Cases Of Infection Research Articles

Clinical characteristics and prediction model of re-positive nucleic acid tests among Omicron infections by machine learning: a real-world study of 35,488 cases

BackgroundDuring the Omicron BA.2 variant outbreak in Shanghai, China, from April to May 2022, PCR nucleic acid test re-positivity (TR) occurred frequently, yet the risk factors and predictive models for TR remain unclear. This study aims to identify the factors influencing Omicron TR and to develop machine learning models to predict TR risk. Accurately predicting re-positive patients is crucial for identifying high-risk individuals, optimizing resource allocation, and developing personalized treatment and management plans, thereby effectively controlling the spread of the epidemic, reducing community burden, and ensuring public health.MethodsA retrospective study was conducted among individuals infected with Omicron BA.2 variant from April 12 to May 25, 2022, in the largest Shanghai Fangcang shelter hospital. Five machine learning models were compared, including k-nearest-neighbors (KNN), logistic regression (logistic), bootstrap aggregation (bagging), error back-propagation (BP) neural network, and support vector machines (SVM), to select the best prediction model for the TR risk factors.ResultsA total of 35,488 cases were included in this real-world study. The TR and control groups comprised of 6,171 and 29,317 cases respectively, with a re-positive rate of 17.39%. Higher occurrence of TR was observed in young age, males, those with obvious symptoms, underlying diseases, and a low Ct value. The KNN model proved to be the best in predicting the prognosis in the overall evaluation (accuracy = 0.8198, recall = 0.8026, and AUC = 0.8110 in the test set).InterpretationHigher TR risk was found in infected cases who were underage or with underlying diseases; vaccine brand and inoculation status were not significantly associated with TR. KNN was the most effective machine learning model to predict TR occurrence in isolation.

Bridging the critical gap between infectious disease blood donation screening and connection to healthcare services: the American Chagas disease example.

Chagas disease (Trypanosoma cruzi infection) affects ~ 290,000 USA residents and is included in routine blood donation screening panels. Donors are notified of positive T. cruzi-screening results, deferred from donation, and given limited information for next steps. Individuals living with undiagnosed, uncommon infections often face substantial barriers in accessing physicians with infectious disease competency, confirmatory testing, and continuum of care after the point of blood donor deferral. We assessed 46T. cruzi-deferred donors' experience following deferral, highlight donor challenges, and provide public health institution opportunities to support cases of rare transfusion-transmitted infections in the USA.

Follow-Up of Infants With Congenital Cytomegalovirus Following Maternal Primary Infection in the First Trimester and Normal Fetal Brain Imaging at Midgestation.

To determine outcomes at birth and postnatal sequelae of congenital cytomegalovirus (cCMV) infection following maternal primary infection in the first trimester with normal fetal brain imaging at midgestation. A retrospective, single-center cohort study was conducted, including all cases of proven cCMV infection following maternal primary infection in the first trimester from 2014 until 2021 and normal fetal brain imaging before 22weeks of gestation. All pregnancies were followed according to our protocol, which offers amniocentesis at least 8weeks after the onset of infection, serial ultrasound scans, and a fetal MRI in the third trimester. No women received treatment with CMV hyperimmune globulin or Valacyclovir during pregnancy. Follow-up of newborns was obtained, and newborns were classified as symptomatic or asymptomatic at birth. Postnatal sequelae were evaluated, and cases with a follow-up period of less than 12months were excluded. We found 42 newborns with cCMV, confirmed at birth by PCR for the CMV genome in neonatal urine samples, and normal fetal brain imaging up to 22weeks of gestation. Extracerebral signs of infection were present in 3/42 fetuses at the second trimester ultrasound (20-22weeks of gestation). In the third trimester (28-32weeks of gestation), none showed abnormal brain sonographic findings, but four exhibited extracerebral signs of CMV infection. Among 42 newborns, 29 were classified as asymptomatic (29/42, 69.1%) and 13 as symptomatic at birth (13/42, 30.9%, 95%CI 17.6%-47.1%). Eight newborns had abnormal cranial ultrasound/MRI (8/42, 19%), one presented abnormal postnatal brain imaging associated with hearing loss and four had sensorineural hearing loss (SNHL) at initial assessment. All were treated with oral Valganciclovir. Four newborns with normal hearing at birth had delayed onset SNHL. One case of hearing loss improved after treatment and returned to normal hearing. At a median follow-up of 35months, 8 infants had hearing loss (8/42, 19%, 95%CI 8.6%-34.1%) and none presented with severe brain abnormalities. For infants with congenital CMV following untreated first trimester maternal primary infection, the absence of abnormal prenatal brain ultrasound findings at the mid-trimester morphology scan does not rule out the possibility of postnatal neuroimaging anomalies or the need for treatment after birth. However, no severe brain abnormalities were detected after birth in our cohort, and the only observed sequelae were sensorineural hearing loss.

Pseudorabies virus as a zoonosis: scientific and public health implications.

Pseudorabies virus (PRV) is a herpes virus, also known as Aujeszky's disease virus (ADV), which can cause a highly infectious disease pseudorabies (PR) in a variety of mammals. In the past, it has been debated whether PRV can infect humans, but more and more cases of PRV infection have been reported since 2017. The illness has claimed many victims and left survivors with serious sequelae. This indicates that humans may ignore the zoonotic ability of PRV. This review aims to summarize the pathology and pathogenesis of PRV and speculate on how it infects humans. This paper provides a comprehensive overview of the progression of PRV, including its virology characteristics, genomic organization, and genetic evolution. It also synthesises the existing literature on PRV infection in humans, and analyses the factors contributing to PRV zoonosis. Finally, the pathogenesis of PRV-infected pigs and other mammals was summarized, and the pathogenesis of PRV-infected humans was speculated.

Lack of an association between spleen volume and risk of pneumococcal infection in cancer patients: a nested case-control study

BackgroundThe spleen is a key organ in preventing pneumococcal infection, especially in patients with immunocompromised condition such as those with cancer. Previous studies have shown that a small spleen volume in pneumococcal pneumonia patients is associated with severe disease course. However, it is unknown whether a small spleen increases risk of pneumococcal infection. We investigated the association between spleen volume and risk of pneumococcal infection.MethodsThis study was a retrospective cohort study using a nested case-control design and involved adult patients with malignancy who underwent chest and/or abdominal CT scans from January 1, 2008, to September 30, 2020, at a tertiary care center in Japan. Exclusion criteria comprised patients diagnosed with hepatic cirrhosis, leukemia, lymphoma, and/or post-splenectomy. From the cohort group that met all selection criteria (n = 22475), we identified all incident cases of pneumococcal infection (pneumococcal pneumonia and/or invasive pneumococcal diseases) and matched them with four controls by age, sex, and follow-up duration. Odds ratios (ORs) for the association between spleen volume and pneumococcal infection were estimated using conditional logistic regression models adjusted for body surface area, performance status, Charlson comorbidity index, and metastatic cancer.ResultsThe median spleen volume was 85.8 (interquartile range, 65.8–120.8) cm3. Over a median follow-up of 4.95 (interquartile range, 1.54–9.25) years, 60 patients were diagnosed with pneumococcal infection (20 with invasive pneumococcal disease and 40 with pneumonia without invasive pneumococcal disease) and matched with 240 controls. Spleen volume reduction (per 10 cm3) did not increase risk of pneumococcal infection in a crude analysis [OR 1.04 (95% CI 0.98–1.11)]. The outcome remained unchanged in the multivariable analysis (OR 1.01 [95% CI 0.95–1.08]).ConclusionsSmall spleen volume did not increase risk of pneumococcal infection in cancer patients.

HPV genotypes in invasive cervical cancer: prevalence, risk attribution, and optimized vaccine strategies in western China

BackgroundUnderstanding the HPV genotype distribution in invasive cervical cancer (ICC) is essential for vaccine optimization. This study presents a comprehensive analysis of HPV genotypes in ICC tissues from patients in western China, with the aim of informing regional vaccine policy and prevention strategies.MethodsDNA was extracted from 1,908 paraffin-embedded ICC samples, and 23 HPV genotypes were detected via PCR and reverse dot hybridization gene chip assays. The genotypic distribution of HPV infections was analyzed, the attribution of each HPV genotype found in multiple infection cases was calculated using the fractional contribution approximation. Furthermore, the cumulative attribution rates of HPV genotypes included in each vaccine combination were totaled to estimate the potential vaccination coverage of ICC across various histologic types and age groups.ResultsThe overall prevalence of HPV infection was 94.9% (95% CI 93.8–95.8) among 1,908 women with ICC. HPV genotypes 16 and 18 were detected in 1645 of 1810 HPV-positive patients (90.9, 95% CI 89.5–92.1) of ICC. HPV16, 18, 33, 52, and 58 were detected in 1,749 patients (96.6, 95% CI 95.7–97.4), the five most common genotypes in different age groups. HPV genotypes contained in the 9-valent vaccine were detected in 1776 patients (98.1, 95% CI 97.4–98.7). By weighted imputation analysis, the cumulative attribution rates of the bivalent vaccine was 83.4%, and that of the nine-valent vaccine was 89.8%. Optimization group A included the five genotypes with the highest prevalence, HPV16, 18, 33, 52, and 58, with a cumulative attribution rates of 88.5%, and optimization group B included the nine most common HPV genotypes, HPV16, 18, 31, 33, 35, 45, 52, 58, and 59, with a cumulative attribution rates of 90.5%.ConclusionOur comprehensive postsurgical analysis of HPV in ICC patients in western China revealed that the incorporation of the bivalent vaccine into the national program is cost-effective, with group A optimization closely matching the vaccination coverage of the 9-valent vaccine, which can be used to guide future prevention strategies.

Genetic Diversity and Epidemiology of Enteroviruses and Rhinoviruses in Children Hospitalized with Acute Respiratory Infections in Novosibirsk, Russia (2023–2024)

Rhinoviruses and respiratory enteroviruses remain among the leading causes of acute respiratory infections, particularly in children. Little is known about the genetic diversity of enteroviruses and rhinoviruses in pediatric patients with acute respiratory infections in Russia. We assessed the prevalence of human rhinoviruses/enteroviruses (HRV/EV) in 1992 children aged 0 to 17 years hospitalized with acute respiratory infections during the 2023–2024 epidemic season using PCR. The detection rate of HRV/EV was 11% (220/1992). We performed typing of 58 HRV and 28 EV viruses by partial sequencing of the VP1 gene. Rhinovirus A was the most common among HRV, followed by rhinovirus C; rhinovirus B was detected in only three cases. Enteroviruses were represented by all four species, with the EV-D68 genotype being the most frequently detected. Phylogenetic analysis of the VP1 fragment of EV-D68 showed that all our sequences belonged to the B3 subclade. We identified the first case of EV-C105 infection in Russia in a two-year-old girl hospitalized with pneumonia. Phylogenetically, the Novosibirsk strain EV-C105 was closely related to a strain discovered in France in 2018. This research helped to fill a critical gap in understanding the epidemiological landscape of HRV/EV in pediatric populations within Russia.

Detection of antibodies against H5 subtype highly pathogenic avian influenza viruses in multiple raccoons in Tokachi District, Hokkaido, Japan, from 2022 to 2023.

In recent years, infection cases of H5 subtype highly pathogenic avian influenza viruses (HPAIVs) in wild mammals have increased globally. To obtain recent epidemiological information regarding influenza A virus (IAV) infection in raccoons (Procyon lotor), the prevalence of anti-IAV antibodies in sera was analyzed among raccoons captured in Tokachi District, Hokkaido, Japan, from 2019 to 2023. Screening of serum samples using enzyme-linked immunosorbent assay and agar gel precipitation test detected anti-IAV antibodies in 5 of 114 (4.4%) raccoons. All positive sera were from raccoons captured from 2022 to 2023. The hemagglutination inhibition test revealed that all five serum samples contained anti-H5 subtype HPAIV antibodies, and one also contained anti-H1 subtype antibodies. The neuraminidase inhibition test revealed that all five sera contained anti-N1 subtype antibodies, and one also contained anti-N8 subtype antibodies. In the virus neutralization test, these five sera showed stronger neutralization activity against the H5 subtype clade 2.3.4.4b HPAIV strain recently circulating worldwide compared to the old H5 HPAIV strain isolated in Japan in 2007. Findings suggested that raccoons could be involved in the circulation of H5 HPAIVs in nature.

Spreading of dengue virus infection cases in Malda district of West Bengal, India during COVID-19 pandemic situation (2020 to 2022): A cross-sectional study

Introduction: One of the most widespread arboviral infections is caused by the dengue virus (Family: Flaviviridae) having a positive sense single-stranded RNA genome. It causes common symptoms like fever with headache, rashes, and other associated features like thrombocytopenia. This study aims to determine the prevalence of dengue virus infection and serotype dominance in the Malda district, West Bengal, India. Methods: During January 2020 to December 2022, the fever cases visited out-patient department or admitted to in-patient department at Malda Medical College were assessed for the presence of dengue NS1 antigen (fever<5 days) along with dengue IgM (fever≥5 days) in serum by ELISA. Serotype(s) of the dengue NS1-positive patients was determined using RT-qPCR. Results: The results revealed NS1 positivity to be 2.94% in 2020, 6.50% in 2021 and an increase up to 7.36% in 2022. Dengue IgM positivity was 0.35% in 2020, 5.59% in 2021 and reached 10.89% in 2022. During this period, the male population was infected more than the female. In 2020, the age-group<15 years was mostly infected (43%), while the age-group of 15-30 years accounted for the highest rate in 2021 (38%) and 2022 (34%). The serotyping data revealed that DENV-2 was most prevalent (60%), while some mixed infections (10%) with DENV-1 and DENV-3, were also found. Conclusion: Dengue infection is a major concern in this region and the rate of infection is continuously increasing yearly. DENV-2 serotype was found most predominant. Appropriate prevention along with proper awareness among the population, is utmost necessary.

Pyomyositis Due to a Rare Fungal Infection-Findings on 68Ga-NOTA UBI PET/CT.

It is very rare to see fungal arthritis and pyomyositis in immunocompetent patients. Here, we report a case of Scedosporium infection in an immunocompetent patient with interesting 18F-FDG PET/CT and 68Ga-NOTA UBI PET/CT findings.

Mycobacterium tuberculosis infection complicated by talaromycosis in a patient with positive anti-interferon-γ autoantibodies: a case report

High-titer antibodies to interferon-gamma (IFN-γ) are strongly correlated with infections caused by intracellular pathogens, particularly non-tuberculous mycobacteria and Talaromyces marneffei (TM). However, cases of concurrent infections with TM and Mycobacterium tuberculosis (MTB) in non-immunosuppressed patients are extremely rare. We presented a clinical case of a patient with anti-IFN-γ autoantibodies who developed an MTB infection complicated by Talaromyces marneffei, which subsequently led to secondary hemophagocytic syndrome. This report aimed to raise clinicians' awareness of this rare association to minimize the risk of misdiagnosis and overdiagnosis.

The Use of POCUS to Identify Subgaleal Fluid Collections and Intracranial Infections.

Point-of-care ultrasound (POCUS) has been useful in describing soft tissue infections, such as cellulitis and abscesses. There has been limited use of ultrasound to describe findings of intracranial infections, such as Pott's puffy tumor, in cases of forehead prominence and signs of infection. In this case series we present POCUS findings in 2 cases of intracranial infections and one case of soft tissue edema without intracranial involvement from a single pediatric tertiary care center. Ultrasound findings revealed subgaleal fluid collections with associated periosteal lifting of the frontal bone in cases of Pott's Puffy tumor and intracranial infection, but no bony disruption or periosteal lifting in the patient with traumatic soft tissue edema. As pediatric intracranial infections may continue to have uncharacteristic seasonal peaks, POCUS may be considered as a first-line imaging technique for patients presenting with forehead swelling for differentiating infectious and traumatic etiologies as well as judging the need for further imaging techniques such as computed tomography and magnetic resonance imaging.

Implementation and validation of a new qPCR assay to detect imported human Plasmodium species.

Diagnosis of imported malaria is based on microscopic examination of blood smears (BS), detection of circulating plasmodial antigen by immunochromatography (ICT), or detection of Plasmodium spp. DNA by loop mediated isothermal amplification. We have developed duplex (Plasmodium spp. and Plasmodium falciparum) real-time PCR (qPCR) and species-specific qPCR assays for the identification and quantification of human Plasmodium species. Whole nucleic acids from 523 samples prospectively collected from 410 patients suspected of malaria between June 2016 and March 2021 were tested by qPCRs and compared to standard diagnostic procedures. All qPCRs were designed on 18S ribosomal ribonucleic acid. The limit of detection of duplex qPCR was 8 copies/reaction, and analytical specificity of species-specific qPCRs was 100%. Seventy-nine patients diagnosed for single species malaria involving P. falciparum, P. vivax, P. ovale, and P. malariae were positive with duplex and species-specific qPCRs. P. knowlesi qPCR detected DNA from a P. knowlesi culture. Of eight cases of mixed Plasmodium species infection, five were identified with our qPCR assays with better sensitivity as compared to BS and ICT. Eight out of 323 patients with negative BS were hospitalized for symptoms suggestive malaria after malaria-endemic area travel or known with history of malaria had a low positive duplex qPCR. Between day of diagnosis and post-treatment follow-up at D2-D4 of malaria, a 3.1-log P. falciparum load decrease was observed by qPCR. These new Plasmodium qPCRs allowing detection of human plasmodial species have excellent species specificity and allow rapid detection of P. falciparum cases, malaria with low parasitaemia, and mixed Plasmodium species infection.IMPORTANCEMalaria is a disease transmitted by a Plasmodium parasite genus. Most cases are caused by Plasmodium falciparum. Despite a significant drop of incidence and mortality since 2000, 249million cases and 608,000 deaths have been estimated in 2022, mainly in Africa. Due to the increasing number of travels to endemic areas, incidence of imported malaria is rising in Europe. Various techniques are used in European laboratories, such as microscopic examination of thin and thick smears and rapid diagnostic tests. However, these techniques require skilled operators to differentiate plasmodial species and have limited sensitivity. Actually, molecular diagnosis is carried out using point-of-care test for rapid results with excellent sensitivity but is unabled to determine involved species and assess parasitaemia. In this study, we developed a combined molecular tool based on both detection of all human plasmodial species (Plasmodium spp.) and P. falciparum. We have also developed specific qPCRs for each human plasmodial species.

The increasing burden of group B Streptococcus from 2013 to 2023: a retrospective cohort study in Beijing, China.

Group B Streptococcus (GBS) is a leading pathogen responsible for fatal infections in newborns primarily due to vertical transmission from colonized mothers. Cases of invasive GBS infections in adults have also increased and attracted attention recently. To comprehensively understand the evolving burden of vaginal GBS carriage in pregnant and non-pregnant women, as well as the trends in invasive GBS diseases and antibiotic resistance in China, we conducted a retrospective study using data from a large tertiary hospital in Beijing from 2013 to 2023. Over the past decade, improvements in GBS screening methods for pregnant women have significantly increased the GBS recovery rate. The detection rate of GBS and its proportion among vaginal pathogens have shown a gradual increase in GBS colonization in both pregnant and non-pregnant women. An analysis of vaginal pathogen composition revealed variations in GBS prevalence across different age groups, as well as a potential competitive relationship between GBS and Enterococcus faecalis in the vaginal environment. Additionally, we analyzed 165 invasive GBS cases, including three in newborns. The incidence of invasive GBS cases has risen since 2016, particularly among individuals over the age of 40. The 5,858 GBS isolates exhibited notably high resistance rates to erythromycin (72.2%), clindamycin (60%), and levofloxacin (50.1%), with 30.8% classified as multidrug-resistant. Importantly, invasive GBS strains exhibited a higher resistance rate to levofloxacin (61.2%) compared to colonizing strains (49.8%). This study highlights the importance of continuous screening and monitoring for GBS, especially given the concerning antibiotic resistance rates of GBS.IMPORTANCEGroup B Streptococcus (GBS) is an important pathogen that commonly causes infections in newborns and the elderly. This retrospective study provides a comprehensive analysis of GBS strains isolated from a large tertiary hospital in Beijing between 2013 and 2023, revealing an increasing colonization rate of GBS in both pregnant and non-pregnant women. Analysis of vaginal pathogens indicates a growing proportion of GBS among vaginal pathogens. Additionally, the high resistance rates of GBS to erythromycin, clindamycin, and levofloxacin, as well as the prevalence of multidrug resistance, are issues that merit attention. We also examined the differences in resistance rates of GBS strains from various sample types, finding that the levofloxacin resistance rate in GBS strains causing invasive infections was significantly higher than in colonizing strains. This study provides new data and insights for clinical research on GBS.

Microbiology Profiles and Antibiotic Susceptibility in Pediatric Microbial Keratitis.

The purpose of this study was to assess trends in microbiology profiles and antibiotic susceptibility among pediatric infectious keratitis cases in Southern California, United States. This is a retrospective chart review of patients aged 18 years or younger diagnosed with infectious keratitis with a positive microbiology culture between 2006 and 2019 at a tertiary academic institution. Patient demographics, microbiology results, and antibiotic susceptibilities were analyzed. There were 23 patients included in the study period. The mean age (±SD) was 11 ± 7 years, with 60% 10 years and older. 75% were female, and 45% were of Hispanic or Latino descent. A total of 14 patients (61%) presented between June and November. A total of 30 microorganisms were identified from 24 corneal cultures of 23 eyes, and 92% were bacterial. The most common gram-positive and gram-negative isolates were Staphylococcus spp. (5/13, 38%) and Pseudomonas spp. (9/15, 60%), respectively. 92.3% gram-positive isolates were susceptible to vancomycin, but only 7.7% were susceptible to erythromycin. Gram-negative isolates were susceptible to gentamicin (86%), ciprofloxacin (79%), and ceftazidime (55%). Pseudomonas spp. was highly susceptible to gentamicin (100%) and ciprofloxacin (83%), and it was moderately susceptible to tobramycin (44%) and ceftazidime (67%). Pediatric microbial keratitis cases in Southern California were predominantly bacterial infections, with gram-positive isolates highly susceptible to vancomycin and gram-negative isolates, particularly Pseudomonas spp., showing high susceptibility to gentamicin and ciprofloxacin.

Does Peer‐to‐Peer Lending Have Resilience During the COVID‐19 Pandemic? Evidence From China

ABSTRACTDoes Peer‐to‐Peer (P2P) lending, a digital FinTech platform, show resilience in response to COVID‐19 shocks? We examine this question by considering both the absorbing and adapting abilities based on psychological perceptions and objective infection cases. We collect data on infection cases, the Baidu search index, and 54,166 textual news articles to propose a novel perspective that incorporates both subjective psychological perceptions and objective infection cases to measure the response of P2P lending firms to COVID‐19 shocks. We calculate the extent of P2P lending's resilience using four metrics: maximum loss, total loss, recovery periods, and net impacts from local projections impulse responses. Our findings demonstrate that P2P lending displays resilience, as its total trade volume, new investors, and new investments initially decrease slightly and then rebound in response to the COVID‐19 shock. Psychological perception of COVID‐19 shocks, rather than objective infection, elicits a more pronounced response in the performance of P2P lending firms.

Is the Presence of Sinus Tract in Periprosthetic Joint Infection Still One of the Main Deciding Factors for Septic Revision?

Introduction Two of the most common complications of joint arthroplasty surgery are aseptic and septic loosening. While aseptic loosening has a well-established treatment protocol, and diagnosis is quite straightforward, bacterial colonization of the implants is associated with a more difficult diagnosis and treatment, more surgeries, and higher morbidity for the patient. Accurate diagnosis is essential in choosing the right treatment plan. The aim of the current study was to assess the current diagnostic methods for periprosthetic joint infection and the influence of clinical signs like sinus tract on the treatment algorithm and outcomes of the patients.We wanted to highlight that sinus tract is still one of the major criteria in periprosthetic joint infection diagnosis and its presence increases the probability of choosing the right therapeuticoption. Materials and methods During the three-year period of the study, we included 48 cases of patients who presented in our hospital with pain around their hip or knee prostheses. Inclusion criteria were patients diagnosed with septic or aseptic loosening of the prosthesis that required surgical revision of the implant in one stage or two stages. We excluded patients who did not require surgery yet or had major contraindications for revision surgery, patients who refused surgery, acute periprosthetic joint infections (less than 1 month since implantation), or extrinsic mechanical complications of the prosthesis like periprosthetic fractures, implant dislocations. Results Out of 48 patients, 25 underwent one-stage revision and 23 underwent two-stage revision surgery (septic revision). In the subgroup of two-stage revision, 18 patients (78.2%) presented a sinus tract communicating with the prosthesis, this clinical sign being a major characteristic of the subgroup. We managed to successfully identify 21 out of 23 cases (91.3%) of periprosthetic joint infections prior to or during the surgery. In the two cases in which we misdiagnosed the infection, the sinus tract or a positive bacterial culture was absent prior to surgery, in addition to other clinical or paraclinical findings indicating only a small probability of periprosthetic joint infection, influenced the attending medical doctor's therapeuticdecision. In these particular cases of culture-negative periprosthetic joint infections, the outcome was poor, with patients needing additional surgeries in order to eradicate the infection. Discussion When present, a clear sign of periprosthetic joint infection, such as a sinus tract, facilitates the diagnostic protocol and allows the medical staff to initiate the appropriate treatment earlier. In the absence of such obvious signs, differential diagnosis remains difficult, and we should consider the future development of faster, cheaper, and more accurate tests for periprosthetic joint infectiondiagnosis, especially for chronic low-grade infections that could be easily misdiagnosed.

First Experience with the NPseal®: A Novel Mechanically Powered Negative Pressure Dressing Applied to Colorectal Surgery Wounds.

The use of prophylactic closed-incisional negative pressure wound therapy after colorectal procedures has been shown to reduce postoperative wound complications and surgical site infection. We present our experience with a novel, closed-incision, mechanically powered negative pressure (MP-NPD) dressing after colorectal procedures. This was a prospective, single-center, single-arm observational study assessing patient reported and wound healing outcomes of colorectal surgical incisions dressed with a MP-NPD. Consecutive patients, 18years and older, that met inclusion criteria were enrolled between May 2021 and December 2021. Thirty patients were included (13 male/17 female) with a mean age of 62.7 ± 11.8years and mean body mass index of 25.5 ± 4.4kg/m2. The mean incision length covered was 3.0 ± 1.8cm. The median number of manual pinches required to initially activate the dressing with negative pressure within -75 to -125mmHg was 12 (range 7-20). Four dressings were changed (13.3%) after drainage was noted inside the pump; not including these, 88.5% (23/26) of dressings held pressure consistently without any re-pinching during the 72-h period since they were first applied in the operating room. 75.9% of patients reported the dressing was "very comfortable" and none reported the dressing restricted mobility. 79.3% of patients reported the dressing was "very easy" to use. There were no cases of major wound complication or surgical site infection within 30days. The use of MP-NPD appears to be feasible on primarily-closed colorectal incisions. Further randomized controlled study is warranted to ascertain its clinical efficacy.

Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)

Background. Infectious complications remain one of the main causes of mortality and morbidity in blast injury among military personnel. The prevalence of infectious complications in blast injury reaches 35 %, and often the causative agents of such infections are multidrug-resistant microorganisms. The purpose was to analyze the dynamics of causative agents of wound infections in military personnel during the full-scale russian invasion. Materials and methods. We conducted a retrospective cohort study of servicemen who were injured during hostilities and were treated at the Feofaniya Clinical Hospital from March 2022 to March 2024. Wound culture was mandatory for study inclusion. Samples were taken from wounds with signs of inflammation, and microbiological testing was carried out in the laboratory of Feofaniya Clinical Hospital. Cultures were conducted in accordance with standard methods of medical microbiology. The disc diffusion method was used to determine the sensitivity of isolates to antimicrobial drugs. Results. The study included 478 servicemen (mean age of 36.60 ± 0.42 years, range 18–67, 99.6 % were males) who have had 1441 wound cultures, and 2483 isolates were identified. No pathogen was detected in 289 cases (11.63 %), fungal isolates were detected in 59 (2.38 %) cases, and the remaining isolates (2135; 85.98 %) were found to be bacterial. Gram-negative flora predominated among them — 80.2 % (95% confidence interval (CI) 78.4–81.8), while Gram-positive flora accounted for 19.8 % (95% CI 18.2–21.6), p < 0.001. The most common pathogens were Klebsiella pneumoniae (22.8 %; 95% CI 21.2–24.5), Acinetobacter baumannii (20 %; 95% CI 18.5–21.6), Pseudomonas aeruginosa (13.6 %; 95% CI 12.3–14.9) and Enterococcus spp. (6.2 %; 95% CI 5.3–7.2). Other pathogens were observed with a proportion of < 5 %. Monomicrobial cultures accounted for 50.5 % (95% CI 47.8–53.3), two isolates were found in 34.0 % (95% CI 31.4–36.6), three isolates — in 12.7 % (95% CI 10.9–14.5), four isolates — in 2.2 % (95% CI 1.4–3.0) and five isolates — in 0.6 % (95% CI 0.3–1.1) of all cultures. There was a significant level of antibiotic resistance — 99.7 % of Klebsiella pneumoniae isolates were multidrug-resistant. Conclusions. Wound infection in blast injury is characterized by a significant predominance of Gram-negative microflora with a high prevalence of antibiotic resistance. Polymicrobial flora was identified in half of the cases of wound infection.

Severe Panton–Valentine-Leukocidin-Positive Staphylococcus aureus Infections in Pediatric Age: A Case Report and a Literature Review

Background: Infections caused by S. aureus strains encoding Panton–Valentine leukocidin (PVL-SA) have become increasingly relevant in community settings and can cause severe conditions in pediatric populations. We present the pediatric case of an invasive disease caused by PVL-SA and provide a literature review of severe manifestations caused by these strains in children. Methods: A PubMed search (February 2024) found studies that included relevant clinical outcomes, diagnostics, and treatments, excluding cases of asymptomatic infection or in adult populations. A logistical multivariate analysis was used to find predictors of the need for intensive care. Results: A 10-year-old boy came to the attention of our Pediatric Infectious Diseases Unit with fever, chest pain, and tachypnea. A rapid worsening of his clinical conditions was observed, with the development of necrotizing pneumonia, osteomyelitis, deep vein thrombosis (DVT), and multiple abscesses. Blood cultures confirmed the presence of PVL-producing methicillin-resistant S. aureus (MRSA). The initial treatment included linezolid and ceftaroline and was later adjusted to clindamycin, daptomycin, and fosfomycin, with clinical improvement. Discussion: Our review collected 36 articles, including 156 pediatric cases of severe PVL-SA infection. Bacteremia was present in 49% of cases, lung infection in 47%, and osteomyelitis in 37%. The presence of pulmonary localization was predictive of the need for intensive care, O.R. 25.35 (7.46–86.09; p < 0.001). Anti-toxin molecules were used in about half the cases where information on treatment was reported. Our report highlights the capacity of PVL-SA to cause life-threatening complications in children, while also discussing the full range of its clinical spectrum and the most effective therapeutic approaches.