Infected Patients Research Articles

Risk factors for anxiety, depression, stress, and their comorbidities among nurses: a prospective cohort from 2020 to 2022

BackgroundNurses are at the forefront of healthcare delivery during the COVID-19, placing them at an increased risk for mental health issues. This study aimed to identify the risk factors for anxiety, depression, stress, and their comorbidities among nurses during the 2020–2022 period.MethodsA prospective cohort of nurses in Zunyi City, China, was followed from 2020 to 2022. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Perceived Stress Scale (PSS) were used to assess anxiety, depression, and stress, respectively. A self-reported questionnaire was utilized to collect data on demographic characteristics, lifestyle habits, socioeconomic status, work-related factors, and medical history. The Healthy Eating Index (HEI) was calculated to evaluate diet quality. Univariate and multivariate logistic regression analyses were conducted to examine the associations between risk factors and mental health outcomes.ResultsAmong the 516 participating nurses, the incidence rates of new-onset anxiety, depression, and stress were 27.1%, 33.9%, and 39.9%, respectively. Frontline experience with infected patients, night shift work, longer working hours, and higher body mass index were consistently associated with increased risks of anxiety, depression, and stress, whereas a higher healthy eating index score was linked to reduced odds of these mental health outcomes. Notably, higher BMI (≥ 28: OR = 1.67, 95% CI: 1.12–2.16, p = 0.011), night shifts (> 1/week: OR = 5.12, 95% CI: 3.64–5.99, p < 0.001), longer working hours (> 40/week: OR = 1.99, 95% CI: 1.66–2.89, p < 0.001), and frontline experience (OR = 6.11, 95% CI: 4.52–8.88, p < 0.001) significantly increased comorbidity risk, while higher HEI (> 3: OR = 0.51, 95% CI: 0.36–0.70, p < 0.001) reduced the risk.ConclusionOur study highlights the considerable mental health burden among nurses during the 2020–2022 period and identifies key risk factors associated with anxiety, depression, stress, and their comorbidities. These findings underscore the importance of providing targeted interventions and support for nurses, including workload management, work-life balance promotion, and healthy lifestyle encouragement, to mitigate the negative consequences of identified risk factors and improve mental health outcomes.

Association between Hepatitis B virus infection and COVID-19: outcomes from clinical analysis and online survey from Beijing, China

ObjectiveWe aim to investigate whether Coronavirus disease 2019 (COVID-19) worsens chronic hepatitis B virus(HBV)infection and explore the incidence of long COVID symptoms in patients with chronic hepatitis B virus infection.MethodsPatients with chronic HBV infection and COVID-19 patients attending the hepatitis clinic or fever clinic were included in the study. Clinical manifestations of COVID-19 and information about long COVID were collected for all patients. For patients with chronic hepatitis B virus infection, laboratory test results such as HBV-DNA, liver function, and kidney function were collected three months before and after COVID-19.ResultsA total of 940 patients with COVID-19 were included in this study. These patients were divided into two groups: the hepatitis B virus infection group with 189 patients and the non-hepatitis B group with 751 patients. Further matching analysis was conducted, selecting 156 patients from each group. Within the hepatitis B group, patients were further divided into two subgroups based on whether they received antiviral therapy: 90 patients in the antiviral therapy group and 99 patients in the non-antiviral therapy group. Neither group experienced a significant increase in HBV-DNA after COVID-19. There were significant differences between the two groups regarding BMI and symptoms of sore throat, loss of smell, and nasal congestion during COVID-19. The incidence of long COVID symptoms was higher in the hepatitis B group compared to the non-hepatitis B group (64.1% vs. 48.7%, p < 0.001), with the top five symptoms being cough, fatigue, palpitations, insomnia, and memory impairment.ConclusionPatients with chronic HBV infection did not show a significant rise in HBV DNA after COVID-19 in this study. They had a lower incidence of COVID-19 symptoms but experienced a higher incidence of long COVID symptoms.

Active cytomegalovirus infection in mechanically ventilated patients with sepsis

BackgroundActive cytomegalovirus (CMV) infection is associated with poor prognosis in septic patients with critical illness. Patients of septic category are highly likely to benefit from prophylactic antiviral therapy. Nevertheless, the clinical characteristics for CMV reactivation are lacking among septic patients requiring mechanical ventilation. The aim of this study was to investigate the incidence, risk factors, and clinical outcomes regarding active CMV infection in mechanically ventilated patients with sepsis.MethodsA single-center, retrospective cohort study conducted from January 2021 to December 2023 that included septic patients on mechanical ventilation at the intensive care unit (ICU) of a national hospital. Study participants were divided into active and non-active CMV infection groups based on CMV DNAemia within a 28-day hospitalization period in ICU. Clinical features, laboratory findings, treatment measures, and clinical outcomes were compared between the two groups.ResultsAmong 118 septic patients, 21 (17.8%) exhibited active CMV infection within 28-day ICU admission. Hemoglobin served as an independent risk factor and predictor for active CMV infection (P < 0.05). Moreover, the duration of mechanical ventilation and ICU stay in active CMV infection patients were significantly higher than in the comparison group (P < 0.05).ConclusionsActive CMV infection is common and associated with adverse clinical outcomes in mechanically ventilated patients with sepsis. A low level of hemoglobin is an independent risk factor for active CMV infection. Further prospective studies are warranted to assess the efficacy of initiating prophylactic and preemptive antiviral therapies among patients with sepsis disorders.

Identification and evaluation of plasma exosome RNA biomarkers for non-invasive diagnosis of hepatocellular carcinoma using RNA-seq

BackgroundNon-invasive diagnostic methods, including medical imaging techniques and blood biomarkers such as alpha-fetoprotein (AFP), have been crucial in detecting hepatocellular carcinoma (HCC). However, imaging techniques are only effective for tumor size larger than 2 cm. AFP measurement remains unsatisfactory due to high rate of misdiagnosis and underdiagnosis. Therefore, new reliable biomarkers and better non-invasive diagnostic approach are necessary for HCC identification.MethodsThe differentially expressed genes were identified using multiple public RNA-seq data of liver tissues from healthy individuals and HCC patients including peritumoral and tumor tissues. The hub genes for HCC diagnosis were identified combining pathway enrichment analysis and protein–protein interaction network analysis. The performance of hub genes for non-invasive HCC diagnosis was analyzed in plasma of healthy individuals, HBV infected patients, and HCC patients based on exosomal RNA-seq data. A multi-layer perceptron (MLP) model based on exosomal hub genes was developed for non-invasive HCC diagnosis.ResultsThrough differential gene expression and pathway enrichment analysis on multiple public RNA-seq datasets, we first identified 30 dysregulated genes in HCC tissues. Protein-protein interaction analysis further narrowed down this list to 10 key genes: BRCA2, CDK1, MCM4, PLK1, DNA2, BLM, PCNA, POLD1, BRCA1 and FEN1. By further evaluation using additional public HCC tissue datasets, POLD1 and MCM4 were excluded from consideration as potential biomarkers due to their suboptimal performance. Notably, CDK1, FEN1, and PCNA gene were found to be significantly elevated in the plasma exosomes of HCC patients compared to non-HCC individuals, including those with HBV-infected hepatitis and healthy controls. The MLP model, based on three biomarkers, showed an area under the curve (AUC) of 0.85 and 0.84 in training and test dataset respectively, after adjusting for the covariates sex and age.ConclusionWe identified three key genes, CDK1, FEN1, and PCNA, as exosomal biomarkers for non-invasive diagnosis of HCC. The MLP model utilizing three biomarkers showed good differentiation between non-HCC individuals and HCC patients, which exhibits promising potential as a non-invasive diagnostic tool for detecting HCC. Additional validation with a larger sample size is essential to thoroughly assess the reliability of the biomarkers and the model’s performance.

Prevalence of multidrug-resistant gram-negative bacilli (MDR-GNB) in hospital-acquired and ventilator-associated pneumonia: A comparative study from a tertiary care center, Gujarat

Antibiotic resistance poses a formidable challenge to global healthcare, with Gram-negative bacteria emerging as a primary concern. Multidrug-resistant Gram-negative bacilli (MDR-GNB) have become a significant cause of nosocomial infections, particularly pneumonia, complicate therapy, and have a detrimental impact on patients’ outcomes. This study aims to investigate the etiology, risk factors, and antibiotic resistance patterns associated with Gram-negative bacilli (GNB) isolated from nosocomial pneumonia cases.This prospective cross-sectional study was conducted at the Microbiology laboratory of a tertiary care Hospital in Gujarat. Patients hospitalized for &amp;#62;48 hours with new lung infiltrates and at least two of the following clinical features: fever, leukocytosis/leukopenia, purulent secretions, or decreased oxygenation were included. The study was initiated after the ethical approval. Patient demographic and clinical details were noted in the preformed questionnaire. A total of 64 specimens [Sputum (n= 28) and Endotracheal aspirate (ET, n=36)] were cultured on MacConkey’s agar and Blood agar and further species identification with Antimicrobial Susceptibility Pattern was done by automated Vitek-2 compact system. Ventilator-associated Pneumonia (VAP) was found in 14.6% of infected patients, with male predominance and common in the 30-50 years age group. Out of them, 72% were mainly associated with late-onset. Overall, the major isolates were (20/64, 31%), followed by (19/64, 29.6%) and (17/64, 26.5%) both as solitary and mixed infections.76% strains of and 85% of strains were resistant to carbapenems and 93.3% of were resistant to cephalosporins and carbapenems. strains were 100% resistant to carbapenems. The study recommends effective Infection control practices and strong antibiotic stewardship programs to reduce the morbidity and mortality of nosocomial pneumonia.

Mycobacterium tuberculosis and human immunodeficiency virus coinfection in Alagoas, Brazil: a picture from 2009 to 2019

Objective: The present study surveyed the sociodemographic characteristics of individuals affected by co-infection with Human immunodeficiency virus (HIV) and tuberculosis (TB) in Alagoas-Brazil. Methods: The study was conducted with two different databases of Sistema de Informação de Agravos e Notificação (SINAN) with cases notified between 2009 and 2019. An additional cohort of HIV infected patients from PAM Salgadinho Specialized Health Unit, Municipal Health Department of Maceió-Alagoas, Brazil was also evaluated. The data was analyzed descriptively and by statistical tests to evaluate the population profile and potential associations. Results: During the period evaluated, 14,318 cases of tuberculosis and 1,438 human immunodeficiency virus and tuberculosis co-infections were notified. Most co-infected cases were identified in men (63.13%), between 30 and 59 years old (72.53%), with incomplete primary education (27.88%), alcoholics (61.02%), and homeless (48.09%). Significant correlations suggest that death by co-infection was more common among men, population between 30 and 59 years old and with complete superior education. Also, the HIV viral load was significantly higher in the co-infected group. Conclusion: The results show the recent scenario of HIV/TB co-infection in Alagoas-Brazil, revealing a profile of social vulnerability situation and increased risk of death. These observations suggest that public health policies should be developed looking carefully at this portion of the population, to provide quality of life, less death and more adherence to TB treatment.

Studying the prevalence of chronic general somatic diseases among medical workers based on a cross-sectional epidemiological study

Introduction. Obtaining objective data on the long-term consequences of health disorders of medical workers who have suffered COVID-19 while performing professional duties is an important problem of occupational health. The establishment of background indicators of the health status of medical workers before their contact with infectious patients in the performance of professional duties is the first stage of monitoring the long-term consequences of coronavirus infection. The study aims to assess the prevalence of chronic general somatic diseases among medical workers of various industrial and professional groups for further monitoring of their health status. Materials and methods. The object of the study was the medical staff of the regional clinical hospital. The authors have analyzed the results of periodic medical examinations. The total number of medical workers amounted to 495 people. Experts have formed three production and professional groups: doctors, nursing staff, and junior medical staff. The authors performed a cross-sectional epidemiological study, during which they studied the prevalence of chronic general somatic diseases in medical professionals. The reliability of the results obtained was assessed by the Student's coefficient. Results. In the course of a cross-sectional epidemiological study, scientists found that the prevalence of chronic diseases in individual industrial and occupational groups is at the same level. In the structure of chronic general somatic diseases of medical workers, the first two places are occupied by diseases of the circulatory system and diseases of the musculoskeletal system and connective tissue. Diseases of the endocrine system, eating disorders and metabolic disorders occupy the third place. Chronic diseases of the musculoskeletal system and connective tissue are equally common among medical workers of various professional groups and amount to 63.0±2.2 (per 100 employees). The prevalence of chronic diseases of the circulatory system among medical workers is 50.7±2.2 per 100 employees. When comparing the indicators between professional groups, the authors found that the prevalence of diseases of the system of this class of diseases among doctors (38.6±3.2) was significantly (p&lt;0.05) lower compared with employees of the average (55.2±3.9) and junior (63.2±4.2) medical personnel. The prevalence of diseases of the endocrine system, eating disorders and metabolism among medical workers is 32.1±2.1 per 100 employees. At the same time, the lowest rate was noted among doctors, which is 25.9±3.1 per 100 employees and is significantly lower compared to the group of junior medical personnel (41.4±4.3). Limitations. The study is limited to the observation period. Conclusion. The data obtained as a result of a cross-sectional epidemiological study allowed us to establish that among doctors the prevalence of diseases of the circulatory and endocrine systems, eating disorders and metabolic disorders is significantly lower compared with medical professionals of other professional groups. Ethics. All medical staff have given informed consent to the use of personal data for statistical processing.

Prevalence of SARS-COV-2 infection and outcomes in Greek sarcoidosis patients.

There is limited data on the prevalence of SARS-COV-2 in sarcoidosis patients and the underlying parameters linked to severity. We aimed to conduct a national multicenter study to explore the prevalence of SARS-COV-2 in sarcoidosis patients and investigate its impact on hospitalization and infection rates, describe the characteristics of the infected population and assess the role of these characteristics in determining the likelihood of infection or hospitalization. We recruited all the adult sarcoidosis patients with who were examined across eight Greek Health Interstitial Lung Disease Referral Centers from the beginning of the pandemic until August 1, 2022. All the data was collected using structured questionnaires. 530 sarcoidosis patients with a mean age of 54±12 years, 60% of whom were females, were recruited. 43% of them were under corticosteroid treatment, and 39% were under additional immunosuppression. 18% of Greek sarcoidosis patients were infected by the virus, which is a lower rate than the general population. The infection was mainly mild. Only one-fifth of the infected sarcoidosis patients required hospitalization, and no deaths or ICU admissions were recorded. Vaccination was found to be associated with a reduced likelihood of infection. Younger age, a longer period since diagnosis, abnormal PET-CT findings, and immunosuppression were associated with an increased probability of infection. The COVID-19 infection rate among Greek sarcoidosis patients was lower than the general population. Fewer than 20% needed hospitalization. There were no deaths or ICU admissions. Vaccination reduces the likelihood of infection. Younger age, longer diagnosis, abnormal PET-CT findings, and immunosuppression increased the chance of infection.

HIV/AIDS KNOWLEDGE IMPROVES ANTIRETROVIRAL DRUG COMPLIANCE

Antiretroviral (ARV) therapy compliance is very important for people living with HIV/AIDS (PLWHA) and their support group. Effective ARV medication was essential for HIV infected patients to improve their health, reduce progression, reduce HIV drug resistance, prolong patient life expectancy, and decrease risk of HIV/AIDS transmission to others. Many factors caused non-adherence to ARV drugs. This study aimed to determine the relationship between education, HIV/AIDS knowledge level and ARV compliance. This study was cross-sectional design using consecutive non-random sampling with total sample of 34 subjects. Data were collected using questionnaire. The number of subject conducted in Public Heatlh Center of Cibatu District, Cikarang, Indonesia from October to November 2018. Chi-Square and Fisher test was used to analysed data. Most of the respondents were males, 20-25 years old, intermediate education, HIV/AIDS knowledge level was high, and had good ARV compliance level. There was a significant relationship between education, HIV/AIDS knowledge and ARV medication compliance.

VIVÊNCIA DAS ESTUDANTES DE ODONTOLOGIA DA FACULDADE DO AMAZONAS – IAES NO PROJETO DE EXTENSÃO REFERENTE ÀS PRÁTICAS MULTIDISCIPLINARES EM ODONTOLOGIA HOSPITALAR – UM RELATO DE EXPERIÊNCIA

Introduction: The role of the university is to train critical, reflective and ethical professionals. In this context, as an educational strategy, aligning theoretical teaching with practice, this experience took place at the Hospital and Emergency Room 28 de Agosto. The study was carried out by undergraduate students of the Dentistry course, in their sixth semester, with the practice taking place on two days a week, monthly, with a total duration of eight hours. The activities included lectures to patients, such as oral hygiene care and intraoral examinations, under the supervision of Prof. MSc. Guilherme Ferreira. Hospital Dentistry is a consolidated specialty in the care of hospitalized patients, encompassing a multidisciplinary approach and dental interventions. The care structure at the hospital was organized, ensuring safety and comfort for patients. In the Intensive Care Unit, there was one intubated patient, receiving continuous monitoring, and the other patients demonstrated good health. This experience report aims to share the experience acquired in the practice of Hospital Dentistry, highlighting the multidisciplinary work, the application of the relevant legislation and the challenges faced. Methodology: Descriptive in nature, providing an insight into the dental practices applied in the hospital environment – ​​description of the care provided, the clinical conditions of the patients, the multidisciplinary approaches and the difficulties faced by the professionals. Results and Discussion: Dental care provided to patients with various clinical conditions was observed, allowing an immersion in hospital dentistry. There was an opportunity to learn about hospital protocols and how they align with the hospital's standards and procedures, in relation to infection control and patient safety. The experience highlighted the complexity of dental care and highlighted the importance of multidisciplinary collaboration. Conclusion: The experience was an essential act for future professional practice, providing theoretical and practical learning, the opportunity to observe in a real clinical environment, to verify the complexity of hospital dental care and to adapt to the challenges of the environment.

Emerging Molecular and Clinical Challenges in Managing Lung Cancer Treatment during the Covid-19 Infection

The COVID-19 pandemic now had a broad impact on the health care system since its start. Cancer patients, specifically lung cancer patients, are undergoing a more vulnerable group due to their complex pathophysiological and immunological characteristics. Therefore, they need more attention and care about health and treatment. It is yet unknown how SARS-CoV-2 (COVID-19) infected lung cancer patient's health and management of treatment impacts them. From a clinical and multidisciplinary perspective, we aimed to explain our main priorities concerning COVID-19 infection in the scenario of lung cancer patients’ group in this chapter. Various types of lung cancer therapeutic strategies, including chemotherapy, radiation therapy, and immunotherapy, can all significantly increase the risk, therefore making a patient's chances of a poor outcome higher. Patients with lung cancer need regular clinical and radiologic examinations and follow-ups, which the COVID-19 pandemic might hamper. COVID-19-related lung cancer patients’ incidental radiologic abnormalities might show up in regular radiology exams, making it challenging to understand disease progression and the effect of therapy. The COVID-19 pandemic has profoundly impacted lung cancer care, highlighting challenges in patient management, treatment outcomes, and ethical dilemmas. Quantitative analysis and exploration of future directions would enhance clinical and research impact. In addition, cancer treatment-induced pneumonitis can exhibit radiologic characteristics that are identical to those seen in acute SARS-CoV-2 pneumonia, possibly due to a wrong diagnosis and misinterpretation. The current COVID-19 health crisis is affecting many healthcare requirements, including the necessity for regular healthcare accessibility, particularly follow-ups, and the clinical trials in which this patient group may be included. The COVID-19 epidemic has placed healthcare practitioners, scientists, researchers, and institutions in a complex and dangerous situation, forcing them to address challenges with ethical scenarios.

Sero-prevalence of Hepatitis C infection among the Municipal Waste collectors in Aden, Yemen

Objectives: Hepatitis C virus infection is major global health problem. The present study was aimed to determine the prevalence of Hepatitis C infection among municipal waste collectors and to identify clinical findings and risk factors associated with HCV infection among those collectors in Aden, Yemen. Methods: A cross-sectional study was conducted on 100 municipal waste collectors. The blood samples were collected from all MWCs, then the clotted blood was separated by centrifuge and the sera were tested for presence of HCV antibodies (Anti-HCV) by Cobas technique that based on ECLIA. Results: Out of 100 municipal waste collectors, majority was males 89(89/100). The total mean age of those members was 36.74±10.98years. The range of ages was 16 and 60 years. Only 1(1/100) had HCV infection. This case was male, married and within age group ≥ 45years which comprised; 1.1%, 1.2% and 4.5%, respectively. The positive case was illiterate and had low economic status and had duration of work as municipal waste collector from 10-20years and alone accommodation which comprised 1.1%, 1.6% 2.4% and 9.1%, respectively. This 1(7.8%) HCV infected patient infection lives in Al-Muallhe. Significant associations found between HCV infection and exposing to blood transfusion, catheterization and needles stick as risk factors (p=0.002,0.0001 and 0.080), respectively and liver cirrhosis as complicated clinical finding (p=.0001),but the association was not significant between HCV infection and sources of waste (0.620). Conclusion: It can be concluded from this study that the municipal waste collectors in Aden, Yemen had lower rate of HCV infection than most studies globally. The males, married and MWCs in age group≥ 45years, and those had illiterate education and live alone had highest percentages of HCV infection. Blood transfusion, needles stick and catheterization may increase the risk of HCV infection.

Bacterial Etiology of Lower Respiratory Tract Infection that Isolated from Tripoli University Hospital (TUH) Units in 2019

Introduction: Lower respiratory tract infection (LRTI) is one of the common major health problems, causing morbidity and mortality. Aims: The study was conducted to determine the current trends of bacterial etiology of LRTIs among patients who attended the University Teaching Hospital (UTH) and their antimicrobial susceptibility profile with special interest on drug resistance. Study Design: The study was a Cross sectional study. All patients’ files were selected as diagnosed with LRTIs and their demographic data, other illness, prescribed treatment /antibiotic used previously. Place and Duration of Study: This study is designed to collect data from files of lower respiratory tract infection patients following in units of university hospital in Tripoli. Methodology: The study was conducted between January to December 2019. at the unit in university hospital in Tripoli city in Libya. Sputum samples of 465 patients with suspected LRTIs were received, after obtaining patients' informed consent and ethical clearance from the UNTH. The samples were collected and processed according to standard laboratory procedures. Results: Of the total 465 sputum samples, 366 (78.7%) were positive for micro-organisms. Four main types of bacteria have been identified: acinetobacter spp. 25.6%, Klebsiellla pneumoniae 25.6%, P. saeroginosa (1.39%), Candida (9.03%). The distribution of lower respiratory tract infections within the hospital department indicated that the isolated strains revealed a higher infection rate of Gram-negative bacteria in the Pediatric Intensive Care Unit (PICU) and General Surgical Intensive Care Unit (GSICU) compared to other departments, with statistical significance. Notably, there was a significant difference in the infection rates of Pseudomonas in the Special Care Baby Unit (SCBU) with 7 cases, and in the Medical Intensive Care Unit (MICU) with 6 cases, as well as in the Neonatal Intensive Care Unit (NICU) with 2 cases. The infection rates for Candida and Streptococcus pneumoniae in the NICU were recorded at 2, 1, and 2, respectively, which were significantly different from those observed in other departments. The prevalence of antimicrobial resistance among Gram-negative and Gram-positive bacterial isolates indicated a very high resistance rate (98–100%) among Acinetobacter baumannii isolates to various antibiotics including AK, AMC, ATM, CAZ, CRO, CIP, GN, MEM, TOB, PRL, and CZ. However, for SXT, the isolate demonstrated the highest sensitivity, with a resistance rate of less than 53%. Conclusion: Understanding the variety of pathogens that cause lower respiratory tract infections (LRTIs) and their patterns of susceptibility to antibiotics, in addition to monitoring antibiotic resistance, is crucial for the effective management of LRTIs. This includes timely clinical and laboratory diagnoses, as well as the implementation of the appropriate treatment strategies.

Analysis of Health Care Professionals’ Knowledge, Attitudes and Behaviours about Hepatitis B, Hepatitis C and HIV/AIDS: A Cross-sectional Clinical Study

Objective: The aim of this study was to determine the level of knowledge about hepatitis B virus (HBV), hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV), their approaches to patients and the deficiencies that need to be corrected among health care workers including physicians and nurses in a training and research hospital. Methods: Healthcare professionals were surveyed on 30.07.2023 for this cross-sectional clinical study. Questions were asked to the respondents about HBV, HCV, and HIV/AIDS (transmission routes, perspectives on the disease, prevention methods, prophylaxis, etc.) via Google Forms. A chi-square test was performed for statistical analysis of the obtained data. Results: A total of 165 healthcare professionals, 77 (46.7%) physicians and 88 (53.3%) nurses, filled out the questionnaire and participated in the study. 89 (53.9%) of them were women. Based on the results of this study, the lack of knowledge about HBV, HCV and HIV/AIDS was less in physicians than in nurses. In addition, as the years of work in the profession increased, the level of knowledge increased with the experience. The majority of the respondents correctly stated that all three viruses were transmitted through blood. However, the percentage of correct answers was low in questions about breastfeeding, vertical transmission, and post-exposure prophylaxis. The most common measure to prevent transmission from infected patients was the “use of gloves” (70.9%). Conclusion: It is necessary to increase the knowledge level of health workers about HBV, HCV, and HIV by periodically organizing in-service trainings. This will help ensure effective infection control.

Procalcitonin, C-reactive protein, and white blood cell count levels in end-stage cancer patients: A retrospective study on inflammatory markers and their prognostic value.

Procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) are commonly recognized as inflammatory markers. Some studies showed that these markers were also related to some cancers. This study aimed to investigate whether these markers were exhibited aberrations in end-stage cancer patients and to assess their correlation with infection and prognosis. The study underscores the potential of inflammatory markers as prognostic indicators in end-stage cancer, proposing that routine monitoring of these markers could substantially enhance patient management and improve outcomes. The medical records of 116 cancer patients were retrospectively reviewed. Data from end-stage cancer patients were collected during the week preceding their death. The control group consisted of cancer patients with a performance status score of 3 to 4 and clinical stage of III to IV. Normally distributed continuous data (mean ± SD) were analyzed using t-test. Non-normally distributed data (median [M] with interquartile range [P25, P75]) were analyzed using Wilcoxon rank-sum test. Numerical data were subjected to Chi-square test. Logistic regression analysis was employed to assess the correlation between inflammatory markers and patient prognosis. There were significant differences between the 2 groups for PCT, WBC, CRP, platelet count, and body mass index. However, subgroup analysis indicated that there were no significant differences in PCT, CRP, and WBC levels between infected and noninfected patients within the deceased group. It is worth noting that elevated levels of PCT (OR = 7.13, 95% confidence interval [CI] = 1.68-30.36, P = .008) and WBC (OR = 2.47, 95% CI = 1.13-1.13, P = .024) were ultimately identified as independent risk factors associated with poor prognosis in cancer patients, as demonstrated by further logistic regression analysis. In the subgroup analysis of noninfected patients, the univariate analysis revealed that both PCT (OR = 11.612, 95% CI = 1.217-110.776, P = .033) and WBC (OR = 3.077, 95% CI = 1.004-9.427, P = .049) had a statistically significant difference in outcomes between the alive group and the deceased group. The PCT, WBC, and CRP levels of end-stage cancer patients were significantly elevated, regardless of infection. An increase in PCT and WBC was associated with an increased risk of death. These findings suggest that monitoring PCT and WBC levels in end-stage cancer patients may provide valuable prognostic information, aiding in clinical decision-making.

QTc interval prolongation and its associated factors among HIV infected patients on ART in Mettu Town

QTc interval prolongation, which is linked to cardiac arrhythmia and sudden cardiac death, is common in HIV-infected patients. This prolongation can be attributed to the side effects of antiretroviral medications, the direct impact of HIV on the heart, and chronic inflammatory responses that disrupt cardiac electrical activity. This study aimed at assessing QTc interval prolongation and associated factors among HIV-infected adults on ART. A cross-sectional study was conducted among consecutively selected 298 HIV-infected patients at Mettu Karl Specialized Hospital, southwest Ethiopia. A face-to-face interview with a structured and pretested questionnaire was employed to collect socio-demographic and behavioural characteristics data. Electrocardiography was done using a 12-lead electrocardiograph, and interpreted by a cardiologist. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 25. Multivariable logistic regression analyses were done at a significance level of P < 0.05. QTc prolongation was prevalent in 12.4% of participants. Being on PIs containing HAART regimen (AOR = 5.7, 95%CI 2.54–12.8), having recent CD4 count of < 350 cells/mm3 (AOR = 4.8, 95%CI 2.19–10.5), and recent viral load of ≥ 1000coppies/ml (AOR = 2.8, 95%CI 1.24–6.42) were significantly associated with QTc prolongation. According to this study, one of the ten HIV-infected patients on ART had QTc prolongation. Therefore, we suggest that HIV-positive patients receiving treatment should undergo screening for QTc interval prolongation.

Clinical characteristics and diagnostic accuracy of preliminary diagnoses in adults with infections in Danish emergency departments: a multicentre combined cross-sectional and diagnostic study

ObjectiveRapid and accurate infection diagnosis is a prerequisite for appropriate antibiotic prescriptions in an ED. Accurately diagnosing acute infections can be difficult due to nonspecific symptoms and limitations of diagnostic...

Pattern of rapidly growing mycobacteria (RGM) species isolated from clinical samples: A 10-year retrospective study in a tertiary care hospital of Bangladesh

PurposeInfections caused by rapidly growing mycobacteria (RGM) are increasing worldwide. The study was conducted in a microbiological laboratory of Bangladesh to determine the pattern of detection of RGM from clinical samples. MethodsAll laboratory culture records of RGM from 2012 to 2022 were collected retrospectively and analyzed. ResultsA total 62 RGM infected patients with surgical site infection (74.1 %), injection site and skin abscess (9.7 %), septicaemia (4.8 %) and UTI (1.6 %) were identified. The annual isolation frequency of RGM increased 4.8 %–29.1 % in between year 2012 and 2022. RGM infected patients (14.5 %) were mistakenly treated with first line anti tubercular drug before correct microbiological diagnosis (median, IQR; 3, 2–5 months). Out of 23 RGM isolates, 86.9 % were M. abscessus and rest 13.1 % were M. fortuitum. Most of them (≥95 %) were sensitive to amikacin, linezolid, clarithromycin where as 27.1 % to imipenem and ciprofloxacin, 40 % to cefoxitin, 35.3 % and 1.7 % to doxycycline and co-trimoxazole respectively. ConclusionMisdiagnosis or delay in diagnosis and erroneous treatment with first line anti tubercular drug may cause prolong morbidity and therapeutic failure to patients with RGM infection. So, early and appropriate diagnosis is crucial for successful outcome.

Utility of the PITT Bacteremia Score for Predicting Mortality in CRE Colonized and Infected Patients

Background: The Pitt Bacteremia Score (PBS) is used to predict 14-day inpatient mortality in bloodstream infections. This study evaluates whether PBS can also predict mortality in ICU patients colonized or infected with Carbapenem -resistant Enterobacterales (CRE). Methods: ICU patients with CRE were selected, and each PBS component was individually assessed. Outcomes were noted after 14 days, and a PBS cutoff score for mortality prediction was analyzed. Results: Of 30 patients, 26 (86%) expired and 4 (14%) survived. A PBS cutoff of ≥4 was associated with a significant increase in mortality. Conclusions: PBS ≥4 may be a valuable predictor of mortality in CRE-infected and colonized ICU patients."

Comprehensive pathogen identification and antimicrobial resistance prediction from positive blood cultures using nanopore sequencing technology

BackgroundBlood cultures are essential for diagnosing bloodstream infections, but current phenotypic tests for antimicrobial resistance (AMR) provide limited information. Oxford Nanopore Technologies introduces nanopore sequencing with adaptive sampling, capable of real-time host genome depletion, yet its application directly from blood cultures remains unexplored. This study aimed to identify pathogens and predict AMR using nanopore sequencing.MethodsIn this cross-sectional genomic study, 458 positive blood cultures from bloodstream infection patients in central Taiwan were analyzed. Parallel experiments involved routine microbiologic tests and nanopore sequencing with a 15-h run. A bioinformatic pipeline was proposed to analyze the real-time sequencing reads. Subsequently, a comparative analysis was performed to evaluate the performance of species identification and AMR prediction.ResultsThe pipeline identified 76 species, with 88 Escherichia coli, 74 Klebsiella pneumoniae, 43 Staphylococcus aureus, and 9 Candida samples. Novel species were also discovered. Notably, precise species identification was achieved not only for monomicrobial infections but also for polymicrobial infections, which was detected in 23 samples and further confirmed by full-length 16S rRNA amplicon sequencing. Using a modified ResFinder database, AMR predictions showed a categorical agreement rate exceeding 90% (3799/4195) for monomicrobial infections, with minimal very major errors observed for K. pneumoniae (2/186, 1.1%) and S. aureus (1/90, 1.1%).ConclusionsNanopore sequencing with adaptive sampling can directly analyze positive blood cultures, facilitating pathogen detection, AMR prediction, and outbreak investigation. Integrating nanopore sequencing into clinical practices signifies a revolutionary advancement in managing bloodstream infections, offering an effective antimicrobial stewardship strategy, and improving patient outcomes.