Source Of Infection Research Articles

Risk assessment of wild fish as environmental sources of red sea bream iridovirus (RSIV) outbreaks in aquaculture.

Red sea bream iridovirus (RSIV) causes substantial economic damage to aquaculture. In the present study, RSIV in wild fish near aquaculture installations was surveyed to evaluate the risk of wild fish being an infection source for RSIV outbreaks in cultured fish. In total, 1102 wild fish, consisting of 44 species, were captured from 2 aquaculture areas in western Japan using fishing, gill nets, and fishing baskets between 2019 and 2022. Eleven fish from 7 species were confirmed to harbor the RSIV genome using a probe-based real-time PCR assay. The mean viral load of the RSIV-positive wild fish was 101.1 ± 0.4 copies mg-1 DNA, which was significantly lower than that of seemingly healthy red sea bream Pagrus major in a net pen during an RSIV outbreak (103.3 ± 1.5 copies mg-1 DNA) that occurred in 2021. Sequencing analysis of a partial region of the major capsid protein gene demonstrated that the RSIV genome detected in the wild fish was identical to that of the diseased fish in a fish farm located in the same area in which the wild fish were captured. Based on the diagnostic records of RSIV in the sampled area, the RSIV-infected wild fish appeared during or after the RSIV outbreak in cultured fish, suggesting that RSIV detected in wild fish was derived from the RSIV outbreak in cultured fish. Therefore, wild fish populations near aquaculture installations may not be a significant risk factor for RSIV outbreaks in cultured fish.

Molecular evidence of sporadic Coxiella burnetii excretion in sheep milk, central Portugal.

Coxiella burnetii is the etiologic agent of Q fever, a worldwide zoonosis. Cattle, sheep and goats are considered the main reservoirs of the disease. Transmission to humans occurs mainly through the inhalation of infectious aerosols from milk, faeces, urine, and birth products from infected ruminants. In this study, a 2-year longitudinal approach was performed to ascertain the excretion of C. burnetii in bulk tank milk samples of sheep from a mountain plateau in central Portugal, with sampling conducted during the years 2015 and 2016. From a total of 156 bulk tank milk samples tested by qPCR, only one showed to be positive for C. burnetii (1.28% [95%CI: 0.03-6.94]), from 2015, the first year of collection. Bidirectional sequencing and phylogenetic analysis of IS1111 transposase partial region confirmed the presence of C. burnetii DNA. The presence of C. burnetii in raw milk samples highlights the necessity for additional research to determine if raw milk is a potential source for human infection. Animal health surveillance and prevention measures against this zoonotic disease should be considered.

Widespread Adoption of Microincision Vitrectomy Surgery Improves Visual Outcomes in Endogenous Endophthalmitis with Poor Initial Vision: A 21-Year Experience in Taiwan

ABSTRACT Purpose To review the presentation and visual prognostic factors of patients with endogenous endophthalmitis before and after the introduction of microincision vitrectomy surgery (MIVS), at a tertiary referral hospital in Taiwan, over a 21-year period. Methods We retrospectively analyzed medical records of patients diagnosed with endogenous endophthalmitis before and after the introduction of MIVS between January 2002 and December 2022. Results Data were collected from 147 patients. Diabetes mellitus was the most common comorbidity (59.9%). Liver abscess (32.7%) was the leading source of infection, followed by urinary tract infection (15.0%), and infective endocarditis (5.4%). Klebsiella pneumoniae (50.4%) was the most common pathogen, followed by Staphylococcus aureus (13.5%), and Candida albicans (8.3%). Poor initial visual acuity worse than counting fingers (CF) (p < 0.001) and diabetes mellitus (p = 0.008) were significantly associated with poor visual outcomes. In the treatment of 98 patients with poor initial visual acuity worse than CF, the proportion of vitrectomy surgeries performed increased from 13/56 (23.2%) to 24/42 (57.1%) (p = 0.001) after the introduction of MIVS. Final visual acuity of CF or better increased from 7/56 (12.5%) to 12/42 (28.6%) after the introduction of MIVS (p = 0.046). Vitrectomy was a better prognostic factor for final visual outcome in patients with poor initial visual acuity of worse than CF (p = 0.011) than other factors. Conclusion In endogenous endophthalmitis patients presenting with poor initial visual acuity, vitrectomy was a better visual prognostic factor. MIVS has allowed more patients to undergo vitrectomy and improved visual outcomes.

Investigation on KAP Model of Urban Residents in Prevention and Control of COVID-19

Objective: To investigate the knowledge, attitude and practice of the residents in Changxing community in the prevention and control of novel coronavirus pneumonia, and put forward targeted suggestions for formulating epidemic prevention and control measures. Methods: Convenience sampling method was used to invite residents to fill in the self-designed questionnaire online. Results: Total of 294 valid questionnaires were obtained. Among them, the awareness rates of the infectious source, transmission route, incubation period and epidemic situation of COVID-19 were 84.7%, 94.2%, 90.1% and 83.0% respectively. The proportions of judging that COVID-19 has high infectious characteristics, low mortality and high cure rate were 89.5%, 40.1% and 62.6%. The proportions of mastering the knowledge of preventive behaviors such as wearing masks, avoiding family and friends' gatherings, and washing hands correctly were 98.0%, 96.6% and 90.8%; The level of attitude towards epidemic prevention and control measures and awareness of prevention behavior exceeded 90%. Conclusion: The knowledge, attitude and practice of residents in Changxing community on COVID-19 are good.

Dirofilaria sp. and Blood Meal Analysis in Mosquitoes Collected in Vojvodina and Mačva, and the First Report of Setaria tundra (Issaitshikoff & Rajewskaya, 1928) in Serbia.

Dirofilaria immitis and D. repens are the two most widespread and important species of mosquito-borne nematodes, posing a significant threat to veterinary health and particularly affecting canines and felines. While D. immitis causes cardiopulmonary dirofilariasis, D. repens causes subcutaneous infections in dogs and other carnivores. Despite the extensive knowledge on these parasites, little is known about their natural vectors in Serbia. The parasite Setaria tundra, known to infect deer, has not yet been detected in Serbia but has been documented in neighboring countries. Thus, the aim of this study was to (i) further map out Dirofilaria sp. hotspots in the Vojvodina Province and detect S. tundra for the first time, (ii) detect positive mosquito species that can provide insights into how the nematodes spread in Serbia, and (iii) analyze the blood-fed female mosquitoes of species found to be infected, in order to identify the potential source of parasite infection. A total of 2902 female mosquitoes were collected across 73 locations during 2021 and 2022. Molecular biology methods, based on conventional PCR, were used to analyze non-blood-fed (2521 specimens) and blood-fed (381 specimens) female mosquitos, in order to detect filarial nematode presence and identify blood-meal sources, respectively. When the parasite genome was detected, the amplicon (cox1 gene, 650 bp fragment) was sent for Sanger sequencing, further confirming the presence of nematodes and species assignation. D. immitis was detected in three Culex pipiens mosquitoes collected in Zrenjanin (August 2021) and Glogonj and Svetozar Miletić (both in July 2021). Additionally, Setaria tundra was detected in Aedes vexans collected in Iđoš (mid-August 2021) and Aedes caspius, which was collected in Mali Iđoš (end of July 2021). This work identifies two new locations where D. immitis occurs in Vojvodina, and is the first report of S. tundra in Serbian territory. Blood-meal analysis provided insights into the preferences of mosquitoes that were positive for Dirofilaria sp. and S. tundra.

Knowledge and perceptions of infectious disease physicians about epidemiology, causes, diagnosis, treatment and prevention of Q fever in the Republic of Kazakhstan: results of online survey

&lt;b&gt;Background:&lt;/b&gt; Q fever is a significant zoonotic infectious illness triggered by the pathogen known as &lt;i&gt;Coxiella burnetii&lt;/i&gt;, whichcauses severe symptoms when inhaled through the respiratory tract. Serious acute Q fever may cause complications as pneumonia, hepatitis or myocarditis, and some patients may develop chronic Q fever due to incomplete treatment and the topical resistance of &lt;i&gt;C.burnetii&lt;/i&gt;. This often requires surgical intervention and anti-infective treatment up to several years, seriously endangering the health of the patients and resulting in the increase of economic burdens. Poor awareness of clinicians about the disease can be one of the reasons for delay intreatment. In view of the above, a survey has been carried out to collect information on the approach of modern Kazakhstani doctorsto the problem of Q fever.&lt;br /&gt; &lt;b&gt;Methods&lt;b&gt;:&amp;nbsp;&lt;/b&gt;&lt;/b&gt;The electronic survey was conducted among infectious disease physicians from different cities of Kazakhstan, based on convenient sampling through social network platforms. Data were collected anonymously between November 14, 2022 and December 14, 2022 among infectious disease doctors. The data collection form consisted of 24 questions including demographic information, general questions about epidemiology, causes, diagnosis, treatment and prevention of Q fever. Duplicate entries were avoided and standard guidelines for reporting Internet surveys were followed.&lt;br /&gt; &lt;b&gt;Results:&amp;nbsp;&lt;/b&gt;The majority of the respondents (91.7%) considered themselves to have knowledge of information, however 80.2% of physicians showed satisfactory level of knowledge. Westudied the relationship between the proficiency level and various socio-demographic features of the respondents.&amp;nbsp; A statistically significant difference was found in relation of work experience and age (&lt;sup&gt;*&lt;/sup&gt;&lt;i&gt;P&lt;/i&gt;&amp;lt;0.05). When comparing the level of knowledge in terms of age categories, it was found that age groups 50-55 years, above 55 yearsshowed significantly more "good" results than other age groups. There were no statistically significant differences in the knowledge level of the participants according to the level of education, gender, place of residence and type of institution (&lt;i&gt;P&lt;/i&gt;&amp;gt; 0.05). According to the domains explored, the weakest knowledge was on routes of transmission (39, 32.2%), risk factors of the disease (24, 19.8%), materials used for diagnosis (33, 27.3%), prevention (53, 43.8%), outcomes and complications (33, 27.3%) of Q fever. While there werehigh indicators on the knowledge of sources of infection (87, 71.9%), about the vector (63, 52.1%) and seasonality of the disease (79, 65.3%), symptoms (63, 52.1%), differential diagnosis (73, 60.3%), diagnostic methods (91, 75.2%) and treatment (93, 76.9%).&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; According to the results of the study, the level of experience of infectious disease physicians about Q fever can be assessed as satisfactory. However, the study revealed gaps, especially among young specialists, in the awareness about transmission, risk factors, diagnosis, prevention, outcomes and complications of the disease. &lt;b&gt;We also found that the level of registration of its’ diagnosis is low due to the lack of diagnostic testing systems and poor knowledge about the disease in Kazakhstan. As a consequence, we consider it advisable to enhance the level of knowledge about Q fever among young specialists by including comprehensive information in training programs, seminars, conferences in the field of infectiology, epidemiology and public health, as well as expanding diagnostic opportunities in Kazakhstan.&lt;/b&gt;

Epidemiological and clinical aspects of HFRS in the territory of the Voronezh region

At this time, hemorrhagic fever with renal syndrome remains one of the most common infectious diseases in the Russian Federation. An active natural focus of HFRS is the Voronezh region, where the natural reservoir of hantaviruses and the source of infection for people are wild rodents — bank vole, field mouse, and gray vole. The highest incidence rates of HFRS in the Voronezh region were recorded in 2019, significantly exceeding the rates of other years. The article presents data on the features of the epidemiology of HFRS and analyzes in detail the characteristic clinical manifestations of the disease. Important epidemiological aspects of hantavirus infection in the Voronezh region are the summer-autumn seasonality, the predominance in the structure of sick young men of working age living within the city. The pronounced summer-autumn seasonality of HFRS is due to contacts of patients with natural objects in both foci of infection. The clinical picture revealed a cyclical course of the disease, prolonged febrile-intoxication syndrome, enlarged liver and spleen, hemorrhagic syndrome, signs of renal pathology, thrombocytopenia. At the initial stage of the disease, typical manifestations of infection — symptoms of kidney damage, hemorrhagic manifestations, ophthalmological complaints, dry mouth and thirst — are rare or not clearly expressed. The studied features of the epidemiological aspects and clinical manifestations of HFRS in the Voronezh region are of great practical importance for differential diagnosis and early diagnosis at the prehospital stage for the purpose of timely hospitalization of the patient.

The main directions of prevention of occupational infection viral hepatitis with a contact transmission mechanism in hospitals in Saint-Petersburg

The high level of hepatitis B and C infection in the modern period in the general population increases the frequency of contact of hospital specialists with patients with this infectious pathology. A significant concentration of infection sources in medical organizations and violations in the implementation of disinfection and sterilization algorithms and requirements for hand hygiene of medical workers create conditions for the nosocomial spread of viral hepatitis pathogens with a contact transmission echanism.The aim. Substantiation of the main directions of prevention of occupational infection viral hepatitis with a contact transmission mechanism in hospitals of Saint Petersburg.Materials and methods. A retrospective epidemiological analysis of the annual reports of Saint-Petersburg hospitals was carried out, which contain information on the number of new cases chronic forms of viral hepatitis among specialists of medical organizations and on the number personnel under dispensary supervision for these infectious diseases, as well as on the number of injuries received by hospital staff while performing functional duties, as well as vaccination coverage against viral hepatitis B, measles and diphtheria for the period from 2009 to 2022. The assessment of the equipment of megapolis healthcare institutions modern washing-disinfecting and sterilization equipment was also carried out.Results and discussion. The realization of the possibility of infecting hospital specialists viral hepatitis with a contact transmission mechanism is predetermined by the high concentration of patients with this pathology in healthcare institutions; the presence of occupational injuries during the implementation of medical and diagnostic procedures and disinfection and sterilization measures.Conclusion. A set of measures for early detection of sources of infections with a contact transmission mechanism among patients and staff; disinfection of medical devices using modern disinfection and sterilization equipment; revaccination against hepatitis B and equipping workplaces of specialists with personal protective equipment in full remains relevant for the prevention of occupational infection of medical workers.

Urosepsis: pathophysiology, diagnosis, and management-an update

Urinary tract infections vary widely in their clinical spectrum, ranging from uncomplicated cystitis to septic shock. Urosepsis accounts for 9-31% of all cases of septicemia and is often associated with nosocomial infections. Amajor risk factor for urosepsis is the presence of obstructive uropathy, caused by conditions such as urolithiasis, tumors, or strictures. The severity and course of urosepsis depend on both the virulence of the pathogen and the patient's specific immune response. Prompt therapy, including antimicrobial treatment and eradication of the infection source, along with supportive measures for circulatory and respiratory stabilization, and adjunctive therapies such as hemodialysis and glucocorticoid therapy, is crucial. Due to demographic changes, an increase in cases of urosepsis is expected-thus, it is of utmost importance for urologists to be familiar with targeted diagnostics and effective treatment.

Midregional-proAdrenomedullin as a prognostic tool in sepsis and septic shock: A systematic review and meta-analysis.

Midregional-proAdrenomedullin (MR-proADM) has been recently proposed as a tool in patients with sepsis and septic shock. Our aim was to evaluate the prognostic role of MR-proADM in hospitalized patients with sepsis and septic shock. PRISMA guideline was followed. MEDLINE and EMBASE were searched up to June 2023. Primary outcome was mean difference in MR-proADM among survivors and nonsurvivors, secondary outcome mean difference in MR-proADM according to infection severity and type. Risk of bias was evaluated using Newcastle-Ottawa scale for observational studies and Cochrane tool for randomized trials. Pooled mean differences (MD) with corresponding 95% confidence intervals (CIs) were calculated in a random-effects model. Twenty-four studies included 6730 adult patients (1208 nonsurvivors and 5522 survivors) and three studies included 195 paediatric patients (30 nonsurvivors and 165 survivors). A total of 10, 4 and 13 studies included, respectively, patients with sepsis (3602 patients), septic shock (386 patients) and a mixed population (2937 patients). Twenty-one studies included patients with different source of infection, three with pneumonia and one with a catheter-related infection. Most studies (n = 12) had a follow-up of 28 days. In adult cohort, pooled mean difference between nonsurvivors and survivors of MR-proADM was 2.55 mmol/L (95% CI: 1.95-3.15) with higher values in patients with septic shock (4.25 mmol/L; 95% CI, 2.23-6.26 mmol/L) than in patients with sepsis (1.77 mmol/L; 95% CI: 1.11-2.44 mmol/L). In paediatric cohort, pooled mean difference was 3.11 mmol/L (95% CI: -0.02-6.24 mmol/L). Higher values of MR-proADM are detectable in nonsurvivors adult and paediatric-hospitalized patients with sepsis or septic shock.

Sepsis and Septic Shock in Patients Undergoing Thyroidectomy: Incidence, Risk Factors, and Outcomes

IntroductionPostoperative sepsis represents a rare complication following thyroidectomy. We aimed to explore the incidence, risk factors, sources, and outcomes of postoperative sepsis and septic shock among adult patients undergoing thyroidectomy. MethodsData from the American College of Surgeons National Surgical Quality Improvement Program were used in this retrospective cohort study. Patients aged ≥18 y who underwent elective thyroidectomy between 2005 and 2019 were included. Multivariable binary logistic regression models were computed to explore risk factors and outcomes of 30-d sepsis and septic shock. ResultsAmong the 180,373 included patients, 0.1% developed sepsis or septic shock. Male gender, low body mass index, American Society of Anesthesiologists classes 3-5, functional dependence, smoking, diabetes mellitus, pulmonary disease, inpatient surgery, malignant indication, clean-contaminated wound classification, and operation time ≥150 min were significant risk factors for development of sepsis or septic shock. Common infectious sources of sepsis included surgical site infections (29.6%), pneumonia (18.6%), urinary tract infections (16.2%), and multiple infections (6.9%). Patients with postoperative sepsis or septic shock were significantly more likely to develop complications, including wound disruption, stroke, cardiac and renal complications, thromboembolism, prolonged length of stay, unplanned reoperation, and mortality. ConclusionsSepsis is rare following thyroidectomy. Our study provides insight into risk factors and procedural characteristics which may contribute to the development of postoperative sepsis or septic shock in this population.

Exploring Acute Febrile Illness in Children: Clinical Characteristics and Diagnostic Challenges.

Background Pediatric febrile illnesses are a major cause of hospital admissions and are often associated with significant morbidity and mortality. These illnesses pose a diagnostic challenge to both clinicians and laboratories. This study aims to explore the clinical characteristics of acute febrile illness in children and examine the effectiveness of various diagnostic techniques. Methods This prospective study was carried out at the Mahatma Gandhi Memorial Hospital, Warangal, India, from January 2020 to October 2022. It included children aged one month to 12 years. Results Out of 245 identified cases, 195 met the inclusion criteria. This study found that 18 patients (9.23%) suffered from serious bacterial infections (SBIs). In 63 patients (32.20%), the source of infection remained unidentified. Among those with SBI, UTIs were the most frequent. Bacteremia was identified in 2.5% of the patients. Conclusion SBIs were identified in 18 hospitalized children (9.23%), with UTIs being the most common SBI in children aged one to 36 months. Children in this age group presenting with toxic symptoms should be thoroughly evaluated for SBIs. The study also observed a higher prevalence of Gram-negative bacteremia compared to Gram-positive cases.

Genotypic and phenotypic characteristics of Candida parapsilosis bloodstream isolates: Health Care Associated Infections in a teaching Hospital in Italy

BackgroundCandidemia is the most common healthcare associated invasive fungal infection. Over the last few decades, candidemia caused by Candida species other than Candida albicans, particularly the Candida parapsilosis complex, has emerged worldwide. The aims of this study were: to analyze the genotypic and phenotypic characteristics of C. parapsilosis strains isolated from blood cultures and the environment in a hospital in southern Italy, to study the possible source of infection and to correlate the isolated strains. MethodsFrom April to October 2022, cases of candidemia due to C. parapsilosis in patients admitted to a hospital in the Apulia region were investigated. However, 119 environmental samples from the intensive care unit were collected for identification of the likely environmental reservoir of infection. Routine antifungal (amphotericin B, anidulafungin, fluconazole) susceptibility was performed on all isolates. Whole genome sequencing was performed to study the genotypic correlation of the isolates. Biofilm biomass and metabolic activity were also quantified for all isolates. ResultsA total of 43 C. parapsilosis isolates were cultured from the bloodstream of each patient in different departments, and seven surface samples were positive for C. parapsilosis. Most of the isolated yeasts (41/50; 85 %) were resistant to fluconazole and were genetically related to each other, suggesting an ongoing clonal outbreak of this pathogen. The fluconazole-susceptible isolates produced significantly more biofilm than did the resistant isolates. Metabolic activity was also higher for fluconazole-susceptible than resistant isolates. ConclusionCross-transmission of the microorganisms is suggested by the phenotypic similarity and genetic correlation between clinical and environmental strains observed in our study.

Influence of initial misdiagnosis on mortality in patients with bacteraemia: propensity score matching and propensity score weighting analyses

BackgroundThe diagnostic process is a key element of medicine but it is complex and prone to errors. Infectious diseases are one of the three categories of diseases in which diagnostic errors can be most harmful to patients. In this study we aimed to estimate the effect of initial misdiagnosis of the source of infection in patients with bacteraemia on 14 day mortality using propensity score methods to adjust for confounding.MethodsData from a previously described longitudinal cohort of patients diagnosed with monobacterial bloodstream infection (BSI) at the Leiden University Medical Centre (LUMC) between 2013 and 2015 were used. Propensity score matching and inversed probability of treatment weighting (IPTW) were applied to correct for confounding. The average treatment effect on the treated (ATT), which in this study was the average effect of initial misdiagnosis on the misdiagnosed (AEMM), was estimated. Methodological issues that were encountered when applying propensity score methods were addressed by performing additional sensitivity analyses. Sensitivity analyses consisted of varying caliper in propensity score matching and using different truncated weights in inversed probability of treatment weighting.ResultsData of 887 patients were included in the study. Propensity scores ranged between 0.015 and 0.999 and 80 patients (9.9%) had a propensity score > 0.95. In the matched analyses, 35 of the 171 misdiagnosed patients died within 14 days (20.5%), versus 10 of the 171 correctly diagnosed patients (5.8%), yielding a difference of 14.6% (7.6%; 21.6%). In the total group of patients, the observed percentage of patients with an incorrect initial diagnosis that died within 14 days was 19.8% while propensity score reweighting estimated that their probability of dying would have been 6.5%, if they had been correctly diagnosed (difference 13.3% (95% CI 6.9%;19.6%)). After adjustment for all variables that showed disbalance in the propensity score a difference of 13.7% (7.4%; 19.9%) was estimated. Sensitivity analyses yielded similar results. However, performing weighted analyses without truncation yielded unstable results.ConclusionThus, we observed a substantial increase of 14 day mortality in initially misdiagnosed patients. Furthermore, several patients received propensity scores extremely close to one and were almost sure to be initially misdiagnosed.

Putting 'X' into context: the diversity of 'Candidatus Phytoplasma pruni' strains associated with the induction of X-disease.

Recurrent epiphytotics of X-disease, caused by 'Candidatus Phytoplasma pruni', have inflicted significant losses on commercial cherry and peach production across North America in the last century. During this period, there have been multiple studies reporting different disease phenotypes, and more recently, identifying different strains through sequencing core genes, but the symptoms have not, to date, been linked with genotype. Therefore, in this study we collected and assessed differing disease phenotypes from multiple U.S. states and conducted multi-locus sequence analysis on these strains. We identified a total of five lineages associated with the induction of X-disease on commercial Prunus species and two lineages that were associated with wild P. virginiana. Despite a century of interstate plant movement, there were regional trends in terms of lineages present, and lineage-specific symptoms were observed on P. avium, P. cerasus, and P. virginiana, but not on P. persica. Cumulatively, these data have allowed us to define 'true' X-disease-inducing strains of concern to the stone fruit industry across North America, as well as potential sources of infection that exist in the extra-orchard environment.

Skin Disease Detection Using CNN

This study explores using advanced computer technology, specifically Convolutional Neural Networks (CNNs), for diagnosing diseases. By training the computer model with a variety of medical images, it learns to recognize patterns associated with different illnesses. The research investigates how well the model can accurately and quickly identify various medical conditions. Factors like the quality of the dataset, the design of the model, and fine-tuning its settings are considered. The results suggest that this method could enhance disease diagnosis speed and accuracy, contributing to discussions on AI's role in healthcare. Skin diseases are common across all age groups and a major source of infection in sub-Saharan Africa. Traditional diagnosis methods involve multiple tests, making the process laborious and time-consuming, requiring in-depth domain knowledge.

Herbal Bioactive Compounds for Skin Infections and Inflammatory Conditions

Skin microbiota is an integral part of the human immune system. Staphylococcus aureus is one of the essential components of the normal flora. Approximately 20–30% of healthy individuals are persistently colonized with S. aureus, whereas the remainders are considered low-level intermittent carriers. Despite these natural aspects of existence, S. aureus can be a major opportunistic human pathogen. This versatile microorganism can infect a variety of anatomical sites, causing a broad spectrum of pathologies ranging from superficial to invasive infections. It developed a variety of strategies to adopt to a changing microenvironment. This attributed to the emergence of resistance to antibiotics of different classes during the past six decades. Methicillin-resistant S. aureus (MRSA) was originally confined to health-care settings (health-care-associated MRSA). Later on, community-acquired MRSA was identified as another source of infections. Recent figures indicate that MRSA strains have been associated with approximately 75% of all S. aureus infections worldwide. Several guidelines have been published to establish an adequate treatment of skin and soft tissue infections (SSTIs) caused by MRSA strains. In the first part of this review, we focus on current treatment guidelines with a focus on medical drug therapy, but drug therapy has its own limitations. Recently, the interest in herbal remedies has greatly increased. There is growing evidence of antimicrobial activity of medicinal plants and their extracts. The second part of this review is dedicated to herbal compounds to circumvent antibiotic resistance. Herbal compounds may potentiate the action of antibiotics and restore the activities of antibacterial agents against which S. aureus has developed a drug resistance. Part 2 focuses on the role of S. aureus in pathology of the two major inflammatory skin diseases, i.e., atopic dermatitis (AD) and psoriasis. Finally, Part 3 provides an overview on natural compounds with antimicrobial activity against S. aureus and possible use in the treatment of SSTIs,

Epidemiologic Trends and Distributions of Imported Infectious Diseases Among Travelers to Japan Before and During the COVID-19 Pandemic, 2016 to 2021: A Descriptive Study.

Little is known about the trends of imported infectious diseases among travelers to non-endemic countries during the novel coronavirus disease 2019 (COVID-19) pandemic. This article aimed to describe those among travelers to Japan. This is a descriptive study based on national surveillance data. Imported infectious disease cases were defined as those with a reported overseas source of infection among 15 diseases pre-selected based on the probability and impact of importation. The number of notified cases from April 2016 to March 2021 were described by disease and time of diagnosis. The relative ratio and absolute difference in case counts-both by number and per arrival-were calculated by disease comparing those from the pandemic period (April 2020-March 2021) to the pre-pandemic period (April 2016-March 2020). A total of 3,524 imported infectious disease cases were diagnosed during the study period, including 3,439 cases before and 85 cases during the pandemic. The proportionate distribution of diseases changed but notification counts of all 15 diseases decreased during the pandemic. Accounting for arrivals, however, seven diseases showed a two-fold or greater increase, with a notable absolute increase per million arrivals for amebiasis (60.1; 95% confidence interval [CI], 41.5-78.7), malaria (21.7; 95% CI, 10.5-33.0), and typhoid fever (9.3; 95% CI, 1.9-16.8). The epidemiology of imported infectious diseases changed during the pandemic. While the number of imported infectious disease cases decreased, the number of cases per arrivals increased considerably both in relative and absolute terms for several diseases of public health and clinical importance.

A Thai guideline summary in management of pediatric septic shock

Sepsis-associated organ dysfunction, particularly septic shock, is a prevalent critical illness characterized by increased morbidity and mortality, particularly in children. Recognizing the imperative to enhance outcomes, a septic shock guideline tailored for pediatric patients was formulated. This guideline strives to establish an evidence-based framework for the effective management of septic shock and sepsis-associated organ dysfunction in Thai children. Key components encompass the prompt identification and stabilization of patients, meticulous titration of fluids and vasoactive agents, initiation of empirical antimicrobial therapy, judicious infectious source control, respiratory support, administration of sedation and analgesia, blood and blood product transfusion, correction of electrolyte imbalances, management of metabolic derangements, renal replacement therapy, and the implementation of multimodal monitoring. The objective is to optimize management, achieving therapeutic goals while continuously reassessing the patient's condition. Additionally, this guideline demonstrates adaptability by tailoring its suggestions to the resources available in Thailand’s medical facilities. Recognizing the diverse capabilities of healthcare institutions, the guideline endeavors to ensure its implementation is practical and feasible.

Exposure of small ruminants and humans to Coxiella burnetii in the semi-arid region of Northeastern Brazil.

Q fever is a zoonotic disease caused by the obligate intracellular pathogen Coxiella burnetii, for which domestic ruminants are the primary source of infection in humans. Herein, we investigated the presence of C. burnetii in humans, sheep, and goats in the semi-arid region of northeastern Brazil. The presence of anti-C. burnetii antibodies was surveyed using indirect immunofluorescence assay, and detection of C. burnetii DNA was performed by polymerase chain reaction (PCR). Anti-C. burnetii antibodies were detected in 60% of farms, 4.8% of goats, 1.5% of sheep, and 4.5% of human samples. PCR was positive in 18.9% of blood samples, 7.7% of milk samples, and 7.7% of vaginal mucus samples. A DNA sequence of a C. burnetii DNA sample extracted from the goat vaginal mucus showed 99.2-99.4% nucleotide identity with other strains previously reported in Brazil. These results indicate that C. burnetii is present in the surveyed area, where it poses a risk to both public and animal health. These findings indicate an urgent need for educative actions to protect population, as well as better training of veterinarians to detect and report Q fever.