Infection Control Strategies Research Articles

Family-based Helicobacter pylori infection control and management strategy and screen-and-treat strategy are highly cost-effective in preventing multiple upper gastrointestinal diseases in Chinese population at national level.

The overall benefits of the newly introduced family-based Helicobacter pylori (H. pylori) infection control and management (FBCM) and screen-and-treat strategies in preventing multiple upper gastrointestinal diseases at national level in China have not been explored. We investigate the cost-effectiveness of these strategies in the whole Chinese population. Decision trees and Markov models of H. pylori infection-related non-ulcer dyspepsia (NUD), peptic ulcer disease (PUD), and gastric cancer (GC) were developed to simulate the cost-effectiveness of these strategies in the whole 494 million households in China. The main outcomes include cost-effectiveness, life years (LY), quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER). When compared with no-screen strategy, both FBCM and screen-and-treat strategies reduced the number of new cases of NUD, PUD, PUD-related deaths, and the prevalence of GC, and cancer-related deaths. The costs saved by these two strategies were $1467 million and $879 million, quality-adjusted life years gained were 227 million and 267 million, and life years gained were 59 million and 69 million, respectively. Cost-effectiveness analysis showed that FBCM strategy costs -$6.46/QALY and -$24.75/LY, and screen-and-treat strategy costs -$3.3/QALY and -$12.71/LY when compared with no-screen strategy. Compared to the FBCM strategy, the screen-and-treat strategy reduced the incidence of H. pylori-related diseases, added 40 million QALYs, and saved 10 million LYs, but at the increased cost of $588 million. Cost-effectiveness analysis showed that screen-and-treat strategy costs $14.88/QALY and $59.5/LY when compared with FBCM strategy. The robustness of the results was also verified. Both FBCM and screen-and-treat strategies are highly cost-effective in preventing NUD, PUD, and GC than the no-screen strategy in Chinese families at national level. As FBCM strategy is more practical and efficient, it is expected to play a more important role in preventing familial H. pylori infection and also serves as an excellent reference for other highly infected societies.

Infection-related mortality and infection control practices in childhood acute myeloid leukemia in a limited resource setting: Experience with the Indonesian national protocol.

In resource-limited settings, addressing infections remains a substantial challenge in the management of children with Acute Myeloid Leukemia (AML). In Indonesia, infection-related mortality (IRM) is thought to be high compared to high-income countries. However, there has been no previous study of infection profile and IRM in Indonesian patients with AML. This study aimed to describe infections and IRM in children with AML treated according to the Indonesian National AML protocol and to describe the implementation of infection control practices in resource-limited settings. This retrospective observational study used secondary data from the medical records of pediatric patients with AML treated with the National Protocol at Dr. Sardjito Hospital, Yogyakarta, Indonesia, from April 2012 to September 2018. Essential patient characteristics, time of IRM, and cause of death were recorded, and infection control practices were observed. Data were analyzed using descriptive statistics. 113 patients with AML were treated with the National protocol, and 83 met the inclusion criteria. Infections occurred in 69 (83%) patients with a total of 123 episodes (mean 1.8/patient). Death was seen in 48 (58%) patients, with 19 (23%) IRM. The majority of infections were in the gastrointestinal tract (n = 51, 30.5%), sepsis (n = 29, 17%), and respiratory tract (n = 28, 17%). Infections mostly occurred during the first induction (41%). There were 90 (73%) episodes of clinically documented infection and 33 (27%) episodes of microbiologically documented infection. The positivity rate of blood cultures was only 27%. The majority of bacteria detected were gram-negative (n = 25, 69%), and among them were Klebsiella pneumonia (19%) and Escherichia coli (19%). Candida albicans was detected in 1 (2%) culture. Suboptimal infection prevention and control were found in the clinical practice. Infections and infection-related mortality in children with AML treated using the National protocol were frequent, mainly occurring during the first induction phase. Compliance with infection prevention and control measures needs improvement. Urgent attention is required for better supportive care, including isolation rooms, antibiotics, and antifungals. The predominance of Gram-negative bacterial infections highlights the necessity for further research into effective prophylaxis. Enhanced healthcare and nursing professional vigilance and tailored antibiotic strategies are vital. Improving compliance and ensuring adequate supportive care resources are essential, emphasizing nursing's pivotal role. Further research is crucial to drive advancements in infection control strategies.

Prevalence of surgical site infection in orthopedic procedures, in an institution in the municipality of Pereira, 2022

Background The acquisition of healthcare-associated infections (HAI) is characterized by developing during the patient’s hospital stay and even after the hospital stay during the recovery period, as long as it is due to factors intrinsic to the hospitalization or medical treatment of the entity, as well as surgical techniques that require prophylactic treatment and medical surveillance. Methods Type and design of research: Quantitative, observational, descriptive, cross-sectional, retrospective. The population and sample is made up of patients who underwent orthopedic surgery in an institution in the municipality of Pereira, between January and December 2022. Results The results showed that there are significant differences between genders in the incidence of certain medical conditions and response to certain treatments. Women appear to be more prone to deep infections, use more chlorhexidine as an antiseptic, and show a higher prevalence of pathologic conditions compared to men. In addition, differences in the distribution of ASA classification and surgical wound type suggest possible health disparities between genders in the context of orthopedic surgery. Conclusions The importance of implementing infection prevention and control strategies adapted to specific contexts is evident. Despite the differences in the risk factors identified, both studies highlight the importance of optimizing antibiotic prophylaxis and adequately managing specific comorbidities to reduce the incidence of postsurgical infections. Furthermore, attention to perioperative surveillance and surgical time management are suggested as key areas to improve surgical outcomes in both cohorts of patients, as they can contribute significantly to the reduction of the incidence of SSIs in patients undergoing orthopedic procedures.

KPC-2-producing Enterobacterales from ready-to-eat food to hospitalized patients

Foodstuffs are a well-documented source of multidrug-resistant bacteria, and hospitalized patients are usually susceptible to hospital infections owing to their immune status. Therefore, this study aimed to investigate the presence of beta-lactamase-producing Enterobacterales in ready-to-eat foods consumed by hospitalized patients. For this purpose, 51 vegetable and meat samples were collected over 2 months and analyzed. Enterobacterales isolates were identified and subjected to antimicrobial susceptibility testing, followed by beta-lactamase gene screening, pH tolerance assays, and whole-genome sequencing (WGS). Isolates harboring genes encoding extended-spectrum beta-lactamases, cephalosporinases, or carbapenemases were detected, and all isolates tolerated pH levels similar to those in the human gastrointestinal tract. The blaKPC-2 carriers were characterized by WGS and lineages closely related to those causing human infections were identified. These results showed that dietary intake is an alternative route for the transmission of antimicrobial-resistant bacteria, which must be considered when designing effective strategies for infection control.

Potential of Wormwood and Oak Bark-Based Supplement in Health Improvement of Nosema ceranae-Infected Honey Bees.

Nosema ceranae, a microsporidian parasite, as one of the stressors that contribute to honey bee decline, has a significant negative impact on the longevity, productivity, and reproductive capacity of honey bee colonies. There are several different strategies for Nosema infection control, including natural-based and antibiotic-based products. In this study, we tested wormwood and oak bark-based supplement "Medenko forte" on survival, Nosema infection, oxidative stress, and expression of immune-related genes in artificially N. ceranae-infected bees. The results revealed a positive influence on the survival of Nosema-infected bees, irrespectively of the moment of supplement application (day 1, day 3, or day 6 after bee emergence), as well as reduction of Nosema loads and, consequently, Nosema-induced oxidative stress. Supplementation had no negative effects on bee immunity, but better anti-Nosema than immune-stimulating effects were affirmed based on expression levels of abaecin, defensin, hymenoptaecin, apidaecin, and vitellogenin genes. In conclusion, the tested supplement "Medenko forte" has great potential in the health protection of Nosema-infected bees. However, further investigations need to be performed to elucidate its mechanisms of action.

A quanta-independent approach for the assessment of strategies to reduce the risk of airborne infection

The Wells-Riley model is extensively used for retrospective and prospective modelling of the risk of airborne transmission of infection in indoor spaces. It is also used when examining the efficacy of various removal and deactivation methods for airborne infectious aerosols in the indoor environment, which is crucial when selecting the most effective infection control technologies. The problem is that the large variation in viral load between individuals makes the Wells-Riley model output very sensitive to the input parameters and may yield a flawed prediction of risk. The absolute infection risk estimated with this model can range from nearly 0 % to 100 % depending on the viral load, even when all other factors, such as removal mechanisms and room geometry, remain unchanged. We therefore propose a novel method that removes this sensitivity to viral load. We define a quanta-independent maximum absolute before-after difference in infection risk that is independent of quanta factors like viral load, physical activity, or the dose-response relationships. The input data needed for a non-steady-state calculation are just the removal rates, room volume, and occupancy duration. Under steady-state conditions the approach provides an elegant solution that is only dependent on removal mechanisms before and after applying infection control measures. We applied this method to compare the impact of relative humidity, ventilation rate and its effectiveness, filtering efficiency, and the use of ultraviolet germicidal irradiation on the infection risk. The results demonstrate that the method provides a comprehensive understanding of the impact of infection control strategies on the risk of airborne infection, enabling rational decisions to be made regarding the most effective strategies in a specific context. The proposed method thus provides a practical tool for mitigation of airborne infection risk.

Evaluation of the spatial distribution of aerosols produced by various respiratory activities

This study investigated the dispersion and evaporation characteristics of droplets and droplet nuclei emitted during human respiratory activities. A specially designed wind tunnel was filled with purified air, wherein selected subjects performed various respiratory activities with their heads positioned inside. An optical particle sizer was used to collect particles with sizes of 0.3–10 μm at 63 points in front of the mouth. The dilution factors were analyzed to investigate the impact of combining the exhaled airflow with ambient air on droplet evaporation. At a distance of 0.01 m from the mouth opening, the volume concentration of the particles was the highest during breathing, followed by coughing and speaking. The volumetric concentration of particles decreased with an increase in the distance from the inlet for all activities. The spatial volume concentration distribution of particles showed that coughing tended to disperse the particles in the forward direction, whereas speaking tended to disperse them laterally. Utilizing these findings in CFD analysis can provide in-depth insights into dispersion and evaporation dynamics. This can contribute significantly to the development of preventive measures through the implementation of proactive HVAC systems to effectively remove infectious particles and control the spread of infectious diseases. Future studies should explore a wider range of particle sizes and advanced sampling techniques for a clear understanding of respiratory particle dynamics and infection control strategies.

The clinical, microbiological, and demographic aspects of Burkholderia infections: insights from a tertiary healthcare setting

Background and objectives. Optimal management requires an understanding of Burkholderia infections demographic, clinical, microbiological, and antibiotic features. This study aims to improve treatment and infection control strategies by investigating the clinical profiles and antibiotic susceptibilities of Burkholderia infections in a tertiary care context. Material and Methods. A retrospective analysis of 48 individuals with Burkholderia infections was carried out in a tertiary care environment. We gathered and analyzed data on antimicrobial susceptibility, clinical presentation, microbiological identification, and demographic features. Results. The mean age of the participants was 49.27 years, and their gender distribution was equal. Diabetes, heart disease, and hypertension are common comorbidities. The most typical symptoms were fever and cough, with infections varying in severity from minor to severe. Burkholderia was predominantly found in urine, blood, and respiratory secretions. Testing for antibiotic susceptibility showed inconsistent findings; some drugs, including ceftazidime and meropenem, were more successful than others. Conclusion. The research highlights the broad demographics impact of Burkholderia infections, in addition to their acute and occasionally fatal characteristics. It highlights how important it is to treat every patient differently, accounting for comorbidities and the severity of symptoms. The results emphasize how much more study is required to improve treatment options and learn more about the origins of Burkholderia infections.

Genomic insights into the expansion of carbapenem-resistant Klebsiella pneumoniae within Portuguese hospitals

Carbapenem-resistant Klebsiella pneumoniae (CR-KP) are a public health concern, causing infections with a high mortality rate, limited therapeutic options and challenging infection control strategies. In Portugal, the CR-KP rate has increased sharply, but the factors associated with this increase are poorly explored. In order to address this question, phylogenetic and resistome analysis were used to compare the draft genomes of 200 CR-KP isolates collected in 2017-2019 from five hospitals in the Lisbon region, Portugal. Most CR-KP belonged to sequence type (ST) 13 (29%), ST17 (15%), ST348 (13%), ST231 (12%) and ST147 (7%). Carbapenem resistance was conferred mostly by the presence of KPC-3 (74%) or OXA-181 (18%), which were associated with IncF/IncN and IncX plasmids, respectively. Almost all isolates were multi-drug resistant, harbouring resistance determinants to aminoglycosides, beta-lactams, trimethoprim, fosfomycin, quinolones and sulphonamides. In addition, 11% of isolates were resistant to colistin. Colonizing and infecting isolates were highly related, and most colonized patients (89%) reported a previous hospitalization. Moreover, among the 171 events of cross-dissemination identified by core genome multi-locus sequence typing data analysis (fewer than five allelic differences), 41 occurred between different hospitals and 130 occurred within the same hospital. The results suggest that CR-KP dissemination in the Lisbon region results from acquisition of carbapenemases in mobile genetic elements, influx of CR-KP into the hospitals by colonized ambulatory patients, and transmission of CR-KP within and between hospitals. Prudent use of carbapenems, patient screening at hospital entry, and improvement of infection control are needed to decrease the burden of CR-KP infection in Portugal.

Incorporating social vulnerability in infectious disease mathematical modelling: a scoping review

BackgroundHighlighted by the rise of COVID-19, climate change, and conflict, socially vulnerable populations are least resilient to disaster. In infectious disease management, mathematical models are a commonly used tool. Researchers should include social vulnerability in models to strengthen their utility in reflecting real-world dynamics. We conducted a scoping review to evaluate how researchers have incorporated social vulnerability into infectious disease mathematical models.MethodsThe methodology followed the Joanna Briggs Institute and updated Arksey and O'Malley frameworks, verified by the PRISMA-ScR checklist. PubMed, Clarivate Web of Science, Scopus, EBSCO Africa Wide Information, and Cochrane Library were systematically searched for peer-reviewed published articles. Screening and extracting data were done by two independent researchers.ResultsOf 4075 results, 89 articles were identified. Two-thirds of articles used a compartmental model (n = 58, 65.2%), with a quarter using agent-based models (n = 24, 27.0%). Overall, routine indicators, namely age and sex, were among the most frequently used measures (n = 42, 12.3%; n = 22, 6.4%, respectively). Only one measure related to culture and social behaviour (0.3%). For compartmental models, researchers commonly constructed distinct models for each level of a social vulnerability measure and included new parameters or influenced standard parameters in model equations (n = 30, 51.7%). For all agent-based models, characteristics were assigned to hosts (n = 24, 100.0%), with most models including age, contact behaviour, and/or sex (n = 18, 75.0%; n = 14, 53.3%; n = 10, 41.7%, respectively).ConclusionsGiven the importance of equitable and effective infectious disease management, there is potential to further the field. Our findings demonstrate that social vulnerability is not considered holistically. There is a focus on incorporating routine demographic indicators but important cultural and social behaviours that impact health outcomes are excluded. It is crucial to develop models that foreground social vulnerability to not only design more equitable interventions, but also to develop more effective infectious disease control and elimination strategies. Furthermore, this study revealed the lack of transparency around data sources, inconsistent reporting, lack of collaboration with local experts, and limited studies focused on modelling cultural indicators. These challenges are priorities for future research.

Non-Tuberculous Mycobacterial isolates from Panama: A retrospective 5-year analysis (2017-2021)

BackgroundThe genus Mycobacterium includes well-known bacteria such as M. tuberculosis causing tuberculosis and M. leprae causing leprosy. Additionally, various species collectively termed non-tuberculous mycobacteria (NTM) can cause infections in humans and animals, affecting individuals across all age groups and health conditions. However, information on NTM infection prevalence in Panama is limited. MethodsThis study conducted a retrospective analysis of clinical records from 2017 to 2021, specifically focusing on patients with NTM isolates. Data were categorized by variables like sex, age, HIV status, and sample source. ResultsAmong the 4430 clinical records analyzed, 698 were linked to patients with NTM isolates. Of these patients, 397 were male, and 301 were female. Most female patients with NTM isolates (n = 190) were aged >45 to 85 years, while most male patients (n = 334) fell in the >25 to 75 years age group. A noteworthy proportion of male patients (n = 65) were aged 25–35 years. A significant age difference between male (median [min-max] = 53 years [3–90]) and female (median [61 years [6–94]) patients was observed (p < 0.001). Regarding HIV status, 77 positive individuals were male, and 19 were female (p < 0.001). Most samples (n = 566) were sputum samples, with additional pulmonary-associated samples such as broncho-alveolar lavage, tracheal secretions, and pleural fluid samples. Among extrapulmonary isolates (n = 48), sources included catheter secretions, intracellular fluids, peritoneal fluid, blood cultures, cerebrospinal fluid, bone marrow samples, and capillary transplant lesions. Specifically, the analysis identified the pathogenic microorganisms responsible for mycobacteriosis in Panama during the specific period 2017–2021, as M. fortuitum (34.4%), M. intracellulare (20.06%), and M. abscessus (13.75%), respectively. ConclusionsThis study highlights the growing public health concern of NTM infections in Panama. The research provides valuable insights into the prevalence and distribution of NTM species in the country, offering a foundation for the development and implementation of effective prevention and control strategies for NTM infections in Panama.

Management of a large Stage 4 sacrococcygeal pressure injury with surgical debridement and Negative Pressure Wound Therapy

Background: Pressure injuries, affecting millions annually, pose substantial challenges globally. Aim: Presentation of the management of a patient with a large sacrococcygeal pressure injury in our tertiary hospital. Case presentation: Our (case) study highlights the case of a 67-year-old male with severe comorbidities and a significant sacrococcygeal pressure injury managed through surgical debridement and negative pressure wound therapy (NPWT). The patient’s condition, complicated by infection, necessitated tailored treatment. NPWT, applied for 80 days and followed by absorbent dressings, facilitated granulation tissue formation and wound closure within 162 days post-NPWT cessation. Conclusion: The case underscores the efficacy of NPWT in conjunction with infection control strategies, offering insights into managing complex pressure injuries, especially in settings with limited surgical resources.

Detection of resistance integrons among biofilm and non-biofilm producing clinical isolates of Pseudomonas aeruginosa.

Integrons are genetic systems that may confer antibiotic resistance to Pseudomonas aeruginosa. Biofilm formation can facilitate gene exchange and can accelerate the development of antibiotic resistance. The aim of this work was to assess the distribution of resistance integrons including class 1, 2 and 3 among biofilm- and non-biofilm producing clinical strains of P. aeruginosa. We also aimed to investigate the relationship between the existence of these integrons and the isolates' resistance patterns. Specimens were obtained from patients showing evidence of infection. P. aeruginosa isolates were identified using conventional techniques, while disk diffusion test was used to detect their antimicrobial susceptibilities. Biofilm formation was detected by the tissue culture plate technique, while classes of integrons were detected by polymerase chain reaction. Out of 106 P. aeruginosa isolates, 55.7% were class 1 integron-positive while 19.8% were class 2 integron-positive. However, class 3 integrons were not detected. Significant associations were found between class 1 integrons and resistance toward amikacin, gentamicin, cefepime, ceftazidime and ciprofloxacin. Class 2 integrons were associated with amikacin, ceftazidime and cefepime resistance. Of pseudomonal isolates, 61.3% were biofilm producing. Biofilm production was associated significantly with the existence of class 1 integrons (p<0.001) and class 2 integrons (p=0.039). About two thirds of isolated strains harbored resistance integrons, which emphasized their significance in our locality. The frequencies of class 1 and 2 integrons were significantly higher among biofilm forming isolates. Ongoing surveillance and infection control strategies are necessary to limit spread of integrons.

Possibilities of Using Geoinformation Technologies in Epidemiological Surveillance of COVID-19 Infection at the Regional Level

Relevance. The spread of the new coronavirus infection throughout the world has led to expressed interest in studying, among other things, the patterns of territorial distribution of cases of the disease. Aim. To investigate the spatial distribution of cases of COVID-19 infection and develop proposals for the use of GIS technologies in the epidemiological supervision system for the new coronavirus infection at the regional level. Materials and methods. The study was conducted on the territory of the closed administrative- territorial entity of Zelenogorsk, Krasnoyarsk Territory. 4176 cases of COVID-19 infection were reported during the study period of 57 weeks (04/12/2020 to 06/18/2021). Each case of the disease was geocoded by the residence of the sick person using a projection coordinate system from the open data of the Open Street Map resource. The spatial distribution of COVID-19 cases was studied with geographic information system QGIS Desktop version 3.28.0. Spatial autocorrelation analysis was carried out using the Getis-Ord index. Results. During the application of GIS technologies, the density of distribution of COVID-19 infection cases was estimated, six zones with an average core density were discovered, the outbreaks in the northern part of the city had the greatest epidemiological significance. When assessing the clustering of cases within the specified territorial zones, eleven clusters were identified, three of which were characterized by the highest density of cases - 1210.1 cases per 1 sq. km, 1155.9 and 1116.7 cases per 1 sq. km. The Getis-Ord index value ranged from 0.00 to 2.576, the majority of cases was recorded in territorial clusters located in the northern part of the city. Conclusions. New knowledge obtained on the basis of modern GIS technologies about the presence of “hot spots” or clusters in the administrative territory will make the adjustment of preventive measures in micro-areas with a high prevalence of infection possible and develop strategies for more effective control of COVID-19 infection.

From COVID-19 Reflections: Crucial Strategies for Ensuring Healthcare Worker and Patient Safety in Developing Countries

Globally, as millions of individuals stopovered at home to curtail the spread of COVID 19, healthcare workers (HCWs) remained in field to save mankind from the deadly virus. They attended the hospitals as well as clinics, exposed themselves to risk of COVID 19. Despite multiple steps taken by global health agencies, about 704,301,493 individuals were infected and 7,006,979 died around the globe. A significant proportion of transmissions was reported from health care settings among the health care workforce and patients. About 20% of the health care workforce of Italy was infected and many died in that outbreak, along with significant ratio of disease transmission to thir families. Physical and mental health of HCWs were affected badly because of the nuisance of hard triage verdicts and expiry of patients and colleagues. The frequency of HCWs who have acquired COVID 19 was high among the endemic countries. The key causative factors for the healthcare-associated COVID 19 spreads included lack of personal protective equipment availability, improper use of PPEs, lack of training of HCWs, overcrowding in hospitals and lack of proper acquiescence to and acceptance of the significance of fulfilling infection prevention and control (IPC) strategies. This credence was reinforced by globally renowned agencies i.e., WHO and the CDC. The agencies facilitated and implemented adopting IPC measures

Infection Prevention Measures for Service Recipients in Postpartum Care Homes

&lt;p&gt;產後護理之家服務對象，包括產後未滿二個月產婦及出生未滿二個月嬰兒。又嬰兒出生後來自母親的抗體逐漸消退，且免疫力尚未達到成熟階段，感染疾病風險高及可能嚴重併發症，因此對於服務對象入住機構內健康管理、包括疾病監測、疑似感染及適當隔離等，防範於未然及有效感染控制措施至為重要，各項感染管制訂定如：陪住家屬及訪客管理，遵守政府規範防疫政策；服務對象之配膳、飲食衛生、哺餵、哺育器材清消，飲用水衛生安全、供水設施等措施並落實執行，維護產婦、嬰兒及工作人員等之健康，建構優質安全環境，提升照護品質。機構管理者及工作人員應瞭解基本的感染預防及管制策略，確實執行應用，避免機構內感染及群聚事件，且配合衛生主管機關評鑑及感染管制查核督導，強化各項感染管制措施，共築完善防疫網。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Postpartum care homes provide services to mothers and infants in the first 2 months after birth. During this time, antibodies from the mother gradually diminish in infants, whose immunity is insufficiently mature, placing them at high risk of contracting diseases and developing serious complications. Therefore, adhering to and implementing strict infection control measures is crucial. For service recipients of health management in postpartum homes, infectious disease monitoring, isolation precautions, rules for managing family members and visitors, disease control regulations, meal preparation and feeding hygiene, access to cleaning and disinfection equipment, and regular cleaning and disinfection of water supplies are all critical measures for improving service quality and creating a high-quality and safe care environment. Institutional managers and staff must understand basic infection prevention and control strategies and carefully implement them to avoid infections and cluster incidents in postpartum homes. They must also cooperate with health authorities for institution accreditation, infection control inspection, and supervision to strengthen infection control measures and create comprehensive epidemic prevention strategies.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Genetic Diversity of Leishmania major Isolated from Different Dermal Lesions Using ITS2 Region.

Cutaneous leishmaniasis (CL) is still considered to be an uncontrolled endemic disease that spreads in many countries. The current study aimed to determine intra-species relationships of L. major using ITS2 sequencing. The study was conducted from the beginning of March to the end of November 2022. All medical information regarding CL was collected from patients of Thi-Qar province who attended the Dermatology Department of Al-Hussein Teaching Hospital in Nasiriyah city. Seventy-three samples were selected for the molecular identification after confirming microscopy with Giemsa stain. In this study, the primers were designed using NCBI GenBank sequence database and Primer 3 plus primer design online software. The results recorded 21 (28.77%) positive samples of L. major using the internal transcribed spacer 2 region (ITS2) in ribosomal RNA gene. The local L. major IQN.1-IQN.10 were submitted to NCBI GenBank database with accession numbers OM069357.1-OM069366.1, respectively. The phylogenetic analysis revealed that local isolates of L. major showed a close relationship with NCBI-BLAST L. major Iran isolate (KU680848.1). ITS2-PCR is suitable for identifying Leishmania spp. and determining genetic diversity. A phylogenetic data analysis may provide an idea on the genetic homogeneity of local isolates and knowing the genetic origin of the dermal lesion. However, the local isolates showed genetic proximity to the KU680848.1 isolate. This signifies the possibility of infection prevalence from Iranian areas. In general, genetic variation of L. major isolates may give several clinical manifestations of the cutaneous lesion. Therefore, determination of the heterogeneity is important for detecting the infection origin, epidemiology, therapy, and control strategies.

Prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) at a maternity and children hospital in Saudi Arabia: A cross-sectional study

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) pathogens are considered a serious global health threat, leading to increased mortality and antimicrobial resistance. Rates in Saudi Arabia remain high, necessitating continuous surveillance. This study investigates MRSA prevalence and susceptibility at a Saudi maternity and children's hospital. MethodA cross-sectional study was conducted on pediatric (<18 years) and maternal patients with S. aureus infection from Jan. 2020 to March. 2022. Bacterial strains were obtained from patient’s clinical specimens and was identified by standard method. The BD Phoenix™ M50 was used for antibiotic susceptibility tests and MRSA detection. Data were analysed using descriptive and inferential statistics (Chi-square test) with SPSS software. ResultsOut of 152 S. aureus cases, 114/152 (75 %) were pediatric and 38/152 (25 %) were maternal patients. The overall MRSA infection was 69/152 (45.4 %). Among pediatrics, 31/54 (57.4 %) MRSA cases were female; over 30/54 (56 %) were under 1 year old; and most MRSA infections were obtained from skin 29/54 (53.7 %) compared to other sites of infections (p = 0.024). Among maternal cases, 15/38 (39.5 %) were MRSA, primarily from wound infections 14/15 (93.3 %) compared to other sites of infections (p = 0.39). All MRSA isolates were sensitive to vancomycin and linezolid. While 51/60(85 %) were sensitive to Trimethoprim/ sulfamethoxazole. ConclusionThis investigation found a high prevalence of MRSA among pediatrics and maternal inpatients, indicating a significant burden. All MRSA isolates were susceptible to vancomycin but demonstrated variable sensitivity to other antibiotics. These findings highlight the need for ongoing surveillance, infection control strategies, and research into alternative treatment options to combat this major public health threat.

Impact of alternative Non-Pharmaceutical Interventions strategies for controlling COVID-19 outbreak in Bangladesh: A modeling study.

The COVID-19 pandemic has been a major health concern in Bangladesh until very recently. Although the Bangladesh government has employed various infection control strategies, more targeted Non-Pharmaceutical interventions (NPIs), including school closure, mask-wearing, hand washing, and social distancing have gained special attention. Despite significant long-term adverse effects of school closures, authorities have opted to keep schools closed to curb the spread of COVID-19 infection. However, there is limited knowledge about the impact of reopening schools alongside other NPI measures on the course of the epidemic. In this study, we implemented a mathematical modeling framework developed by the CoMo Consortium to explore the impact of NPIs on the dynamics of the COVID-19 outbreak and deaths for Bangladesh. For robustness, the results of prediction models are then validated through model calibration with incidence and mortality data and using external sources. Hypothetical projections are made under alternative NPIs where we compare the impact of current NPIs with school closures versus enhanced NPIs with school openings. Results suggest that enhanced NPIs with schools opened may have lower COVID-19 related prevalence and deaths. This finding indicates that enhanced NPIs and school openings may mitigate the long-term negative impacts of COVID-19 in low- and middle-income countries. Potential shortcomings and ways to improve the research are also discussed.

Early Childhood Anemia in Rural Bangladesh: The Role of Iron Deficiency, Infections, and Inadequate Complementary Feeding Techniques

Anemia and iron deficiency increased quickly until 8 to 9 months of age, while the prevalence of subclinical infections remained stable. Apart from age and male sex, iron deficiency and subclinical infections were the main risk factors for anemia. Similarly, age, male sex, and subclinical illnesses were important risk factors for iron deficiency. In early rural Bangladeshi newborns, the burden of anemia and iron deficiency is particularly severe during the key transition period of increased physiological Fe requirements corresponding to the early phase of supplementary feeding, which lasts from 6 to 11 months of age. Nutritional and infection control strategies alone are insufficient. as soon as they begin providing them with complimentary foods. The increasing prevalence of anaemia and Iron Deficiency during the first 3 months of the complementary feeding period highlights the need to support mothers to introduce Fe supplements or Fe-rich foods or products in their infants’ diet as soon as they start giving them complementary foods. In order to reduce anemia and Iron Deficiency in this population, it is imperative to incorporate methods related to water, sanitation, and hygiene, as well as parasitic disease control, given the high prevalence of subclinical infections and their role in these conditions. In order to avoid anemia during infancy in Bangladesh, a multipronged approach involving both infection control techniques and dietary Fe consumption improvements is required. A person&amp;apos;s capacity to work is restricted by anemia and iron deficiency, which can potentially have serious negative economic repercussions and impede the advancement of the country. Because of all of this, it is generally accepted that lowering the global burden of iron deficiency and iron deficiency anemia is a top priority in public health nutrition.