Implementation Of Control Measures Research Articles

Long term variation of microphysical properties of black carbon in Beijing derived from observation and machine learning

The microphysical attributes of black carbon (BC) can determine its absorption and hygroscopic properties. However, long-term information is difficult to obtain from the field. In this study, the BC properties including mass concentration, the coating volume ratio (VR) relative to the refractory BC (rBC), the rBC diameter and the fraction of cloud condensation nuclei (CCN), are derived from a number of field experiments using a random forest model. This model effectively derives the long-term BC microphysical properties in the Beijing region from 2013 to 2020 using continuous measurements of particulate matter, gas, BC mass concentration and meteorological parameters. The results reveal notably higher BC coatings (mean VR = 7.2) and a greater fraction of CCN-like BC (51%) in the winter compared to other seasons. Following the implementation of national air pollution control measures in 2017, BC mass exhibited a substantial reduction of 60% (29%) in the winter (summer), and VR decreased by 45% (24%). Apart from the influence of meteorological variations, these can be attributed to the declined primary emissions and the gas precursors which are associated with secondary formation of BC coatings. The reduction of both BC mass loading and coatings leads to its solar absorption decreasing by 50%, and the fraction of CCN-like BC (likely in clouds) decreasing by 23%. Environmental regulation will therefore continue to reduce both direct and indirect radiative impacts of BC in this region.

Mathematical Modeling of Infectious Disease and Prey-Predator Interaction with Optimal Control

In this paper, the impact of viral illnesses on the predator-prey relationship with an optimal control analysis is studied. An ecoepidemiological model of four compartments, namely, susceptible prey, susceptible predator, infected prey, and infected predator populations, in the interaction of the prey-predator system is formulated. The fundamental tenet of our ecoepidemiology model is that sick predators do not engage in predation. It is confirmed that the system’s solution exists, is positive, and is bounded. The system’s equilibrium points are determined and computed. Lyapunov functions and a linearizing form are used for local and global stability analysis, respectively. The next generation matrix approach is used to calculate the threshold value for diseased predators and prey at the disease-free equilibrium point. Optimal treatment options for vulnerable and infected populations are established by applying optimal control theory to the ecoepidemiology model of a prey-predator system. MATLAB software is utilized to obtain numerical simulations that validate the analytical outcomes. The optimal control problem simulations demonstrate that the number of infected populations in a given prey-predator system can be decreased by implementing control measures.

A cross-sectional study of SARS-CoV-2 antibodies among healthcare workers in a tertiary care hospital in Taiwan: implications for protection against the Omicron variants

BackgroundTaiwan, deeply impacted by the 2003 SARS outbreak, promptly implemented rigorous infection control and prevention (ICP) measures in January 2020 to combat the global COVID-19 pandemic. This cross-sectional serologic study was conducted among healthcare workers (HCWs) in a tertiary care hospital in Taiwan from August 1, 2022, to February 28, 2023. The study aimed to assess HCWs’ antibody responses to COVID-19 vaccination against Omicron subvariants BA.1, BA.4, and BA.5, considering variations in prior infection. Additionally, it evaluated the effectiveness of ICP and vaccination policies within the hospital setting in Taiwan.MethodsA cross-sectional serology study was conducted in Taiwan to investigate the seroprevalence rates of Omicron subvariants BA.1, BA.4, and BA.5 among HCWs. A total of 777 HCWs participated in this study. A structured questionnaire was collected to obtain the epidemiological characteristics and risk factors for potential exposure. Enzyme-linked immunosorbent assay was used to detect antibody responses. Serum samples were selected for protection against Omicron subvariants BA.1, BA.4, and BA.5 by using a pseudotyped-based neutralization assay.ResultsMore than 99% of the participants had received SARS-CoV-2 vaccination. Overall, 57.7% had been infected with SARS-CoV-2, with some being asymptomatic. The SARS-CoV-2 Anti-Spike S1 protein IgG (Anti-S) distribution was 40,000 AU/mL for 20.2% (157/777) of participants, with a mean ± standard deviation of 23,442 ± 22,086. The decay curve for Anti-S was less than 20,000 AU/ml after 120 days. The probability curve of 50% neutralization showed an Anti-S of 55,000 AU/ml. The optimum Anti-S was 41,328 AU/mL (equal to 5,869 WHO’s standard BAU/mL), with 86.1% sensitivity and 63.5% specificity.ConclusionsIn this significant study, 20.2% of HCWs achieved seroprotection against Omicron subvariants BA.1, BA.4, and BA.5. Their immunity against Omicron subvariants was further reinforced through recommended vaccinations and the development of natural immunity from SARS-CoV-2 exposure, collectively enhancing their protection against Omicron.

Occupational exposure, carcinogenic and non-carcinogenic risk assessment of formaldehyde in the pathology labs of hospitals in Iran

Formaldehyde, a known carcinogenic compound, is commonly used in various medical settings. The objective of this study was to assess the carcinogenic and non-carcinogenic risks associated with occupational exposure to formaldehyde. This study was conducted in the pathology labs of four hospitals in Tehran. Cancer and non-cancer risks were evaluated using the quantitative risk assessment method proposed by the United States environmental protection agency (USEPA), along with its provided database known as the integrated risk information system (IRIS). Respiratory symptoms were assessed using the American thoracic society (ATS) questionnaire. The results indicated that 91.23% of exposure levels in occupational groups exceed the NIOSH standard of 0.016 ppm. Regarding carcinogenic risk, 41.03% of all the studied subjects were in the definite carcinogenic risk range (LCR > 10−4), 23.08% were in the possible carcinogenic risk range (10−5 < LCR < 10−4), and 35.90% were in the negligible risk range (LCR < 10−6). The highest index of occupational carcinogenesis was observed in the group of lab technicians with a risk number of 3.7 × 10−4, followed by pathologists with a risk number of 1.7 × 10−4. Furthermore, 23.08% of the studied subjects were within the permitted health risk range (HQ < 1.0), while 76.92% were within the unhealthy risk range (HQ > 1.0). Overall, the findings revealed significantly higher carcinogenic and non-carcinogenic risks among lab technicians and pathologists. Therefore, it is imperative to implement control measures across various hospital departments to mitigate occupational formaldehyde exposure levels proactively. These findings can be valuable for policymakers in the health sector, aiding in the elimination or reduction of airborne formaldehyde exposure in work environments.

Contamination, morphological and chemical characterization, and hazard risk analyses of microplastics in drinking water sourced from groundwater in a developing nation

Groundwater (GW) plays a crucial role as the primary source of potable water in numerous developing nations. However, the increasing presence of microplastics (MPs) represents a concealed danger, threatening activities that guarantee safe drinking water in these countries. Despite this, there is limited awareness about the widespread existence of MPs in these regions of the world. In this study, we investigated the contamination levels, distribution, morphological characteristics, chemical composition, and associated public health risk of MPs in groundwater samples from six coastal districts of Bangladesh using stereomicroscopy and Fourier transform infrared spectroscopy (FTIR). MPs were prevalent at all sampling stations, with average concentrations of 24.63 ± 16.13 items/L and a range of 4–75 items/L. The majority of MPs (97.6%) were fibers, indicating a likely origin from fabric disintegration during drying, washing, discarded fishing nets, personal care items, and municipal waste. Smaller-sized MPs (&amp;lt;0.5 mm), transparent and violet-colored, were predominantly observed. Additionally, FTIR confirmed the presence of plastic polymers, including low-density polyethylene (LDPE), high-density polyethylene (HDPE), ethylene vinyl acetate (EVA), and polyethylene terephthalate (PETE). Despite the high visibility observed or focus given for PETE, PE was found to be abundant. These are thought to have come from runoff from agricultural fields, seeping from landfills where plastic trash is disposed of, synthetic fabrics, and inappropriate plastic product disposal. Estimated dietary intake was recorded as 1.85 particles/person/day (i.e., 675 particles/year), suggesting the possible health risk to consumers. Hazard analyses based on the polymeric risk score revealed diverse risks associated with polymer levels, with PETE indicating a medium risk and other polymers, e.g., HDPE, LDPE, and EVA at 39%, 31%, and 17%, respectively, showing a minor risk to human health from drinking water from the studied sources. This is the first study from the regions, and the findings will be valuable for identifying sources, implementing control measures, shaping policies, and safeguarding public health against plastic pollution.

Evaluation of the impact of erosion control measures on dam siltation and upstream erosion using radioisotope technique 7Be and MUSLE model in the watershed upstream of Allal El Fassi dam, Morocco

Water erosion poses a significant threat to the sustainability of natural resources and hydro-agricultural infrastructure, particularly in the Mediterranean region, including Morocco. The Allal El Fassi watershed faced such challenges and underwent anti-erosion measures between 2008 and 2014. This study aims to evaluate the effectiveness of these measures in mitigating dam siltation within the watershed. The methodologies employed include the utilization of the MUSLE model, optimized with bathymetric surveys of the dam, to estimate the amount of sediment reaching the dam and derive the P-factor associated with the implemented anti-erosion measures. Additionally, the radioisotope technique was utilized to assess erosion rates at managed and unmanaged sites within the watershed. The results obtained using the MUSLE model and bathymetric data revealed a noteworthy reduction in mean annual soil loss within the timeframe of 2002–2010 to 2010–2013, resulting in a 13.9% decrease in sediment reaching the dam. Furthermore, variations in the P-factor of erosion control measures were observed, ranging from 0.31 to 0.52 during the respective periods. Utilizing the radionuclide 7Be, erosion rates ranging from 6.8 to 25.3 t.ha−1 were determined for the studied plots, facilitating the calculation of P-factors for specific erosion control measures. Significantly, gabion check dams displayed a P-factor of 0.47, dry stone barriers had a P-factor of 0.41, fruit trees with basins showed a P-factor of 0.51, and enclosures exhibited a P-factor of 0.67. These findings suggest a causal relationship between the implementation of erosion control measures and the reduction in sedimentation rates at the Allal El Fassi Dam, highlighting the interdependence between the two phenomena.

Spatial distribution and environmental correlations of Culex pipiens pallens (Diptera: Culicidae)in Haidian district, Beijing.

Culex pipiens pallens Coquillett, 1898(Diptera: Culicidae)was the dominant health threat to mosquito species in Beijing, and it is important to unravel the spatial distribution and environmental correlations of Cx. pipiens pallens in Beijing. 3S technology methods and spatial statistics were used to clarify the distribution pattern. Subsequently, linear and spatial regression were performed to detect the environmental factors linked with the density of Cx. pipiens pallens. The same "middle peak" spatial distribution pattern was observed for Cx. pipiens pallens density at the community, subdistrict, and loop area levels in our study area. In addition, there were various correlated environmental factors at the community and subdistrict scales. At the community scale, the summary values of the Modified Normalized Difference Water Index (MNDWI) in 2 km buffer zone (MNDWI_2K) were negatively correlated, and the summary values of Normalized Difference Built-up Index (NDBI) in 800 m buffer zone (NDBI_800) was positively correlated to the Cx. pipiens pallens density. However, the summary values of Normalized Difference Vegetation Index and Nighttime Light Index significantly affected Cx. pipiens pallens density at the subdistrict scale. Our findings provide insight into the spatial distribution pattern of Cx. pipiens pallens density and its associated environmental risk factors at different spatial scales in the Haidian district of Beijing for the first time. The results could be used to predict the Cx. pipiens pallens density as well as the risk of lymphatic filariasis (LF) infection, which would help implement prevention and control measures to prevent future risks of biting and LF transmission in Beijing.

Sequencing analysis of SARS-CoV-2 cases in Slovenian long-term care facilities to support outbreak control

IntroductionResidents of long-term care facilities (LTCFs) are at high risk of morbidity and mortality due to COVID-19, especially when new variants of concern (VOC) emerge. To provide intradisciplinary data in order to tailor public health interventions during future epidemics, available epidemiologic and genomic data from Slovenian LTCFs during the initial phases of the COVID-19 pandemic was analyzed.MethodsThe first part of the study included SARS-CoV-2 reverse-transcription Real-Time PCR (rtRT-PCR) positive LTCF residents, from 21 facilities with COVID-19 outbreaks occurring in October 2020. The second part of the study included SARS-CoV-2 rtRT-PCR positive LTCF residents and staff between January and April 2021, when VOC Alpha emerged in Slovenia. Next-generation sequencing (NGS) was used to acquire SARS-CoV-2 genomes, and lineage determination. In-depth phylogenetic and mutational profile analysis were performed and coupled with available field epidemiological data to assess the dynamics of SARS-CoV-2 introduction and transmission.Results370/498 SARS-CoV-2 positive residents as well as 558/699 SARS-CoV-2 positive residents and 301/358 staff were successfully sequenced in the first and second part of the study, respectively. In October 2020, COVID-19 outbreaks in the 21 LTCFs were caused by intra-facility transmission as well as multiple independent SARS-CoV-2 introductions. The Alpha variant was confirmed in the first LTCF resident approximately 1.5 months after the first Alpha case was identified in Slovenia. The data also showed a slower replacement of existing variants by Alpha in residents compared to staff and the general population.DiscussionMultiple SARS CoV-2 introductions as well as intra-facility spreading impacted disease transmission in Slovenian LTCFs. Timely implementation of control measures aimed at limiting new introductions while controlling in-facility transmission are of paramount importance, especially as new VOCs emerge. Sequencing, in conjunction with epidemiological data, can facilitate the determination of the need for future improvements in control measures to protect LTCF residents from COVID-19 or other respiratory infections.

Genetic differentiation of wild boar populations in a region affected by African swine fever

In the European Union, African swine fever (ASF) affects wild boar (Sus scrofa) populations in several Member States. Knowledge of population connectivity is important for the implementation of control measures, in particular the establishment of effective barriers. Population genetic comparisons of neighbouring populations can be very helpful in this respect. The present study investigated the genetic differentiation of wild boar in eastern Germany. This region has been affected by ASF since September 2020. A total of 1,262 wild boars from 31 hunting grounds (populations) in ASF-affected and ASF-free districts were sampled over a total area of almost 100,000 km². The study area encompassed a network of geographical factors that promote (roads, rivers, cities) or inhibit (natural areas, habitat corridors) genetic differentiation between wild boar populations. The genetic differentiation of the areas was based on 12 microsatellite markers. Three different Bayesian algorithms were used to analyse the data. The results were combined into a common approach with 9 clusters. Based on the cluster distribution in each population, the connectivity between the areas was quantified. The strongest differentiation was found along an imaginary line along the lower Elbe valley through Berlin and the A11 freeway to the Szczecin Lagoon. In contrast, the Mecklenburg Lake District and the south-east of the study area showed strong connectivity between areas. The special features of the landscapes along the lower Elbe valley, which was assessed as highly connective, and the high barrier effect of the A11 freeway in contrast to the other freeways in the study area show that barrier effects cannot be generalised in principle, but are actually determined by the circumstances of individual structures. The results of the connectivity analysis were compared with the distribution of viral lineages and variants. The genotypes of the wild boar populations and the ASFV lineages and variants showed a good explanatory approach for the observed disease dynamics in the study area. The newly gained knowledge on barriers and regionally different connectivity between wild boar populations can support considerations and measures for the containment of ASF in the affected areas by improving the understanding of wild boar dispersal dynamics.

Evolution of Antimicrobial Resistance in Klebsiella pneumoniae over 3 Years (2019-2021) in a Tertiary Hospital in Bucharest, Romania.

The antimicrobial resistance (AMR) of Klebsiella pneumoniae recorded a steep upward trend over the last two decades, among which carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most concerning strains considering the development and spread of AMR. The aim of this study was to analyze the evolution of AMR for Klebsiella pneumoniae and to describe the risk factors of AMR for Klebsiella pneumoniae, including the COVID-19 pandemic. We conducted a retrospective study on Klebsiella pneumoniae non-duplicative isolates collected from patients admitted to a tertiary hospital in Bucharest, Romania, from January 2019 to December 2021. We evaluated AMR changes by comparing resistance between 2019 and the mean of 2020-2021. The rates of AMR increased for third-generation cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and colistin and decreased for trimethoprim/sulfamethoxazole (TMP/SMX), 45.7% in 2019 vs. 28.3% in 2021. A longer length of hospital stay (ꭓ2 = 49.68, p < 0.01); recent antibiotic consumption, RR = 1.38, 95% CI [1.21, 1.57]; and recent contact with hospital settings, RR = 1.54, 95% CI [1.32, 1.8] were risk factors for multidrug-resistant (MDR) Klebsiella pneumoniae. The AMR of Klebsiella pneumoniae increased during 2020-2021 for most of the potential active antibiotics; only TMP/SMX resistance decreased, and it may represent a treatment option for CRKP or MDR Klebsiella pneumoniae infections. Decreasing the excessive use of antibiotics and the implementation of prevention and control measures in healthcare settings are mandatory for avoiding further increases in the AMR rate of Klebsiella pneumoniae.

Botulism Cases in Romania-An Overview of 14-Year National Surveillance Data.

Botulism is a priority disease worldwide because it has a very severe course of evolution that can lead to death. This paper aims to describe the main epidemiological characteristics of botulism cases confirmed in Romania over 14 years (2007-2020). We performed a retrospective study using the publicly available national surveillance data and reported to the National Institute of Public Health. A total of 325 cases of foodborne botulism were reported in Romania, with no infant or wound botulism. Most of the cases (125, 38.5%) were reported among young adults (25-44 years old), over half (205, 63%) of them living in rural areas. The incriminated food item was identified in 161 cases; in most cases (145, 90%) the food item was prepared in the household. The main food category was represented by meat and meat-based products (94, 68.6%). In almost all cases the identified type was BoNT/B (230/231, 99.5%). Fifteen deaths were recorded, and the case fatality rate was 4.6%. Botulism cases were reported annually in Romania. Surveillance data are essential for implementing control measures and adapting educational campaigns according to existing needs.

Carbapenem-Resistant Klebsiella pneumoniae Bacteremia: Counterbalance between the Endemic Load and the Infection Control Program in a Hospital

Carbapenem-resistant Klebsiella pneumoniae (CRKP) remains a significant public health threat, given the associated increased healthcare burden and mortality rate. The objective of the current study was to investigate the association between the incidence of CRKP bacteremia, antibiotic consumption, and infection control measures in a tertiary-care hospital spanning the years 2013–2018. The analyzed indices included the incidence of CRKP bacteremia, antibiotic consumption, the use of hand hygiene solutions, and isolation rates of multidrug-resistant (MDR) carriers. In the total hospital, the incidence of CRKP bacteremia exhibited an absolute decrease during the study period, although this decrease did not reach statistical significance. Antibiotics used to treat CRKP infections, including carbapenems, colistin, tigecycline, and fosfomycin, as well as all classes of antibiotics, correlated positively with an increased incidence of CRKP bacteremia. On the contrary, increased use of scrub disinfectant solutions correlated negatively with a decreased incidence of CRKP bacteremia (IRR: 0.74, 95%CI: 0.59–0.93, p-value: 0.008) in the Adults ICU. Additionally, increased isolation rates of MDR carrier patients correlated negatively with a decreased incidence of CRKP bacteremia (IRR: 0.35, 95%CI: 0.13–0.97, p-value: 0.044). In conclusion, the implementation of multimodal infection control measures in our hospital contributed to the containment of CRKP, particularly in specific hospital sectors. However, the study suggests the need for additional strategies to overcome the endemic plateau.

Influence of sticky trap color, host plant species, and weather factors on the population dynamics of thrips species in Southern Ghana.

It is essential to correctly identify and keep track of the abundance of thrips species on infested host crops to understand their population dynamics and implement control measures promptly. The current study was conducted to evaluate the performance of sticky traps in monitoring thrips species in exporters' eggplant and chili farms and to assess the impact of weather factors on thrips population dynamics. Thrips species were monitored using blue, yellow, and white sticky traps on chili and eggplant farms in Tuba, respectively, in 2020 and 2021. Each field was divided into 8 blocks, and in each replicate, all colors representing 3 treatments were randomly tied to stakes at the center of the respective crop. Data loggers were installed to record hourly weather variables. Three thrips species [Thrips parvispinus Karny (Thysanoptera: Thripidae), Franklinella schultzei Trybom (Thysanoptera: Thripidae), and Thrips tabaci Lindeman (Thysanoptera: Thripidae)] were identified from both farms and the different species showed varied attractiveness to trap color for both seasons, with white proving more attractive to T. parvispinus. The population dynamics of the species varied significantly with the season and weather but not with the crop. Optimum temperatures (28-31 °C) and relative humidity (60%-78%) showed a positive linear relationship between the trapped insects with temperature and RH, while extreme temperatures (35 °C) negatively affected their abundance. All sticky trap colors attracted several nontarget organisms; however, yellow colors had higher populations, including the predator, Orius insidiosus. White sticky traps are recommended for inclusion in the country-wide monitoring for thrips, especially T. parvispinus.

Biodiversity of mosquitoes (Diptera: Culicidae) in phytotelmata from Car Nicobar Island, India.

The Culicidae mosquito family breeds in various natural and artificial water bodies. Phytotelmata are plant structures that hold water and are used by many mosquito species during their life cycle. Mosquitoes are disease vectors, and phytotelmata play an important role in harbouring them. Investigating these phytotelmata will facilitate to develop appropriate site specific vector control strategy. Approximately 750 phytotelmata in 16 locations on Car Nicobar Island was examined. Mosquito larvae were collected from different habitats such as tree holes, root holes, leaf axils, and bamboo stumps. On average, the number of larvae per 10 ml of water ranged from 0.003 to 3.833. Among the 16 mosquito species identified, there were vectors of malaria (Anopheles sundaicus), dengue (Aedes aegypti and Aedes albopictus) and filariasis (Culex quinquefasciatus), belonging to seven genera. The most common phytotelmata were coconut trees (17.5%) followed by Java apple trees (10.3%) and bamboo stumps (7.1%). The most widespread mosquito species was Aedes edwardsi, followed by Aedes malayensis and Ae. albopictus, and the per cent of phytotelmata that contained these species were 42.6, 22.0, and 16.8% respectively. Anopheles mosquitoes had the highest container index (6.1%) in root holes, while Aedes and Culex mosquitoes were more frequently found in bamboo stumps. The alpha biodiversity indices indicated that the mosquito population in Car Nicobar Island was highly diverse (S = 16; DMg = 36.9). Tree holes showed the highest diversity, as all 16 species were collected from them. Assessment of phytotelmata, there is a significant relationship observed between mosquito genus, village, habitat, and tree families, on the remote island of Car Nicobar. Considering the presence of disease-transmitting mosquito vectors in the phytotelmata, these habitats should be considered when implementing control measures to eliminate mosquito-borne infections.

Tracking progress on antimicrobial resistance by the quadripartite country self-assessment survey (TrACSS) in G7 countries, 2017–2023: opportunities and gaps

Antimicrobial resistance (AMR) poses serious challenges to the healthcare systems worldwide. Multiple factors and activities contribute to the development and spread of antimicrobial-resistant microorganisms. Monitoring progress in combating AMR is fundamental at both global and national levels to drive multisectoral actions, identify priorities, and coordinate strategies. Since 2017, the World Health Organization (WHO) has collected data through the Tracking AMR Country Self-Assessment Survey (TrACSS). TrACSS data are published in a publicly-available database. In 2023, 71 (59.9%) out of 177 responding countries reported the existence of a monitoring and evaluation plan for their National Action Plan (NAP) on AMR, and just 20 countries (11.3%) the allocation of funding to support NAP implementation. Countries reported challenges including limited financial and human resources, lack of technical capacity, and variable political commitment. Even across the Group of Seven (G7) countries, which represent some of the world's most advanced economies, many areas still need improvement, such as full implementation of infection prevention and control measures, adoption of WHO access/watch/reserve (AWaRe) classification of antibiotics, effective integration of laboratories in AMR surveillance in the animal health and food safety sectors, training and education, good manufacturing and hygiene practices in food processing, optimising pesticides use and environmental residues of antimicrobial drugs. Continuous and coordinated efforts are needed to strengthen multisectoral engagement to fight AMR.

Predominance of OXA-48 carbapenemase-producingKlebsiella pneumoniae strains in tertiary hospital in Sarajevo, Bosnia and Herzegovina.

Klebsiella pneumoniae, a member of the Enterobacteriaceae family, demonstrates an increasing trend of resistance to carbapenems and is a common cause of both hospital- and community-acquired infections. The current study provides insights into the genetic characterization of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates circulating during 2022 in a Sarajevo tertiary hospital. Among the 87 CRKP strains analyzed, real-time polymerase chain reaction (rtPCR) results showed that 85 (97.7%) tested positive for the carbapenem resistance gene. The oxacillinase-48 (OXA-48) gene was detected in 83 (95.4%) isolates, while the Klebsiella pneumoniae carbapenemase (KPC) and the New Delhi metallo-beta-lactamase (NDM) genes were detected in one isolate each. No Verona integron-encoded-metallo-beta-lactamase (VIM) or imipenemase-metallo-beta-lactamase 1 (IMP-1) genes were found in any of the tested isolates. The multilocus sequence typing (MLST) analysis of sequence types (STs) revealed that ST101, an emerging high-risk clone exhibiting extensive drug resistance, was the most prevalent, whereas ST307 was detected in only one isolate. Phylogenetic analysis of the ten CRKP isolates indicated the presence of three clusters that could constitute an outbreak. A comparison of the results of the utilized phenotypic test (the combined-disk test [CDT]) and rtPCR showed high concordance, suggesting that the phenotypic assay may be useful for the early detection of resistance mechanisms as part of routine susceptibility testing. With the increased affordability of next-generation sequencing (NGS), its application in hospital settings has proven highly beneficial, aiding in the implementation of infection control and prevention measures. Given the significant resistance demonstrated by the CRKP isolates to most tested antibiotics, it is imperative to establish effective methods to restrict the spread of these isolates, as well as to carefully monitor the use of carbapenems in clinical practice.

Cigarette Smoking Among Pregnant Women During the Perinatal Period: Prevalence and Health Care Provider Inquiries - Pregnancy Risk Assessment Monitoring System, United States, 2021.

Cigarette smoking during pregnancy increases the risk for pregnancy complications and adverse infant outcomes such as preterm delivery, restricted fetal growth, and infant death. Health care provider counseling can support smoking cessation. Data from the 2021 Pregnancy Risk Assessment Monitoring System were analyzed to estimate the prevalence of smoking before, during, and after pregnancy; quitting smoking during pregnancy; and whether health care providers asked about cigarette smoking before, during, and after pregnancy among women with a recent live birth. In 2021, the prevalence of cigarette smoking was 12.1% before pregnancy, 5.4% during pregnancy, and 7.2% during the postpartum period; 56.1% of women who smoked before pregnancy quit smoking while pregnant. Jurisdiction-specific prevalences of smoking ranged from 3.5% to 20.2% before pregnancy, 0.4% to 11.0% during pregnancy, and 1.0% to 15.1% during the postpartum period. Among women with a health care visit during the associated period, the percentage of women who reported that a health care provider asked about smoking was 73.7% at any health care visit before pregnancy, 93.7% at any prenatal care visit, and 57.3% at a postpartum checkup. Routine assessment of smoking behaviors among pregnant and postpartum women can guide the development and implementation of evidence-based tobacco control measures at the jurisdiction and health care-system level to reduce smoking among pregnant and postpartum women.

Genetic Structure of Introduced Plasmodium vivax Malaria Isolates in Greece, 2015-2019.

Greece has been malaria-free since 1974, after an intense malaria control program. However, as Greece hosts migrant populations from P. vivax malaria-endemic countries, there is a risk of introducing the disease to specific vulnerable and receptive areas of the country. Knowledge of the genetic diversity of P. vivax populations is essential for understanding the dynamics of malaria disease transmission in a given region. We used nine highly polymorphic markers to genotype 124 P. vivax-infected archived DNA samples from human blood specimens referred to the NMRL from all over Greece throughout 2015-2019. The genotypic variability of the samples studied was noted, as they comprised several unique haplotypes, indicative of the importation of a large number of different P. vivax strains in the country. However, only a few events of local transmission were recorded. Genotyping revealed and confirmed the same clusters as those identified through epidemiological investigation. In only one introduction event was the index case found. No sustained/ongoing malaria transmissions in/between the studied regions or during consecutive years or additional foci of local transmission were observed. Genotyping is an important component in assisting malaria surveillance, as it provides information concerning the patterns of introduction and the effectiveness of implemented malaria control and elimination measures.

The Role of Human Mobility Flow in the Region-to-Region Spread of Respiratory Syncytial Virus Infection among Infants: An Infographic Analysis.

The region-to-region spread of human infectious diseases is considered to be dependent on the human mobility flow (HMF). However, it has been hard to obtain the evidence for this. Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in Japan 2020, the government has enforced countermeasures against COVID-19 nationwide, namely the restriction of personal travelling, universal masking, and hand hygiene. As a result, the spread of acute respiratory infections had been effectively controlled. However, COVID-19 as well as pediatric respiratory syncytial virus (RSV) infections were not well-controlled. The region-to-region spread of pediatric RSV infections in 2020-2021 was recognizable unlike those in 2018 and 2019. In this study, we investigated the correlation between the trend of regional reports of the pediatric RSV infections and the HMF based on cellular phone signal data. Upon closer examination of both epidemiological trend and HMF data, the spread of pediatric RSV infection from one region to another was logically explained by HMF, which would serve as the evidence of the dependence of regional transmission on HMF. This is the first solid evidence where this correlation has been clearly observed for the common respiratory infections. While social implementation of infection control measures has successfully suppressed the droplet-mediated respiratory infections, such as influenza, but not the airborne infections, it was suggested that the aerosol transmission and adult asymptomatic carrier were involved in the transmission of RSV akin to COVID-19.

Candida auris Outbreaks: Current Status and Future Perspectives.

Candida auris has been identified by the World Health Organization (WHO) as a critical priority pathogen on its latest list of fungi. C. auris infections are reported in the bloodstream and less commonly in the cerebrospinal fluid and abdomen, with mortality rates that range between 30% and 72%. However, no large-scale epidemiology studies have been reported until now. The diagnosis of C. auris infections can be challenging, particularly when employing conventional techniques. This can impede the early detection of outbreaks and the implementation of appropriate control measures. The yeast can easily spread between patients and in healthcare settings through contaminated environments or equipment, where it can survive for extended periods. Therefore, it would be desirable to screen patients for C. auris colonisation. This would allow facilities to identify patients with the disease and take appropriate prevention and control measures. It is frequently unsusceptible to drugs, with varying patterns of resistance observed among clades and geographical regions. This review provides updates on C. auris, including epidemiology, clinical characteristics, genomic analysis, evolution, colonisation, infection, identification, resistance profiles, therapeutic options, prevention, and control.