Cases Of Infection Research Articles

18F-FDG PET/CT for the diagnosis and evaluation of antibiotic response in patients with left ventricular assistive device infection: A case report

The left ventricular assistive device (LVAD) is critical for end-stage heart failure patients. Centrifugal flow LVAD recipients have a 4-year survival rate of nearly 60%, with infection occurring in over 50% of patients within 2 years. Herein, we report a case of LVAD infection in a 60-year-old man. The patient presented with fever after 49 days following LVAD implantation. Culture of both blood and areas around the outflow cannula indicated an infection with Enterobacter cloacae and Staphylococcus aureus. After sequential treatment with meropenem and daptomycin, as well as abdominal incisional debridement, the patient’s symptoms of fever disappeared, but the inflammatory markers, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, remained abnormal. Five 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans were performed to evaluate the infection. PET/CT revealed infected lesions around the lower segment of the outflow cannula with high FDG uptake. After continuous oral antibiotic treatment for more than 1 year, the infected areas with high FDG uptake around the outflow cannula gradually declined and eventually disappeared, consistent with the noted changes in both ESR and CRP levels in the serum. Multiple continuous 18F-FDG PET/CT scans can distinguish high FDG uptake areas of infection from sterile inflammatory areas, assisting in the accurate diagnosis of infection and evaluation of antibiotic treatment after LVAD implantation.

Assessing Pain and Functional Outcomes of Percutaneous Stabilization of Metastatic Pelvic Lesions via Photodynamic Nails: A Bi-Institutional Investigation of Orthopaedic Outcomes.

Minimally invasive surgical interventions for metastatic invasion of the pelvis have become more prevalent and varied. Our group hypothesized that the use of percutaneous photodynamic nails (PDNs) would result in decreased pain, improved functional outcomes and level of ambulation, and decreased use of opioid pain medication. We performed a retrospective chart review of patients with metastatic pelvic bone disease undergoing stabilization with PDNs (IlluminOss Medical) at 2 institutions. Functional outcome measures assessed include the Combined Pain and Ambulatory Function (CPAF), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, and PROMIS Global Health-Physical. Pain was assessed using a visual analog scale (VAS). Outcomes were assessed preoperatively and at 6 weeks, 3 months, 6 months, and 1 year following surgery. A total of 39 patients treated with PDNs were included. No cases of surgical site infection or implant failure were identified. The median pain VAS score decreased from 8 preoperatively to 0 at the 6-week time point (p < 0.0001). The median CPAF score improved from 5.5 points preoperatively to 7 points at the 3-month mark (p = 0.0132). A significant improvement in physical function was seen at 6 months in the PROMIS Physical Function (p = 0.02) and at both 6 months (p = 0.01) and 1 year (p < 0.01) for the PROMIS Global Health-Physical. The rate of patients prescribed opioid analgesia dropped from 100% preoperatively to 20% at 6 months following surgery (p < 0.001). By 6 weeks, all patients were fully weight-bearing and able to walk independently with or without assistive devices. Percutaneous stabilization of metastatic periacetabular defects using PDNs is a safe and effective palliative procedure that has been shown to improve patient mobility and provide early pain relief. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

“Risk factors for tuberculosis among close IGRA-negative contacts of persons with infectious tuberculosis in Singapore”

BackgroundContacts of infectious TB cases testing positive on Interferon-Gamma Release Assay (IGRA) are followed up to exclude active disease. However, factors that predispose IGRA-negative contacts to TB could improve screening and follow-up strategies in a medium TB burden country like Singapore. MethodsWe conducted a retrospective study of IGRA-negative contacts aged ≥2 years identified during contact investigation between January 2014 and December 2022. We examined the risk factors associated with developing active TB among contacts previously testing IGRA-negative, using univariate and multivariable logistic regression and odds ratios (OR) with 95% confidence intervals (CI). ResultsOf 60,377 IGRA-negative contacts, 150 developed TB disease and half were notified within 23 months of index diagnosis. IGRA-negative contacts of a smear-positive index were more likely to develop TB. Independent risk factors for TB were being over 50, Malay, having Diabetes or End-Stage Renal Failure, a “family” relationship with the index or exposure in a dormitory or nursing home. ConclusionCertain risk factors could help optimize follow-up strategies and preventive treatment in IGRA-negative individuals. The incidence of TB in this group was 150/100,000 population, substantially higher than in the community, with a median 92 weeks to develop disease. Findings suggest that follow-up be extended to 24 months for contacts with these risk factors.

Risk of severe dengue during secondary infection: A population-based cohort study in Taiwan

BackgroundDengue poses a significant public health concern. Secondary dengue infections with different dengue virus (DENV) serotypes have been linked to an increased risk of severe dengue. This study aimed to assess the risk of severe dengue during secondary infection in Taiwan. MethodsA retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database to identify dengue cases with secondary dengue infection born after 1944 from 2014 to 2015. Ten matched patients with primary infection were selected as controls using propensity score matching for each secondary dengue infection case. The odds ratio (OR) for severe dengue in secondary versus primary infections was calculated using conditional logistic regression. ResultsThis study included 357 cases with secondary dengue infection and 3570 matched controls. The risk of severe dengue was found to be 7.8% in individuals with secondary infection, compared to 3.8% in those with primary dengue infection. Secondary infection significantly increased the risk of severe dengue (OR 2.13, 95% CI: 1.40–3.25, P = 0.0004). Notably, a significant association between secondary infection and severe dengue was observed only when the interval between the first and secondary infection was greater than two years (OR 3.19, 95% CI 2.04–5.00, P < 0.0001). ConclusionSecondary dengue infection significantly increases the risk of severe disease in Taiwan, particularly when the interval between infections is over two years.Healthcare professionals should maintain heightened vigilance for individuals with a history of previous dengue infection, particularly if their initial diagnosis was more than two years prior.

A Historical Study on the Scientific Attribution of Biosafety Risk Assessment in Real Cases of Laboratory-Acquired Infections

This paper provides a comprehensive review of the history of laboratory-acquired infections (LAIs) from a scientific perspective on biosafety risks. It analyzes cases from the late 19th century to the 2020s, whereas the previous research on this topic has primarily focused on social factors. By combining real case studies, this study elucidates the mechanisms of LAI occurrence and development, compares the attribution of risks and mitigation measures, and establishes the scientific patterns of LAIs’ historical evolution. The details of LAI cases are compared to the biosafety risk assessment indices of the World Health Organization (WHO), the United States, and China. These real cases of LAI occurrence risks are now incorporated into biosafety standards and assessments in the modern era. Additionally, factors that pose potential risks of LAIs, even if they have not yet manifested, are also highlighted.

Kluyvera ascorbata: An Emerging Pathogen and Rare Cause of Urinary Tract Infection in Immunocompetent Patients at a Tertiary Care Center in North India

Abstract Kluyvera spp. is a Gram-negative bacillus and was discovered by Kluyver and van Niel, included in the family Enterobacteriaceae. We report two cases of urinary tract infection due to Kluyvera ascorbata. The first case was a 61-year-old male, who was admitted to the nephrology department of the hospital with chief complaints of fever with chills from 1 week, abdominal pain, and difficulty in passing urine. The second case was a 29-year-old female, who presented to the medicine department of the hospital with a 4-day history of fever with associated chills and rigor, abdominal pain, chills, and weakness. These patients were treated with nitrofurantoin given orally for 7 days they recovered completely. This case series highlights the role of K. ascorbata, and in general of Kluyvera species, as an unusual but potentially dangerous pathogen, the need for prompt identification to determine potential pathogenicity in the immunocompetent as well as in the immunocompromised host, and to assess the efficacy of antibiotics such as carbapenems and nitrofurantoin.

Kluyvera ascorbata: An Emerging Pathogen and Rare Cause of Urinary Tract Infection in Immunocompetent Patients at a Tertiary Care Center in North India

Abstract Kluyvera spp. is a Gram-negative bacillus and was discovered by Kluyver and van Niel, included in the family Enterobacteriaceae. We report two cases of urinary tract infection due to Kluyvera ascorbata. The first case was a 61-year-old male, who was admitted to the nephrology department of the hospital with chief complaints of fever with chills from 1 week, abdominal pain, and difficulty in passing urine. The second case was a 29-year-old female, who presented to the medicine department of the hospital with a 4-day history of fever with associated chills and rigor, abdominal pain, chills, and weakness. These patients were treated with nitrofurantoin given orally for 7 days they recovered completely. This case series highlights the role of K. ascorbata, and in general of Kluyvera species, as an unusual but potentially dangerous pathogen, the need for prompt identification to determine potential pathogenicity in the immunocompetent as well as in the immunocompromised host, and to assess the efficacy of antibiotics such as carbapenems and nitrofurantoin.

A parsimonious Bayesian predictive model for forecasting new reported cases of West Nile disease

Upon researching predictive models related to West Nile virus disease, it is discovered that there are numerous parameters and extensive information in most models, thus contributing to unnecessary complexity. Another challenge frequently encountered is the lead time, which refers to the period for which predictions are made and often is too short. This paper addresses these issues by introducing a parsimonious method based on ICC curves, offering a logistic distribution model derived from the vector-borne SEIR model. Unlike existing models relying on diverse environmental data, our approach exclusively utilizes historical and present infected human cases (number of new cases). With a year-long lead time, the predictions extend throughout the 12 months, gaining precision as new data emerge. Theoretical conditions are derived to minimize Bayesian loss, enhancing predictive precision. We construct a Bayesian forecasting probability density function using carefully selected prior distributions. Applying these functions, we predict month-specific infections nationwide, rigorously evaluating accuracy with probabilistic metrics. Additionally, HPD credible intervals at 90%, 95%, and 99% levels is performed. Precision assessment is conducted for HPD intervals, measuring the proportion of intervals that does not include actual reported cases for 2020–2022.

A clinical case of non-tuberculosis mycobacterial infection of the lungs and larynx

ABSTRACT. An actual clinical case of the diagnosis and course features of non-tuberculosis mycobacterial infection (NTMI) of the lungs and larynx in a patient treated at the Zaporizhzhia Regional Phthisiopulmonology Clinical Treatment and Diagnostic Center is presented. The clinical case demonstrates the difficulty of differential diagnosis of NTMI of the lung caused by scotochromogenic mycobacterium and tuberculosis, since the clinical and radiological manifestations for both diseases are identical, and there are no pathognomonic symptoms of NTMI. NTM affect the respiratory system and mimic the symptoms of tuberculosis, which significantly complicates not only timely differential diagnosis, but also leads to “treatment failure” of tuberculosis, which the patient did not have. After a month of antimycobacterial treatment an ulcerative lesion of the right vocal fold was diagnosed in the patient. Detection of the culture of NTM 1.5 months after its inoculation was the only one method of diagnosis in this case, the diagnosis NTMI of both the lungs and the larynx was made considering those results. The patient did not receive appropriate treatment before receiving the results of the bacteriological examination, which led to the development of negative clinical and radiological dynamics. But, despite the late diagnosis of NTMI, after 6 months of appropriate treatment the patient had a positive clinical and X-ray dynamics with healing of the ulcerative lesion of the right vocal fold. Thus, the presented case shows that despite the late diagnosis of NTMI of the lungs, which was complicated by NTMI of the larynx during antimycobacterial therapy, in the absence of severe concomitant lung diseases in the patient, after 6 months of appropriate treatment of NTMI, it was possible to achieve positive clinical and radiological dynamics with complete healing of the ulcerative lesion of the right vocal fold.

Phylogenetic and mutational analysis of H10N3 avian influenza A virus in China: potential threats to human health.

In recent years, the avian influenza virus has emerged as a significant threat to both human and public health. This study focuses on a patient infected with the H10N3 subtype of avian influenza virus, admitted to the Third People's Hospital of Kunming City on March 6, 2024. Metagenomic RNA sequencing and polymerase chain reaction (PCR) analysis were conducted on the patient's sputum, confirming the H10N3 infection. The patient presented severe pneumonia symptoms such as fever, expectoration, chest tightness, shortness of breath, and cough. Phylogenetic analysis of the Haemagglutinin (HA) and neuraminidase (NA) genes of the virus showed that the virus was most closely related to a case of human infection with the H10N3 subtype of avian influenza virus found in Zhejiang Province, China. Analysis of amino acid mutation sites identified four mutations potentially hazardous to human health. Consequently, this underscores the importance of continuous and vigilant monitoring of the dynamics surrounding the H10N3 subtype of avian influenza virus, utilizing advanced genomic surveillance techniques.

CORRELATION OF COVID-19 TO LUNG INFECTIONS AND PREDICTION OF LUNG INFECTIONS IN COVID-19 PATIENTS IN IRAQ USING DATA MINING METHODS

The Covid-19 pandemic emerged as an unforeseen global crisis, exerting a profound influence on various aspects of human life. Hence, the need for collaborative efforts and scholarly investigations to address and alleviate the challenges arising from this crisis is crucial. One notable concern pertains to lung infections, which are recognized as a highly perilous consequence of the aforementioned virus. Thus, this study aims to investigate the potential correlation between Covid-19 and lung infections, and test the efficacy of various algorithms in predicting lung infections amongst Covid-19 patients. For this purpose, data has been procured from multiple health institutions in Iraq. Using this data, a robust correlation between Covid-19 and lung infection cases was found and the bagging, boosting, naïve Bayes, K-Nearest Neighbour, J48, random forest, PART, and logistic regression algorithms showcased a high accuracy in prediction lung infection in Covid-19 patients, with naïve Bayes achieving the highest accuracy of 93.41 percent.

Letter Regarding: Botryosphaeria dothidea: Presenting 2 Cases of Ocular Infection From North India.

Letter Regarding: Botryosphaeria dothidea: Presenting 2 Cases of Ocular Infection From North India.

Monocyte platelet satellitism without thrombocytopenia in a follow-up case of recent complicated Falciparum malaria infection.

Monocyte platelet satellitism without thrombocytopenia in a follow-up case of recent complicated Falciparum malaria infection.

Completion rates and myelosuppression degrees of cancer patients receiving radiotherapy or chemoradiotherapy unchanged regardless of delay duration after Omicron infection

This study aimed to investigate impacts of Omicron infection on cancer patients in China. A retrospective study was conducted, including 347 cancer patients undergoing radiotherapy or chemoradiotherapy between July 2022 and March 2023. Three groups involved: 108 patients without SARS-CoV-2 infection (non-COVID-19 group), 102 patients beginning treatment 10 days after first SARS-CoV-2 infection (≥ 10 days COVID-19 group), and 137 patients beginning treatment less than 10 days after first SARS-CoV-2 infection (< 10 days COVID-19 group). SAA, hsCRP, ALT, etc., were used to assess COVID-19 infection. Serum levels of SAA, hsCRP and IL-6 were all raised in two COVID-19-infected groups (SAA < 0.01, hsCRP < 0.01, IL-6 < 0.05), but PCT, ALT, LDH and HBDH levels were only elevated in ≥ 10 days COVID-19 group (PCT = 0.0478, ALT = 0.0022, LDH = 0.0313, HBDH = 0.0077). Moreover, moderate and severe infected cases were higher in ≥ 10 days COVID-19 group than < 10 days COVID-19 group (12/102 vs 5/137, p = 0.0211), but no significance in myelosuppression and completion rates among three groups. Omicron infection led to inflammation, liver and cardiovascular injury on cancer patients, but delay duration of radiotherapy or chemoradiotherapy after infection did not affect the completion rates and myelosuppression of current therapy. Besides, severity of Omicron infection was even worse among cancer patients who received delayed treatment.

Omicron SARS-CoV-2 infection management and outcomes in patients with hematologic disease and recipients of cell therapy.

Scarce real-life data exists for COVID-19 management in hematologic disease (HD) patients in the Omicron era. To assess the current clinical management and outcome of SARS-CoV-2 infection diagnosed, identify the risk factors for severe outcomes according to the HD characteristics and cell therapy procedures in a real-world setting. A retrospective observational registry led by the Spanish Transplant Group (GETH-TC) with 692 consecutive patients with HD from December 2021 to May 2023 was analyzed. Nearly one-third of patients (31%) remained untreated and presented low COVID-19-related mortality (0.9%). Nirmatrelvir/ritonavir was used mainly in mild COVID-19 cases in the outpatient setting (32%) with a low mortality (1%), while treatment with remdesivir was preferentially administered in moderate-to-severe SARS-CoV-2 infection cases during hospitalization (35%) with a mortality rate of 8.6%. The hospital admission rate was 23%, while 18% developed pneumonia. COVID-19-related mortality in admitted patients was 14%. Older age, autologous hematopoietic stem cell transplantation (SCT), chimeric antigen receptor T-cell therapy, corticosteroids and incomplete vaccination were factors independently associated with COVID-19 severity and significantly related with higher rates of hospital admission and pneumonia. Incomplete vaccination status, treatment with prior anti-CD20 monoclonal antibodies, and comorbid cardiomyopathy were identified as independent risk factors for COVID-19 mortality. The results support that, albeit to a lower extent, COVID-19 in the Omicron era remains a significant problem in HD patients. Complete vaccination (3 doses) should be prioritized in these immunocompromised patients. The identified risk factors may help to improve COVID-19 management to decrease the rate of severe disease, ICU admissions and mortality.

Coccygectomy for refractory coccydynia, old-fashioned but effective procedure: A retrospective analysis.

Coccydynia, characterized by persistent pain in the coccygeal region, significantly impacts patients' quality of life. While various treatment modalities exist, including conservative measures and surgical interventions like coccygectomy, optimal management remains unclear. This retrospective cohort study aimed to compare the clinical outcomes, functional improvements, and quality of life in patients with chronic coccydynia undergoing either infiltrative treatment or coccygectomy. Data from patients treated at our institution from January 2018 to December 2022 were analyzed. Participants meeting inclusion criteria were divided into two groups: Group A underwent coccygectomy, while Group B received conservative therapy. Clinical assessments, radiographic evaluations, and patient-reported outcomes were collected preoperatively and at follow-up intervals. Of the 223 initially examined patients, 55 met inclusion criteria. Group A (n = 21) underwent coccygectomy, while Group B (n = 34) received conservative therapy. Both groups showed significant pain reduction post-intervention, with sustained improvement in Group A. Functional outcomes favoured Group A, with significant improvements in disability and quality of life measures. Complications were minimal, with only one case of superficial wound infection in Group A. Our findings suggest that coccygectomy provides superior and lasting pain relief, functional improvement, and quality of life improvement compared to conservative therapy. While complications were minimal, further research with larger cohorts is warranted to validate these results and explore long-term outcomes. Despite its historical association with complications, advancements in surgical techniques and perioperative care have led to improved outcomes and reduced complication rates. Thus, coccygectomy should be considered in the treatment algorithm for patients with debilitating coccydynia.

КЛИНИЧЕСКОЕ ЗНАЧЕНИЕ РЕАКТИВАЦИИ ГЕРПЕСВИРУСНЫХ ИНФЕКЦИЙ У ДЕТЕЙ С ОНКОЛОГИЧЕСКИМИ ЗАБОЛЕВАНИЯМИ

Herpesvirus infection (HVI) reactivation in children with cancer is a common complication during the period of postcytostatic immunosuppression and occurs mostly after courses of high-dose chemotherapy (HDCT) with hematopoietic stem cell transplantation (HSCT). Clinical manifestations can range from asymptomatic viral reactivation and chemo-induced cytopenia worsening to fatal outcomes of the disease coupled with multiorgan involvement. The purpose of the research was to analyze cases of HVI reactivation in oncological pediatric patients in order to identify the risk factors for HVI development, features of its clinical manifestations and the effectiveness of antiviral therapy. Materials and methods used: a single-center retrospective cohort study was provided. The register of HVI reactivation cases in patients receiving antitumor therapy at the V.A. Almazov National Medical Research Centre of the Ministry of Healthcare of Russia (Saint Petersburg, Russia) in Jan. 2017-Jul. 2021 was analyzed. Routine monitoring of HVI reactivation (CMV, HHV-6A/B, EBV) included determination of viral DNA in patients’ biological materials by PCR using the AmpliSens test system on a Rotor-Gene device (amplifier). Results: 40 cases of HVI reactivation were registered, 22 (55%) were associated with cytomegalovirus infection (CMV), 4 (10%) with human herpes virus 6 (HHV-6A/B), 3 (7.5%) with Epstein-Barr virus (EBV) and 11 (27.5%) mixed. DNAemia was registered in 55%, organ damage in 45%. More often, reactivation of HVI developed after allogeneic HSCT (alloHSCT) (42,5%), autologous HSCT (autoHSCT) (40%). A statistically significant decrease of HVI reactivation cases was observed in patients after alloHSCT without TCRaβ depletion (53% v. 5,5%, p=0.036). Antiviral therapy was carried out in all patients. The first-line drug most often was ganciclovir (60%). Second line antiviral therapy was required in 10% of cases and those were the only CMV infection cases. Conclusion: a statistically significant decrease of HVI reactivation cases was observed in patients without TCRaβ depletion in alloHSCT. The clinical signs usually are not specific and require routine laboratory monitoring. Adequate antiviral therapy allowed achieving infectious control over HVI in most of the cases.

A Severe and Prolonged Case of Ocular Monkeypox Without Systemic Manifestations.

The objective of this study was to present a rare case of prolonged and severe ocular monkeypox virus infection in the absence of systemic manifestations. This was a single case report. A 60-year-old man, having been symptomatic for 9 days, presented with several umbilicated, ulcerated papules on the left cheek, left side of the nose, and left upper eyelid, along with marked follicular conjunctivitis and multiple conjunctival ulcerations. Two weeks after presentation, he developed an irregular, 360° circumferential opacity in the peripheral cornea that progressed to a large epithelial defect with corneal thinning. Although the initial eyelid lesions and conjunctivitis quickly resolved, the patient experienced nonresolving corneal inflammation manifest with peripheral corneal thinning, epithelial defects, and stromal keratitis. Four months after presentation, with the presumptive diagnosis of peripheral ulcerative keratitis, the patient was treated with intravenous steroids and immunosuppressive treatment, after which the ocular surface inflammation improved. However, the inflammation recurred 12 weeks later, and the patient developed severe perilimbal necrotizing conjunctivitis, followed by recurrence of ulcerated nodular eyelid lesions. Eight months after presentation, nucleic acid amplification tests from eyelid lesion swabs returned positive for nonvariola Orthopoxviruses, which led to the diagnosis of mpox. Within 2 weeks of beginning antiviral treatment with systemic tecovirimat and cidofovir and topical trifluridine, the eyelid lesions, conjunctivitis, and corneal inflammation resolved. We present an unusual and challenging case of ocular mpox with severe ocular surface inflammation including peripheral corneal thinning and epithelial defects, without systemic disease. Initiation of antiviral treatment resulted in a quick resolution of the ocular disease.

Instagram for audience engagement: an evaluation of CERC framework in the GCC nations for digital public health during the Covid-19 pandemic

BackgroundIn this study, we investigate the utilization of Instagram by public health ministries across the Gulf Cooperation Council (GCC) nations to disseminate health-related information during the COVID-19 pandemic. With Instagram’s visual-centric approach and high user engagement, the research aims to investigate its critical yet complex role in information dissemination amid a health crisis.MethodsTo examine how Instagram communication strategies align with the CDC’s Crisis and Emergency Risk Communication (CERC) framework, we employ the content analysis method. This approach helps to evaluate the effectiveness and challenges of employing Instagram for health communication within a region known for its significant social media usage.ResultsFindings indicate that Instagram serves as a vital platform for the rapid dissemination of health information in the GCC, leveraging its visual capabilities and wide reach. The GCC ministries of health utilized Instagram to demonstrate a consistent and strategic approach to communicate essential COVID-19 related information. Kuwait and Bahrain were the most active of all the assessed ministries with respect to the number of engagement metrics (likes and comments). Most of the posts, as per the CERC framework, were informational and related to vaccine infection and death cases. The second most salient theme in line with the CERC framework was about promoting actions, followed by Instagram posts about activities, events, and campaigns.ConclusionsThe research underscores Instagram’s potential as a powerful tool in enhancing public health resilience and responsiveness during health emergencies in the GCC. It suggests that leveraging social media, with careful consideration of its affordances, can contribute significantly to effective health communication strategies in times of crisis.

PfHDAC1 is an essential regulator of P. falciparum asexual proliferation and host cell invasion genes with a dynamic genomic occupancy responsive to artemisinin stress.

Malaria is a major public health problem, with the parasite Plasmodium falciparum causing most of the malaria-associated mortality. It is spread by the bite of infected mosquitoes and results in symptoms such as cyclic fever, chills, and headache. However, if left untreated, it can quickly progress to a more severe and life-threatening form. The World Health Organization currently recommends the use of artemisinin combination therapy, and it has worked as a gold standard for many years. Unfortunately, certain countries in southeast Asia and Africa, burdened with a high prevalence of malaria, have reported cases of drug-resistant infections. One of the major problems in controlling malaria is the emergence of artemisinin resistance. Population genomic studies have identified mutations in the Kelch13 gene as a molecular marker for artemisinin resistance. However, several reports thereafter indicated that Kelch13 is not the main mediator but rather hinted at transcriptional deregulation as a major determinant of drug resistance. Earlier, we identified PfGCN5 as a global regulator of stress-responsive genes, which are known to play a central role in artemisinin resistance generation. In this study, we have identified PfHDAC1, a histone deacetylase as a cell cycle regulator, playing an important role in artemisinin resistance generation. Taken together, our study identified key transcriptional regulators that play an important role in artemisinin resistance generation.