiated primary human nasal epithelial cells (hNECs). Mechanistically, we demonstrate that the gained infectivity of SARS-CoV-2 JN.1 over BA.2.86 associates with increased entry efficiency conferred by L455S and better spike cleavage in hNECs. Structurally, S455 altered the mode of binding of JN.1 spike protein to ACE2 when compared to BA.2.86 spike at ACE2H34, and modified the internal structure of JN.1 spike protein by increasing the number of hydrogen bonds with neighboring residues. These findings indicate that a single mutation (L455S) enhances virus entry in hNECs and increases immune evasiveness, which contribute to the robust transmissibility of SARS-CoV-2 JN.1. We further evaluate the in vitro and in vivo virological characteristics between SARS-CoV-2 BA.2.86/JN.1 and EG.5.1/HK.3, and identify key lineage-specific features of the two Omicron sublineages that contribute to our understanding on Omicron antigenicity, transmissibility, and pathogenicity.

Mapping the Mpox discourse: A network and sentiment analysis

Mpox, a zoonotic disease re-emerging from animals to humans, poses a risk of evolving into a global pandemic due to its high infectivity and potential asymptomatic transmission. This study maps the structure and configuration of mpox-related discussions on Twitter/X, identifies key influencers and top hashtags, and analyzes public sentiment. Data were collected using NodeXL Pro from May 7, 2022, to January 15, 2023, with the keyword “Monkeypox” and visualized using Gephi. Social network analysis ranked nodes by betweenness centrality scores to highlight key communicators, and the YifanHu layout algorithm visualized the network. Influential users, source topics, and hashtags were identified, and sentiment analysis was conducted using Azure Machine Learning tools. The analysis identified 11,397 mpox-related tweets. The network structure resembled a community with diverse participants. Influential users included health and science journalists, writers, academics, medical doctors, and public figures. News media and organizational websites were the top information sources, emphasizing the need for accessible scientific information. “Monkeypox” and “Mpox” were the most prevalent hashtags. Negative sentiments dominated the discussion. This analysis provides insights into network structure, key influencers, information sources, and public sentiment, aiding tailored health initiatives to address misinformation and advocate valid health information and emergency responses.

Can the infection risk in elevators be negligible? A comparative study of airborne infection probability in elevators and conference rooms

People in crowded and poorly ventilated elevators are at risk of respiratory infection. However, due to the short duration of the elevator ride, the transmission of respiratory diseases in elevators does not get enough attention. To evaluate the infection risk, this study investigated the airborne transmission of respiratory diseases in the hospital elevator by comparison to the conference room. A validated computational fluid dynamics (CFD) model was adopted to simulate airflow, temperature and tracer gas dispersion in the elevator and conference room. We used Wells-Riley model to evaluate the infection probability of the susceptible persons. In addition, the influences of source patient posture and ventilation strategy on the transmission of tracer gas were analyzed. The results showed that the infection probability in the elevator with 5 min (average 2.70%) was higher than that in the conference room with 50 min (average 1.77%). The effects of source patient posture and ventilation strategy on the infection probability in the elevator were more significant than those in the conference room. Local air circulation could gather the tracer gas inside a confined space in the elevator and led to a high infection probability. The infection risk of respiratory diseases in the elevator was non-negligible.

Potential associations between Schistosoma mansoni infection and physico-chemical characteristics and water-related human activities in Côte d'Ivoire: a cross-sectional study.

Schistosomiasis remains a public health problem, particularly in sub-Saharan Africa. The disease is intimately connected to poverty and environmental factors. Our research was readily embedded into a multi-country schistosomiasis oversampling study. The aim of the study presented here was to determine the prevalence of Schistosoma mansoni and to investigate the role of water body characteristics and water-related human activities in disease transmission. In August and September 2022, a cross-sectional study was conducted in the western part of Côte d'Ivoire. Stool and urine samples were collected from 1602 and 1729 children aged 5-14years, respectively, in 65 villages in the health districts of Biankouma, Ouaninou and Touba. Additionally, data were collected from direct observation of water-related activities at water bodies and interviews conducted with community leaders and health workers. The prevalence and risk factors for Schistosoma infection were assessed using generalised estimating equation models. The prevalence ofS.mansoni and S.haematobium were 27.4% (95% confidence interval [CI] 21.5-34.3%) and 0.1% (95% CI 0.03-0.5%), respectively. Low prevalence of soil-transmitted helminths was observed with 2.4%, 0.4% and 0.2% for hookworm, Trichuris trichiura and Ascaris lumbricoides, respectively. At the health district level, we found S.mansoni prevalence of 34.4% (95% CI 25.0-45.3%), 34.3% (95% CI 24.0-46.2%) and 16.3% (95% CI 9.5-26.6%) for Biankouma, Ouaninou and Touba, respectively. Female and male participants were at a similar risk of infection (29.0% vs. 26.0%, odds ratio [OR]: 1.18, 95% CI 0.92-1.50). Children aged 9-14years showed a higher prevalence than their younger counterparts aged 5-8years (34.5% vs. 22.7%, OR: 1.80, 95% CI 1.42-2.27). High infection prevalence was observed in villages where children were washing clothes and dishes at open surface water sites and pursued recreational activities (e.g. swimming and playing in the water). The temperature, total dissolved solids and pH of water samples showed no significant association with S.mansoni infection at the village unit. Human water-related activities such as washing clothes and playing in the water are risk factors for S.mansoni transmission. Hence, preventive chemotherapy should be combined with information, education and communication to avoid or reduce the frequency of water exposure in children as part of a comprehensive package of interventions towards elimination of schistosomiasis as a public health problem.

Early Fever in Allogeneic Stem Cell Transplantation: Are Presepsin and YKL-40 Valuable Diagnostic Tools?

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a lifesaving treatment but carries a high infection risk. Diagnosing infections remains challenging due to the limited accuracy of standard biomarkers. Methods: This single-center study aimed to evaluate presepsin (PSP) and YKL-40 as infection biomarkers in febrile patients during the allo-HSCT pre-engraftment phase. Biomarker levels were prospectively measured in 61 febrile episodes from 54 allo-HSCT patients at admission, representing baseline levels, and then at Day 1, 3, 5, and 7 following fever onset. The diagnostic value was compared to that of procalcitonin (PCT). Results: PSP showed fair diagnostic value on Day 1 (AUC 0.656; 95% CI: 0.510-0.802) and Day 3 (AUC 0.698; 95% CI: 0.559-0.837). YKL-40 did not provide any significant diagnostic value across measured time points. PCT outperformed PSP and YKL-40, particularly on Day 3 (AUC 0.712; 95% CI: 0.572-0.852). When combining biomarkers, the best model for predicting infection used PSP > 3.144 ng/mL and PCT > 0.28 μg/L on Day 3, resulting in R2 of about 31% (p < 0.001). Conclusions: Neither test showed sufficient discriminative power for early infection to recommend their use as individual diagnostic tools in clinical practice.

Integrating the Transcriptome and Proteome to Postulate That TpiA and Pyk Are Key Enzymes Regulating the Growth of Mycoplasma Bovis.

Mycoplasma bovis is a global problem for the cattle industry due to its high infection rates and associated morbidity, although its pathophysiology is poorly understood. In this study, the M. bovis transcriptome and proteome were analyzed to further investigate the biology of clinical isolates of M. bovis. A differential analysis of M. bovis, a clinical isolate (NX114), and an international type strain (PG45) at the logarithmic stage of growth, was carried out using prokaryotic transcriptome and 4D-label-free quantitative non-labeled proteomics. Transcriptomics and proteomics identified 193 DEGs and 158 DEPs, respectively, with significant differences in 49 proteins/34 transcriptomic CDS post-translational protein sequences (15 jointly up-regulated and 21 jointly down-regulated). GO comments indicate membrane, cytoplasmic and ribosome proteins were important components of the total proteins of M. bovis NX114 clinical isolate. KEGG enrichment revealed that M. bovis NX114 is mainly associated with energy metabolism, the biosynthesis of secondary metabolites, and the ABC transporters system. In addition, we annotated a novel adhesion protein that may be closely related to M. bovis infection. Triosephosphate isomerase (TpiA) and Pyruvate kinase (Pyk) genes may be the key enzymes that regulate the growth and maintenance of M. bovis and are involved in the pathogenic process as virulence factors. The results of the study revealed the biology of different isolates of M. bovis and may provide research ideas for the pathogenic mechanism of M. bovis.

A-261 Outcome of a survey on dengue lateral flow immunoassay test kit reading and interpretation by medical laboratory staff in a hospital laboratory

Abstract Background Lateral flow immunoassay (LFIA) tests, first introduced in 1959, are now the mainstay of clinical laboratories. Khoo Teck Puat Hospital (KTPH) is a 795-bed acute care general hospital located in the north of Singapore. The Department of Laboratory Medicine has been using dengue LFIA test kits for the detection of dengue NS1 antigen, IgM antibodies and IgG antibodies. While kits are cost-effective, user-friendly and provide rapid results, there is subjectivity in reading and interpretation of results. Methods We conducted a survey to assess test reading and interpretation by medical laboratory staff. Six serum and plasma specimens were analysed using Bioline™ Dengue IgG/IgM WB test device. Test kits at the end-point of sample incubation were photographed in both well-lit and dim conditions. A survey questionnaire was prepared using an online form builder tool using the photographs. Staff were invited to participate in the survey. They were allowed to report the result as ‘Positive’, ‘Negative’ or ‘Equivocal’. Results A total of sixteen responses were received. Results were 100% concordant for all 6 specimens in both well-lit and dim conditions. For one case, under a well-lit condition, 15 staff reported the result as ‘Positive’ while one staff reported ‘Equivocal’. Most of the reported results for samples with no consensus is split between ‘Positive’ and ‘Equivocal’. Conclusions Dengue viruses of all 4 known serotypes are endemic in Singapore. Positive results are tracked on a national level to identify areas of high dengue infection for intensive environmental and vector control measures. Hence, accurate reporting and identification of patients with dengue infection is important. Our survey shows that lighting conditions do not affect the interpretation of LFIA results. Reading and interpretation of dengue LFIA test kits however, remain dependent on user interpretation and newer test kits with optical readers may be useful in mitigating this.

Avian malaria in a feral-pet pigeon: a case report

BackgroundAvian malaria is caused by diverse parasite species of the genus Plasmodium, and it affects various bird species. The occurrence of this disease in some wild bird species is sparsely documented due to the scarce availability of samples. Hence the pathogenicity in some hosts is not completely known. In addition, feral birds may act as reservoirs bridging the transmission cycle from wild migratory birds to domestic and zoo-kept bird species.Case presentationAn owner of pigeons adopted a feral pigeon (Columba livia forma domestica) and housed it together with his other pet-pigeons. The bird died unexpectedly a few weeks after a surgical procedure and necropsy revealed a severely anaemic carcass, with pale organs and hydropericardium. Histopathologic analysis revealed inflammatory infiltrates in the lung and liver, and monocytes and Kupffer cells contained haemozoin pigment indicative of phagocytosis of Plasmodium-infected erythrocytes. A high erythrocytic infection rate of 18% was evident in tissues and blood vessels in various organs. Furthermore, the thyroid had masses classified as thyroid carcinomas. Immunohistochemistry with anti- Plasmodium falciparum HSP70 antibody revealed positive signals in erythrocytes and intravascular leucocytes. Further microscopy analysis using a Hemacolor-stained impression smear revealed a high parasitaemia with an asynchronous infection showing all erythrocytic stages. Molecular diagnosis by PCR identified Plasmodium relictum, lineage GRW11 as the aetiological agent. The bird presented died most likely due to an acute infection as evidenced by the high blood parasitaemia, leading to major erythrocyte destruction. Further analyses of feral pigeons (n = 22) did not reveal any additional cases of Plasmodium infections.ConclusionThis study reports the first mortality associated with P. relictum lineage GRW11. The study supports previous studies, suggesting that Plasmodium infections are not frequent in pigeons. Host conditions like immunosuppression due to the tumour may have influenced the infection outcome in this fatal case. Use of anti-P. falciparum HSP70 antibody for detection of P. relictum antigens for immune assays in blood and tissue samples will be a useful tool for future studies.