Pattern Of Infection Research Articles

Infection Patterns of Posthodiplostomum cf. centrarchi and Uvulifer cf. ambloplitis in Centrarchid Hosts from Lake Holiday, Virginia, U.S.A.

Infection Patterns of Posthodiplostomum cf. centrarchi and Uvulifer cf. ambloplitis in Centrarchid Hosts from Lake Holiday, Virginia, U.S.A.

Survey of Post-Prophylaxis Delayed-Onset Cytomegalovirus Management Strategies Among Transplant Providers.

Preventive strategies for cytomegalovirus (CMV) in the posttransplant period have changed the pattern of CMV infections, now more commonly manifesting as late-onset occurrences known as post-prophylaxis delayed-onset CMV disease (PPDOC). We conducted a survey to investigate provider practices in managing PPDOC. A web-based provider survey on the management of PPDOC was developed using Research Electronic Data Capture (REDCap). It was distributed to the online forums of the American Society of Transplantation communities of practice (COP) for Infectious Diseases (IDCOP), Kidney and Pancreas (KPCOP), Liver and Intestinal (LICOP), and Thoracic and Critical Care (TCCOP). The survey was posted twice within a span of a month. Fifty-six respondents, comprising 50 (89%) transplant physicians and 6 (11%) transplant pharmacists, from 46 distinct transplant centers, completed the survey. Universal antiviral prophylaxis (UAP) was the predominant preventive approach for both high-risk (85%) and moderate-risk (85%) transplant recipients. Out of 56, 51 respondents completed the questions regarding management of PPDOC. Regular surveillance with nucleic acid amplification tests (NAAT) (88%) was the most commonly used approach in high-risk recipients, while symptom monitoring (73%) was the most common strategy in moderate-risk recipients. Immunologic monitoring was used only by a few respondents who found it moderately useful in high-risk recipients. Management of PPDOC was highly variable among providers and strategies differed based on patient risk profile. These findings could help shape future studies and guidelines to harmonize CMV management.

Climate change and emerging infections: Risks, adaptation and response

Abstract Background Weather and changing climate are key drivers of the emergence, re-emergence and spread of infectious diseases globally. However, approaches to emerging infections and climate strategies are still largely being developed separately missing the opportunities for integrated climate adaptation actions to address infectious diseases. Description To inform the development of the UK national emerging infectious diseases plan, a literature review of the current and projected risks from extreme weather events and climate change on emerging infections in the UK is currently underway. This will support further work examining and co-designing adaptation options in the context of preparedness and response to emerging infections. Results Key preliminary findings from the literature review have indicated risks predominantly from evolving patterns of vector borne diseases as climatic conditions and habitat suitability of pathogens change. Changing temperatures and hotter summer temperatures have been associated with changing food-borne infection patterns. Further risks driven by extreme weather, including flooding and droughts, could perpetuate changes in water-borne infection patterns. Adaptation actions focussed on these infectious disease groups are currently under review and will cover risk assessment, data and surveillance, preparedness and response. Lessons This work integrates climate action with action on emerging infectious diseases. By examining the evidence on climate sensitive infections and co-designing solutions across teams, awareness is being raised and relationships and infrastructures built to better prepare and respond to both fundamental global public health challenges.

How have respiratory tract infections changed in the post-covid era for children under 5 years?

Abstract Background Social distancing measures introduced in response to the covid-19 pandemic reduced transmission of all respiratory pathogens. Exposure to respiratory pathogens in early life affects future lung health. We aimed to describe changes in the incidence of respiratory tract infections (RTIs) in children <5 years in England in the post-pandemic era. Methods Population-based retrospective cohort study using electronic health records. We included all children aged <5 years registered with a primary care practice from April 2016 to March 2023. We compared monthly GP consultation rates for RTIs in the two post-pandemic years (April 2021 - March 2022 and April 2022 - March 2023) with corresponding months during pre-pandemic years (April 2016 - February 2020). Results There were 3 045 701 respiratory tract infections among 2 894 539 children <5 years registered with a GP practice during the study period. Pre-pandemic, monthly RTI rates varied from lows of 29.1 per 100 child-years in August to highs of 108.8 per 100 child-years in November. In 2021/22, monthly RTI rates were bimodal peaking in June and October, although the winter peak was lower than pre-pandemic years and mean monthly RTI rates were ∼15% lower overall. In 2022/23 mean monthly RTI rates remained ∼15% lower than pre-pandemic years, but there was a single peak in December 2022 of 117.6 RTIs per 100 child-years, exceeding the pre-pandemic winter peaks by 8.1%. Conclusions Overall, monthly RTIs in post-pandemic years were 15% lower than pre-pandemic years. However, there was a concerning peak in December 2022 that exceeded the winter peaks from previous years. Comparisons with national surveillance data suggest this peak reflects changes in RTI incidence, particularly among group A streptococcal infections, but this peak may also reflect changes in access to care or healthcare seeking behaviour. Continued monitoring of post-pandemic seasonal patterns will assist in planning for health service use. Key messages • Respiratory tract infections in children <5 years in post-pandemic years were 15% lower than pre-pandemic years, but winter peaks in incidence may be of greater magnitude in the post pandemic era. • Ongoing monitoring of patterns of respiratory tract infections in young children is important for future health service planning and delivery.

Emergency Department admissions for Acute Respiratory Infections: a retrospective analysis

Abstract Background Acute Respiratory Infections (ARIs) have a relevant impact on public health in terms of prevalence and costs associated with the diseases. The COVID-19 pandemic highlighted the need to adopt accurate surveillance systems to respond to new emergencies and meet the demand for access to care. The aim of our work is to describe the accesses at the Emergency Departement (ED) of the Pisa University Hospital (AOUP), Italy, for ARIs, from 2017 to 2021. Methods A retrospective analysis of electronic medical records from the AOUP was conducted from January 2017 to December 2021. The analysis focused on ED admissions and positive lab test results, examining their correlation with ED visits caused by ARI. Multiple linear regression models were used to understand the influence of viral laboratory results on ARI-related ED admissions, adjusting the results for age. The study also assessed the contribution of each virus incausing ARI within different age groups. Results 33,101 (annual average 5,520) ARI admissions in ED were registered, resulting in 7,426 hospital admissions (22.8%, annual average 1,163) with a seasonal pattern between week 42 of each year and week 17 of the following year. The reduction in emergency room admissions in 2020 (weekly average of 78.2, compared to 144.3 in 2017-2019) may be due to the restrictions implemented for the COVID-19 pandemic. Nevertheless, the average weekly rate of ED admissions caused by ARI was 30.8% in 2020, as compared with 21.7% in 2017-2019. Analysis by age group showed a peak of accesses in the last weeks of 2021 for the <1 and 1-4 years old age groups. Conclusions Data on ARI-related admissions provide valuable insights into the dynamic patterns of seasonal air-borne infections and age-related vulnerabilities. This could be useful in directing health policies to identify indicators of future epidemic waves, contributing to the ongoing efforts to enhance preparedness and response strategies for respiratory infections. Key messages • It is important to create an integrated surveillance system to monitor and respond to ARIs. • Strategies should prioritise vaccination campaigns, particularly for RSV and influenza.

Living without pain: A 10-year study of congenital insensitivity to pain with anhidrosis.

Congenital Insensitivity to Pain with Anhidrosis (CIPA) is a rare hereditary neuropathy caused by NTRK1 gene mutations, predisposing patients to recurrent infections and chronic wounds. Long-term studies on microbial and clinical outcomes in CIPA are limited. This study presents analysis of infection patterns, antibiotic resistance, and clinical outcomes in CIPA patients. A comprehensive ten-year retrospective cohort study was conducted at Soroka University Medical Center, Beer Sheva, Israel, from January 2014 to January 2023. Electronic medical records were reviewed to identify 63 CIPA patients, all were of consanguineous Bedouin families. Data collection included demographic details, clinical presentations, genetic analysis, documentation of infections, wound sites, hospital duration, and surgical interventions. Staphylococcus aureus, notably methicillin-resistant, dominated, with Gram-negative bacteria common in lower limbs. The study noted reduced extended-spectrum beta-lactamase bacteria and linked demographic factors to infection traits, antibiotic resistance, and surgical needs. This study provides valuable insights into the clinical and microbial patterns of CIPA, highlighting dynamic shifts in microbial compositions and antibiotic resistance profiles over time. Staphylococcus aureus, and Gram-negative bacteria particularly in lower limb infections, pose significant challenges in patient management. The findings underscore the importance of tailored approaches to address evolving microbial profiles and optimize patient care in CIPA. Key Message: This is the largest cohort study on CIPA to date, highlighting the dominance of Staphylococcus aureus, including methicillin-resistant strains, and significant Gram-negative bacterial infections in lower limbs. Contribution to Literature: It draws parallels between infection dynamics in CIPA and diabetic foot ulcers, emphasizing similar challenges due to neuropathy and ischemia, enhancing understanding of infection susceptibility and management in neuropathic conditions. The findings inform clinical practices by detailing infection and resistance patterns, supporting the development of targeted treatment strategies to improve outcomes for CIPA and similar conditions.

Bacteriological Profile and Antibiogram Pattern of Wound Infection in a Tertiary Care Hospital

Bacteriological Profile and Antibiogram Pattern of Wound Infection in a Tertiary Care Hospital

Revisiting the epidemiological role of a native vector in Northern California vineyards

Abstract Effective disease management hinges on an accurate understanding of the ecological and epidemiological underpinnings of the pathosystem. New epidemics may prompt consideration of whether knowledge gaps or changes to the pathosystem warrant revision of management strategies. Pierce’s disease of grapevines is highly episodic in coastal Northern California vineyards, with modest incidence in most years punctuated by occasionally severe epidemics. To better understand what was driving a developing epidemic in the region, we revaluated what is known about the ecology and epidemiological role of the dominant vector, the blue-green sharpshooter Graphocephala atropunctata. We monitored vector spatiotemporal dynamics at 32 vineyards over three years, surveyed plant community composition in the adjacent habitat to understand its link to vector recruitment, and quantified patterns of natural infectivity for the pathogen Xylella fastidiosa. Overall, the results were consistent with past studies of G. atropunctata ecology. For example, the scale of dispersal from source habitat and seasonal patterns in activity were generally similar to those documented in prior studies. The results also confirmed the influence of adjacent plant community composition on G. atropunctata activity in vineyards, and the role of riparian habitat and select plant taxa as vector sources. Nonetheless, further consideration of the epidemiological significance of certain features of the pathosystem may be warranted, especially those related to seasonality in X. fastidiosa infection in vectors. A marked increase in infected G. atropunctata late in the season likely reflects pathogen acquisition from infected grapevines, which may have implications for disease management strategies.

Location and timing of infection drives a sex-bias in Haemoproteus prevalence in a hole-nesting bird.

Sex biases in prevalence of disease are often attributed to intrinsic factors, such as physiological differences while a proximate role of extrinsic factors such as behavioural or ecological differences may be more difficult to establish. We combined large-scale screening for the presence and lineage identity of avian malaria (haemosporidian) parasites, in 1234 collared flycatchers (Ficedula albicollis) with life-history information from each bird to establish the location and timing of infection. We found an overall infection rate of 36.2% ± 0.03 (95% CI) with 25 distinct malaria lineages. Interestingly, first-year breeding males and females had similar infection prevalence while females accrued a significantly higher infection rate than males later in life. The sex difference in infection rate was driven by the most abundant Haemoproteus, lineage, hPHSIB1, while the infection rate of Plasmodium lineages was similar in males and females. Furthermore, when infections were assigned to an apparent transmission location, we found that the sex difference in infection rate trend was driven by lineages transmitted in Europe, more specifically by one lineage (the hPHSIB1), while no similar pattern was found in African lineages. We deduce that the observed infection patterns are likely to be caused by differences in breeding behaviour, with incubating females (and nestling individuals of both sexes) being easy targets for the biting insects that are the vectors of avian malaria parasites. Overall, our results are most consistent with ecological factors rather than intrinsic factors underlying the observed sex-biased infection rate of avian malaria in collared flycatchers.

The emergence of multidrug-resistant Proteus vulgaris infection in cage reared Pangasianodon hypophthalmus: Molecular characterization and host-pathogen response

The study investigates the causative agent responsible for massive mortality in Pangasianodon hypophthalmus cage farms. The infected pangasius were lethargic, not taking feed, and had exophthalmia, deep ulceration, and hemorrhage on the ventral body surface. Pathogens were isolated from infected pangasius tissue samples, and the strain was preliminarily identified as Proteus vulgaris based on morphology, biochemical tests, 16S rRNA PCR sequencing, and phylogenetic analysis. The microbiological analysis revealed that P. vulgaris was associated with the disease outbreak and mortality of P. hypophthalmus, as confirmed by the biofilm formation, swimming activity, and survival assay results. The isolated P. vulgaris was resistant to several antibiotics, including Doxycycline, Dicloxacillin, Polymyxin B, Chloramphenicol, and Imipenem, exhibiting multiple antibiotic-resistant phenotypes. Furthermore, a host-pathogen model was developed to investigate the in vivo effect of emerging P. vulgaris infection in striped catfish. Results showed that P. vulgaris infection exhibited varying degrees of cellular changes in the kidney, liver, and gill tissues of infected P. hypophthalmus samples. The transcription analysis further highlights that P. vulgaris modulates the antioxidants, immune activation, growth regulator, homeostasis, degradation of invading DNA, and DNA damage-related gene expression in liver, kidney, spleen, skin, and gill tissue samples of infected P. hypophthalmus. The lessons learned from the study could be critical in understanding the P. vulgaris infection patterns and pathobiology necessary to enable risk assessment and develop management measures to control the bacterium's virulence.

Insights into the Rising Threat of Carbapenem-Resistant Enterobacterales and Pseudomonas aeruginosa Epidemic Infections in Eastern Europe: A Systematic Literature Review.

Antimicrobial resistance is a major global public health challenge, particularly with the rise of carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA). This study aimed to describe the characteristics of CRE and CRPA infections in Eastern Europe, focusing on Bulgaria, Croatia, Czechia, Greece, Hungary, Poland, Romania, Serbia, Slovakia, and Slovenia. Following MOOSE and PRISMA guidelines, a systematic literature review of articles published between 1 November 2017 and 1 November 2023 was conducted using the MEDLINE, Embase, Web of Science, CDSR, DARE, and CENTRAL databases. The search strategy used a combination of free text and subject headings to gather pertinent literature regarding the incidence and treatment patterns of CRE and CRPA infections. A total of 104 studies focusing on infections in both children and adults were included in this review. This review revealed a significant prevalence of carbapenem-resistant Gram-negative isolates and underscored the effectiveness of imipenem/relebactam and ceftazidime/avibactam (CAZ/AVI) against Klebsiella pneumoniae carbapenemase-producing Enterobacterales and of ceftolozane/tazobactam, imipenem/relebactam and ceftazidime/avibactam against non-metallo-β-lactamase-producing CRPA strains. This study highlights the urgent need for comprehensive measures to combat the escalating threat of CRE and CRPA infections in Eastern European countries. At the same time, it shows the activity of the standard of care and new antimicrobials against carbapenem-resistant Gram-negative pathogens in Eastern Europe. Clinical real-world data on the treatment of carbapenem-resistant infections in Eastern Europe are needed.

Highly pathogenic avian influenza management policy in domestic poultry: from reacting to preventing.

The emergence of clade 2.3.4.4b H5N1 highly pathogenic avian influenza (HPAI) viruses in 2021 has led to unprecedented epidemics in poultry, changing epidemiological patterns of year-round infections in resident wild avifauna and more frequent spill-over events to mammals. Given this situation, it is important that we recognise that traditional HPAI management strategies are no longer sufficient, and policy changes are required. Poultry vaccination has emerged as a crucial intervention in the current control of HPAI, as evidenced by France's nationwide campaign targeting domestic ducks. However, due to the logistical challenges and potential trade implications of vaccination, broader structural reforms appear also necessary. These include a shift from farm-level to territorial-level biosecurity approaches, putting into practice the concept of 'regional biosecurity'. Given the role duck farm density has played in successive HPAI epidemics in France, there is a need to think about the spatial distribution of poultry farms as a structural component of regional biosecurity and to consider the reduction of farm concentration as a measure to prevent viral spread. The integration of regional biosecurity and poultry vaccination into prevention strategies should impact the way poultry are produced and traded in the future.

Effects of environmental factors on host-parasite interaction patterns in backyard-tethered goats of Kerala, India

The environment is the most important stratum in the epidemiological triad of a parasitic disease and any variations in the environmental factors may decide the dynamic occurrence and existence of different lifecycle stages of these parasites. The present study investigated the correlations between key biometeorological and demographical parameters with the incidence of different gastrointestinal parasites and hemoparasites among goats. Four hundred and thirty-two goats were screened for parasitic infection in a yearlong survey conducted from July 2022 to June 2023 in the Teaching Veterinary Clinical Complex, Mannuthy, Kerala, India. The weather parameters (Tmax, Tmin, RH, THI, and bright sunshine hours), air quality parameters [AQI, PM2.5, and PM10], and demographic parameters (gender and age) were recorded along with the test positivity of different categories of gastrointestinal parasites and hemoparasites in goats by routine fecal sample examination and blood smear examination, respectively. The infection level was ranked based on the severity of the infection. The mean and daily variations in biometeorological parameters were calculated and the data were statistically analyzed to figure out the pertinent correlations in host-parasite-environment interaction patterns. High levels of parasitic infections with significant month-wise variations and climate-correlated peak infection patterns were noticed. The incidence of parasites was negatively correlated to all parameters except humidity, indicating more severe parasitism during monsoon months. The significant variations in the host-parasite interaction dynamics point towards the need for detailed explorations concerning the lifecycle of each specific parasite with a focus on the possible environment-favourable and resistant lifecycle stages. Future studies may be designed from a biometeorological perspective to develop a crucial understanding of host-parasite-environment interactions in goats ensuring sustainable goat farming.

Epidemiological, clinical, and genotypic characteristics of pediatric Mycoplasma pneumoniae infections: an 8-year survey in Suzhou, China in the pre- and post-COVID-19 eras.

This study examines the epidemiology of Mycoplasma pneumoniae (M. pneumoniae) infections among children in Suzhou, China, during various pandemic phases. The goal is to discern evolving epidemic trends and to furnish robust evidence for clinical diagnosis and treatment. From January 1, 2016, to December 31, 2023, 113,625 consecutive patients with respiratory infections from three hospitals in Suzhou, China (Children's Hospital of Soochow University, Children's Hospital of Wujiang District, and Affiliated Suzhou Hospital of Nanjing University Medical School), were retrospectively enrolled in a surveillance study. Additionally, in 2023, children hospitalized with M. pneumoniae pneumonia at the Children's Hospital of Soochow University were tested for genotype (P1 gene typing, SNP genotyping) and macrolide resistance in their bronchoalveolar lavage fluid. From 2016 to 2023, the M. pneumoniae positive detection rate among pediatric respiratory infections fell from a pre-pandemic 21.1% to pandemic lows, then surged to 45.3% post-pandemic. Before the pandemic, peak M. pneumoniae infection rates occurred in summer, followed by autumn. Post-pandemic, the highest peak rates were in autumn. Peak M. pneumoniae detection rates occurred in 2019 and 2023, with a notable increase in children aged 6 and older in 2023. In this study, 200 M. pneumoniae-positive bronchoalveolar lavage fluid (BALF) cases in 2023 were randomly selected and analyzed for P1 genotype and SNP genotype. Among 156 cases, 81.4% were P1 genotype and 18.6% were P2 genotype. The proportion of severe M. pneumoniae pneumonia with the P1 type was significantly higher than that with the P2 type (p < 0.05). Of the 192 samples analyzed, 11 SNP genotypes were identified, with SNP-27 predominating (36.5%), followed by SNP-0 (21.4%), SNP-11 (18.8%), and SNP-34 (17.7%). Of the 192 BALF specimens, 97.3% exhibited macrolide resistance mutations, with A2063G mutations at 96.17%. The mutation rates for the 23S rRNA 2064 and 2,617 were 1.6 and 1.0%, respectively. Post-COVID-19 in Suzhou, China, M. pneumoniae infection patterns shifted significantly, with initial NPIs-induced declines followed by a sharp rise in cases, especially impacting school-age children. This trend underscores the importance of ongoing epidemiological surveillance and the development of strategic public health responses.

Low penicillin susceptibility in Streptococcus mitis/oralis from bloodstream infections in pediatric populations.

Existing research primarily focuses on specific populations, such as those with hematopathy or tumors, who experience Streptococcus mitis/oralis bacteremia. Limited studies have been conducted on the prevalence of bloodstream infections caused by S. mitis/oralis across the entire pediatric population. It was found that the contamination rate of S. mitis/oralis isolated from blood cultures was notably high in our study. Therefore, this study evaluated the clinical characteristics and drug resistance patterns of bloodstream infections caused by S. mitis/oralis across the entire pediatric populations, explicitly excluding cases of blood culture contamination. The observed low susceptibility rate to penicillin, coupled with the emergence of multi-drug-resistant strains, underscores the imperative for continuous monitoring of the evolving antimicrobial resistance in S. mitis/oralis.

Respiratory pathogen analysis in pediatric inpatients unraveled the infection pattern of Mycoplasma pneumoniae post the COVID-19 pandemic.

To counteract the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented globally, exerting a profound influence on a wide spectrum of infectious diseases, encompassing respiratory tract infections (RTIs). Subsequent to the easing of NPIs, China experienced a significant outbreak of Mycoplasma pneumoniae (MP). Over a decade from 2015 to 2024, our study scrutinized 12 common infectious diseases among pediatric children. Etiologically diagnostic data and clinical outcome metrics of children with RTIs, tested for 13 pathogens, were analyzed to evaluate changes during and after the pandemic compared to pre-pandemic periods, with a notable emphasis on age profile and coinfection patterns of MP. Among 57,471 hospitalized children, 23,178 were diagnosed with infectious diseases. Under NPIs, most respiratory infections declined compared to pre-pandemic levels, rebounding by 69.64% in 2023. While the infection rate of common respiratory pathogens decreased, cases of respiratory syncytial virus increased during the period of extensive NPI implementation. In 2023, pediatric intensive care unit durations for these pathogens increased, suggesting greater severity of illness compared to 2019. MP exhibited the highest infection rate (31.38% average), with a notable outbreak post-pandemic due to severity increase in <3 year olds and rise among older children. NPIs reduced MP coinfections and mitigated their severity, while exerting a significant influence on bacterial coinfections with MP over the span of 5 years, in contrast to their impact on viral pathogens. NPIs effectively curb transmission of respiratory infections by most pathogens, resulting in increased average age of MP infections and altered patterns of coinfection post-pandemic.

Damage-associated molecular patterns in bacteraemic infection, including a comparative analysis with bacterial DNA, a pathogen-associated molecular pattern

Damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) are key triggers of inflammation in sepsis. However, they have rarely been studied simultaneously. Thus, in the present study of patients with bacteraemic infection, we aimed to study how DAMP dynamics are linked to disease severity and outcome and to compare diagnostic and prognostic properties of a DAMP and a previously analysed PAMP (16S rDNA). In a prospective study of adult patients hospitalized with culture-proven community-onset bacteraemic infection, caused by Streptococcus pneumonia (n = 30), Staphylococcus aureus (n = 27), or Escherichia coli (n = 26), dynamics of a PAMP, i.e. 16S rDNA, have previously been presented. For the present study, blood samples obtained on hospital days 1–2 (when blood culture was positive), 3–4, 7 ± 1, 14 ± 2, and 28 ± 4 were analysed for four different DAMPs, i.e., nuclear DNA (nDNA), mitochondrial DNA (mtDNA), heat shock protein 90 alpha (HSP90α), and extracellular high mobility group box 1 (HMGB1). Sepsis was defined according to the Sepsis-3 criteria. The study outcomes were sepsis at admission and negative outcome, defined as intensive care unit (ICU) admission and/or death within 60 days. Of 83 study patients, sepsis was noted in 41 patients (49%) and a negative outcome was noted in 17 patients (20%). nDNA had areas under the receiver operating characteristic (ROC) curves of 0.78 for sepsis and 0.76 for negative outcome, which were higher than those of the other DAMPs and additional biomarkers (CRP, IL-6, IL-8, and IL-10). The nDNA and positive 16S rDNA results on day 1–2 were correlated with each other (r = 0.68, p < 0.001). Multivariate analyses showed that high day 1–2 concentrations of both nDNA and 16S rDNA were independently associated with sepsis. In addition, high day 1–2 concentration of nDNA was independently associated with negative outcomes. While 16S rDNA dissipated from the circulation within days, nDNA concentrations remained elevated throughout the follow-up period in patients with negative outcome. In conclusion, nDNA outperformed the other DAMPs regarding sepsis detection and outcome prediction. Both nDNA (a DAMP) and 16S rDNA (a PAMP) were independently linked to sepsis; nDNA was also associated with negative outcomes and persisted elevated in such cases. This highlights nDNA as an interesting marker within sepsis pathogenesis and as a promising clinical biomarker, warranting further studies.

A Systematic Review of the Incidence and Pattern of Surgical Site Infection in Orthopedic Surgery in Africa

A Systematic Review of the Incidence and Pattern of Surgical Site Infection in Orthopedic Surgery in Africa

Antimicrobial resistance patterns of bacterial and fungal lower respiratory tract infections among COVID-19 patients and their impact on Mortality

Antimicrobial resistance patterns of bacterial and fungal lower respiratory tract infections among COVID-19 patients and their impact on Mortality

Pathogen distribution and infection patterns in pediatric severe pneumonia: A targeted next-generation sequencing study

ObjectiveSevere pneumonia in children represents a significant clinical challenge due to its high incidence and associated mortality. This study aimed to assess the distribution of pathogens and patterns of infection in pediatric patients with severe pneumonia. MethodsThis study included 110 pediatric patients diagnosed with severe pneumonia, who were admitted to Guangxi Maternal and Child Health Hospital between July 2021 and November 2023. Pathogen-targeted next-generation sequencing (tNGS) was employed to identify respiratory pathogens in these cases. ResultsPathogens were detected in 109 out of 110 cases, yielding a positive detection rate of 99.09%. Among these cases, 25 (22.72%) involved single-pathogen infections, while 84 (76.36%) were characterized by mixed infections. The infection pattern in children with severe pneumonia was relatively common with bacterial-viral coinfection (28.2%, 31/110). A total of 39 pathogens were identified from the 110 children with severe pneumonia, with the top three pathogens being Mycoplasma pneumoniae (30.91%, 34/110), Human Respiratory Syncytial Virus Type A (26.36%, 29/110), and Human Herpesvirus (18.18%, 20/110). Notably, 38.2% (13/34) of the cases were found to have macrolide-resistant Mycoplasma pneumoniae (MRMP). Additionally, 40% (44/110) of the children required admission to the intensive care unit (ICU). ConclusionThe application of tNGS demonstrates significant utility in the detection of pathogens in pediatric patients with severe pneumonia. The predominant pathogens identified in this study are Mycoplasma pneumoniae, Human Respiratory Syncytial Virus, and Human Herpesvirus. Furthermore, mixed infections involving multiple pathogens were observed in 76.36% of the cases, and a substantial proportion (40%) of these patients necessitated intensive care.