Perianal Swabs Research Articles

Psoriasis

Key Points Psoriasis is characterized by well-demarcated erythematous papules and plaques with overlying scale. Scalp and face may be common sites in children.Guttate psoriasis can follow a streptococcal infection; consider a throat and perianal swab for streptococci to assist in diagnosis and treatment.Medium- to high-potency topical steroids with or without calcipotriol (Dovonex) or calcipotriene are first-line therapy.Refer to dermatology specialist if persistent or widespread disease for consideration of systemic or light therapy.

The Impact of Universal Glove and Gown Use on Clostridioides Difficile Acquisition: A Cluster-Randomized Trial.

Clostridioides difficile is the most common cause of healthcare-associated infections in the United States. It is unknown whether universal gown and glove use in intensive care units (ICUs) decreases acquisition of C. difficile. This was a secondary analysis of a cluster-randomized trial in 20 medical and surgical ICUs in 20 US hospitals from 4 January 2012 to 4 October 2012. After a baseline period, ICUs were randomized to standard practice for glove and gown use versus the intervention of all healthcare workers being required to wear gloves and gowns for all patient contact and when entering any patient room (contact precautions). The primary outcome was acquisition of toxigenic C. difficile determined by surveillance cultures collected on admission and discharge from the ICU. A total of 21 845 patients had both admission and discharge perianal swabs cultured for toxigenic C. difficile. On admission, 9.43% (2060/21 845) of patients were colonized with toxigenic C. difficile. No significant difference was observed in the rate of toxigenic C. difficile acquisition with universal gown and glove use. Differences in acquisition rates in the study period compared with the baseline period in control ICUs were 1.49 per 100 patient-days versus 1.68 per 100 patient-days in universal gown and glove ICUs (rate difference, -0.28; generalized linear mixed model, P = .091). Glove and gown use for all patient contact in medical and surgical ICUs did not result in a reduction in the acquisition of C. difficile compared with usual care. NCT01318213.

P1575: DEVELOPMENT OF A RISK PREDICTION MODEL OF SUBSEQUENT BLOOLDSTREAM INFECTION AFTER CARBAPENEM-RESISTANT ENTEROBACTERIACEASE ISOLATED FROM PERIANAL SWABS IN PATIENTS WITH HEMATOLOGICAL DISEASES

Background: Hematological patients are at higher risk of developing carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection (BSI) and associated with high mortality. Prediction model for a subsequent CRE BSI in hematological patients with CRE isolated from previous perianal swab samples can provide timely and useful target treatment strategies. Aims: To developing a quantified risk prediction model based on the risk factors of subsequent BSI in CRE carriers will help clinicians better identify specific individuals who would truly benefit from early, empiric CRE-targeted treatment. Methods: The data were extracted from patients with CRE isolated from perianal swab samples at the Hematopoietic Stem Cell Transplantation Center of Blood Diseases Hospital, Chinese Academy of Medical Sciences between July 2017 to October 2020 January. Patients who developed subsequent CRE BSI were compared with those who did not develop BSI. Univariate logistic analysis, multivariate logistic analysis and stepwise regression analysis were carried on a variety of clinical factors. Results: A total of 215 cases were included and 29 (13.4%) patients of them with CRE isolated from perianal swab samples developed CRE BSI subsequently. Multivariate analysis showed that C-reactive protein(CRP)﹥30mg/l(OR 10.613，95%CI 2.965~37.985，P=0.000）, perianal infection(OR 6.450, 95%CI 2.223~18.714, P=0.001), concomitant gastrointestinal symptoms (OR 4.175，95%CI 1.476~11.813，P=0.007），age﹥44 years (OR 3.415，95%CI 1.222~9.541，P=0.007）and neutrophil count﹤0.025×109/L (OR 4.583，95%CI 0.939~22.369，P=0.060）were risk factors for CRE BSI in patients with CRE isolated from perianal swab samples (P<0.01). They were included in the Logistic regression model to predict BSI. According to receiver operating characteristic (ROC) curve analysis, the cut-off value of the model was 0.921 (0.851-0.968，P<0.001). Image:Summary/Conclusion: Hematological patients with CRE isolated from perianal swab samples have a relatively low incidence of subsequent BSI but a relatively high risk of death. The risk prediction model based on CRP, perianal infection, concomitant gastrointestinal symptoms, age and valley absolute neutrophil may be used for predicting subsequent CRE BSI in patients with isolated from perianal swab samples and provide timely and effective treatment reference for this kind of patients.

Comparison between Perianal Swab and Stool Specimens for Detecting Colonization with Extended-Spectrum Beta-Lactamase-Producing and Fluoroquinolone-Resistant Enterobacterales.

Stool specimens are frequently used to detect gastrointestinal tract colonization with antimicrobial-resistant enteric bacteria, but they cannot be rapidly collected. Perianal swab specimens can be collected more quickly and efficiently, but data evaluating their suitability as a specimen type for this purpose are sparse. We performed selective culture for extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) and fluoroquinolone-resistant Enterobacterales (FQRE) using paired perianal swab and stool specimens that were collected within 1 day of each other from hematopoietic cell transplant recipients and patients with acute leukemia. Nineteen (7.6%) of 251 stool specimens yielded ESBL-E and 64 (26%) of 246 stool specimens yielded FQRE. The positive percent agreement of perianal swab specimens compared to stool specimens was 95% (18/19; 95% confidence interval [CI], 74% to 100%) for detecting ESBL-E and 95% (61/64; 95% CI, 87% to 99%) for detecting FQRE. The concordance between specimen types was 98% (95% CI, 97% to 100%). Perianal swabs are a reliable specimen type for surveillance of the gastrointestinal tract for ESBL-E and FQRE.

A Microbial Signature for Paediatric Perianal Crohn's Disease.

Perianal fistulising disease can affect up to 25% of patients with Crohn's disease [CD] and lead to significant morbidity. Although the role of the gut microbiota in inflammatory bowel disease [IBD] has been increasingly recognised, its role in fistula development has scarcely been studied. Here, we aimed to define the microbial signature associated with perianal fistulising CD in children. A prospective observational study including children age 6-18 years with a diagnosis of perianal fistulising CD was conducted. Stool samples and rectal and perianal fistula swabs were collected. Stool samples and rectal swabs from children with CD without perianal disease and healthy children were included as comparison. Whole shotgun metagenomic sequencing was performed. A total of 31 children [mean age 15.5 ± 3.5 years] with perianal CD were prospectively enrolled. The fistula-associated microbiome showed an increase in alpha diversity and alteration in the abundance of several taxa compared with the rectal- and faecal-associated microbiome with key taxa belonging to the Proteobacteria phylum. Genes conferring resistance to the clinically used antibiotic regimen ciprofloxacin and metronidazole were found in the three sample types. In comparison with children without the perianal phenotype [N = 36] and healthy controls [N = 41], the mucosally-associated microbiome of children with perianal CD harboured a reduced butyrogenic potential. Linear discriminant analysis identified key taxa distinguishing the rectal mucosally-associated microbiome of children with perianal CD from children without this phenotype. The microbial community within CD-related anorectal fistula is compositionally and functionally unique. Taken together, these findings emphasise the need to better understand the ecosystem of the fistula milieu to guide development of novel microbiome-based strategies in this CD phenotype.

RURAL LEFT-BEHIND CHILDREN ARE SERIOUSLY AFFLICTED WITH INTESTINAL HELMINTH INFECTIONS IN SOUTHERN SICHUAH, CHINA.

Rural children are seriously afflicted with intestinal helminth infections in China. Of note, the term rural children includes rural left-behind children (LBC) and rural non-left-behind children (NLBC); the difference in the prevalence of intestinal helminths between the 2 groups remains unclear. In this study, Gulin and Xuyong counties in southern Sichuan were chosen for investigation in 2019. The Kato Katz thick smear method was used to detect the presence of intestinal helminth eggs in rural children. For children aged 3-6 yr, the adhesive tape perianal swab method was used to detect Enterobius vermicularis and tapeworm eggs. Statistical differences in infection rates between the 2 groups were determined by the chi-square test. In total, 1,608 rural children, 911 LBC and 697 NLBC, participated in the investigation. Six species of intestinal helminths were detected. A total of 358 (39.3%) and 130 (18.7%) intestinal helminth positives were found among LBC and NLBC, respectively; the former had a higher (P < 0.05) infection level. Moreover, an analysis of double worm infection rates among intestinal helminth positive LBC and NLBC showed a difference between the 2 groups that was also statistically significant. These surveys indicated that the risk of intestinal helminth infection was substantially higher and the severity of infection much worse in rural LBC in southern Sichuan. More attention should be paid to the parasitic infection of LBC.

Evaluation of PCR technique as a rapid screening method for detection of Group B streptococci colonization in pregnant women

BackgroundGroup-B streptococci (GBS) colonization in pregnant women could be a source of serious neonatal infections, such as meningitis and sepsis; therefore, a rapid and accurate method for detection is needed for early prophylaxis. Conventional culture is a common method used for the detection of GBS. However, polymerase-chain reaction (PCR)-based assay may be another method for detection of GBS colonization.ObjectiveTo evaluate the performance of the PCR as a method for detection of GBS (Strept. agalactiae) colonization in the urogenital tract of pregnant women and to detect its prevalence among these women.MethodsThe present study was done at the Department of Clinical Pathology and Department of Obstetrics/Gynecology, Menoufia University Hospitals, during the period from June 2020 to June 2021. In this study, vaginal and perianal swabs were collected from 250 pregnant women, between the 35th and 37th weeks of pregnancy, who attended the Department of Obstetrics and Gynecology for perinatal care. Their ages ranged from 20 to 40 years. GBS was detected by culture VITEK2 and PCR was done.ResultsThe prevalence of colonization in pregnant women with GBS was 20%. The sensitivity and specificity of PCR and culture were 99% and 98%, respectively.ConclusionsPCR technique is a rapid, specific, and sensitive diagnostic tool for GBS detection. So, PCR could be used as a rapid test for the detection of GBS colonization in pregnant women. The sensitivity and specificity of automated culture were 99.8% and 89.2%, respectively, so it is also a rapid and specific method for the detection of GBS colonization.

Surveillance of soil-borne nematodiasis in Yancheng City from 2016 to 2020

To understand the prevalence of soil-transmitted nematode infections in Yancheng City from 2016 to 2020, so as to provide insights into the development of the scheme for further soil-transmitted nematodiasis surveillance. Soil-borne nematode infections were detected using the modified Kato-Katz method (two slides for one sample) among the permanent residents living in Yancheng City from 2016 to 2020, and Enterobius vermicularis infection was additionally detected among children at ages of 12 years and lower using the adhesive cellophane-tape perianal swab method. The prevalence and intensity of human soil-borne nematode and E. vermicularis infections were descriptively analyzed. A total of 51 259 person-time residents were detected for soil-borne nematode infections in Yancheng City from 2016 to 2020, and 48 egg-positives were identified, with a 0.09% prevalence. The soil-borne nematodes infecting residents included Ascaris lumbricoides, hookworm and Trichuris trichiura, with 0.04%, 0.05% and 0.002% prevalence rates of infections, and all infections were mild. There was a region-specific prevalence of soil-borne nematode infections in Yancheng City (χ2 = 18.21, P = 0.02), with the highest prevalence seen in Funing County (0.21%), while no infections were detected in Dafeng District for five successive years. The overall prevalence of E. vermicularis infections was 0.22% among children at ages of 12 years and lower in Yancheng City. The prevalence of soil-borne nematode infections appears a gradual decline in residents living in Yancheng City from 2016 to 2020, and is at an extremely low level. Further surveillance of soil-transmitted nematodiasis requires to be intensified targeting key regions and populations to consolidate the control achievements.

Trypanosoma cruzi DNA in Desmodus rotundus (common vampire bat) and Histiotus montanus (small big-eared brown bat) from Chile

The protozoan Trypanosoma cruzi, the causative agent of Chagas disease, is transmitted by infected feces or consumption of blood-sucking triatomine insects to several mammalian orders including Chiroptera. In Chile, the distribution of several insectivorous and one hematophagous bat species overlaps with those of triatomine vectors, but the T. cruzi infection status of local chiropterans is unknown. In 2018, we live-captured bats from two protected areas in Chile to collect plagiopatagium tissue, feces and perianal swab samples, in search for T. cruzi-DNA by real time PCR assays using species-specific primers. In Pan de Azúcar island (∼26°S), we examined a roost of Desmodus rotundus (common vampire bat) and sampled tissue from 17 individuals, detecting T. cruzi-DNA in five of them. In Las Chinchillas National Reserve (∼31°S), we examined two roosts of Histiotus montanus (small big-eared brown bat), collecting feces or perianal swab samples from eight individuals, detecting T. cruzi-DNA in four of them. This is the first report of T. cruzi-DNA evidence in bat species from Chile. Both vector-borne and oral transmission are potential infection routes that can explain our results. Further investigation is needed for a better understanding of the role of bats in the T. cruzi transmission cycle.

Amplification of cestode DNA from the peri-anal region of naturally infected foxes by PCR and LAMP: proof of concept for a potential sampling strategy for diagnosing human taeniosis

The diagnosis of human taeniosis can be achieved through coproscopy, ELISA or PCR. An important limitation of these methods is the high turnaround time for stool sample collection and preparation, indicating the need for a straightforward sampling strategy. Due to the high metabolic activity and reproductive potential of Taenia spp., we hypothesise that parasite DNA (cells and eggs) present in the peri-anal region of the host can be exploited as a target for molecular diagnosis. We evaluated the feasibility of recovering parasite DNA from the peri-anal area of foxes naturally infected with Taenia spp. Before necropsy, cotton swabs were rubbed at the peri-anal region of foxes. DNA was extracted using alkaline lysis coupled with a commercial DNA isolation kit (method A) or alkaline lysis alone (method B). DNA was used in the multiplex-PCR assay (previously described and called here swab-PCR) and a novel LAMP assay detecting Taenia spp. commonly found in foxes (swab-LAMP). The results of these assays from 105 foxes were compared with the presence of intestinal helminths determined at necropsy and by the sedimentation and counting technique (SCT). The sensitivity of swab-PCR for detecting Taenia (n = 68) was 89.8% (95% CI, 77.7–96.6) and 89.5% (66.9–98.7) using methods A and B, respectively. The sensitivity of the swab-LAMP assay was 83.7% (70.3–92.7) using method A and 89.5% (66.9–98.7) with method B. We postulate that peri-anal swab sampling followed by simplified DNA extraction and LAMP might be a suitable strategy for surveillance of human taeniosis in resource-limited settings in the future.

Enterobius vermicularis Infection among Preschool Children: A 12-Year (2008-2019) Survey in Large Cities and Provinces of the Republic of Korea.

A 12-year nationwide survey (2008–2019) was performed to investigate the prevalence of Enterobius vermicularis infection among preschool children in Seoul, 4 large cites (Busan, Incheon, Daegu, and Ulsan), and 9 provinces (grouped into 5 localities) in the Republic of Korea (=Korea). The survey was carried out once a year by 16 regional offices of the Korea Association of Health Promotion. The cello-tape perianal swab method (1 smear per child) was applied to detect eggs of E. vermicularis and other helminths. According to the results, the egg positive rate of E. vermicularis infection in 2008–2009 was 1.8–2.0%, but it decreased gradually to 0.6% in 2019 (P<0.05). The prevalence was significantly higher in boys (0.7–5.0%, mean 1.8%) than in girls (0.5–2.8%, mean 1.3%) (P<0.05). The 2 most southern localities, Jeju-do (Province) and Jeolla-do (inclusive of Jeollabuk-do and Jeollanam-do) and a mid-western province, Gyeonggi-do, revealed higher prevalences, whereas Seoul and Gangwon-do showed lower prevalences. The results indicate that a low-grade prevalence of E. vermicularis infection (less than 4%) has been maintained for the recent 12 years among preschool children in Korea. Continuous monitoring of enterobiasis in the child age group is necessary in Korea.

Impact of 1% chlorhexidine gluconate bathing and emollient application on bacterial pathogen colonization dynamics in hospitalized preterm neonates - A pilot clinical trial.

BackgroundChlorhexidine gluconate (CHG) body washes and emollient application may modulate bacterial pathogen colonization and prevent neonatal hospital-acquired infections.MethodsThis pilot, non-randomized, open-label trial, enrolled preterm neonates (1000-1500g; day 1-3 of life) at a tertiary hospital in Cape Town, South Africa. Participants were sequentially allocated to 4 trial arms (n=20 each): 1% aqueous CHG (CHG), 1% CHG plus emollient (CHG+EM), emollient only (EM) and standard of care (SOC: no antiseptic/emollient). Trial treatment/s were applied daily for 10 days (d) post-enrolment, documenting neonatal skin condition score. Anterior nose, neck, umbilical and perianal swabs for bacterial culture were collected at d1, d3, d10 and d16 post-enrolment, (±1 day), reporting pathogen acquisition rates and semi-quantitative bacterial colony counts. (ClinicalTrials.gov identifier: NCT03896893; trial status: closed).FindingsEighty preterm neonates (mean gestational age 30 weeks [SD 2]) were enrolled between 4 March and 26 August 2019. The bacterial pathogen acquisition rate (comparing d1 and d16 swabs) varied from 33·9% [95%CI 22·9-47·0] at the umbilicus, 39·3% [95%CI 27·6-52·4] at the neck, to 71·4% [95%CI 58·5-81·7] at both the nose and perianal region. At d10, CHG babies had reduced bacterial density detected from neck, umbilicus, and perianal swabs compared to other groups (see Table 3). Following intervention cessation, colonization density was similar across all trial arms, but S. aureus colonization was more prevalent among EM and CHG+EM babies. Neonatal skin condition score improved in babies receiving emollient application (EM: -0·87 [95%CI 0·69-1·06] and CHG+EM: -0·73 [0·45-0·99]), compared to the SOC and CHG arms (Table 2); no CHG-related skin reactions occurred.InterpretationBacterial colonization density was significantly reduced in babies receiving 1% CHG washes but colonization levels rebounded rapidly post-intervention. Emollient application improved skin condition but was associated with higher rates of S. aureus colonization.FundingSouth African Medical Research Council; National Institutes of Health (TW010682).

PREVALENCE, CLINICAL AND SOCIODEMOGRAPHIC PARAMETERS OF INTESTINAL PARASITOSIS IN SUSPECTED EGYPTIAN CHILDRENIN BENHA CITY, EGYPT

Intestinal parasitic infections (IPIs) are a public health problem worldwide. This study included300 children of both sexes, from 4-16 years old. All were subjected to a structuredquestionnaire sheet, stool examination using: Direct smear and con- centration technique aswell as perianal swab. The IPIs prevalence was 12.7%, with 7.9% double infections. The protozoaninfections 47.4% was higher than the helminthic ones 44.7%. Giardia duodenalis wasthe commonest protozoan, and Entrobius vermicularis was the commonest worm. The childrensuffered from abdominal pain (11.1%), diarrhea (3.8%), perianal itching (71.4%) andthrive failure (17.4%). Male positivity was 11.9% and female positivity was 13.2%. Intestinalparasites were detected in 25.5% of population drinking tap water, followed by 6.1% amongthose drinking filtrated water. Moreover, IPIs prevalence was 8.1% in children having a familysize equal or less than 5 members, whereas 18.9% of children having a family size more than5 members. Moreover the frequency was higher among rural 15.3% compared to urban inhabitants7.3%, also in farming family was 16.5% followed by 7.7% among other job holders andamong children to illiterate mothers 13% followed by children to educated mothers 12.3%.

Screening for Multidrug-Resistant Organisms in a Tertiary-Care University Hospital in the North West Bank: A Descriptive Study

Background: The prevalence of multidrug-resistant organisms (MDROs) in acute healthcare settings is increasing worldwide. Active screening for MDROs carriers on admission permits the prompt implementation of the appropriate precautions to decrease the probability of cross transmission to other inpatients. Objective: To report the spectrum of bacterial nasal, axilla, and perianal colonization among in patients at Najah National University Hospital (NNUH) during 2018. Methods: A retrospective observational study was performed at NNUH, a tertiary-care referral university hospital in Nablus, north of Palestine, that includes medical and surgical ICUs for both adults and children from January to August 2018. Nasal, axilla, and perianal swabs were collected within the first 24 hours of admission according to hospital policy. Patients who were referred from another hospital, who were admitted to a hospital for at least 2 nights during the previous 8 months, and who are known to have an MDROs in the past were included. Swab samples were processed for isolation and identification of these multidrug-resistant strains. Transmission-based precautions were implemented if positive results were reported (ie, contact isolation) and decolonization regimens were applied according to the CDC recommendations (muporocin ointment for nasal MRSA, daily bathing with chlorhexidine 2% soap for the rest). A daily isolation list was circulated among bed managers and senior nurses and head of departments for appropriate management of beds and reallocation of patients. The antibiotic susceptibility pattern was assessed using the disc-diffusion method on Mueller–Hinton agar and a Vitek-2 system. Results: During the period of the study, 1,425 nasal swabs, 1,245 axilla swabs, and 300 perianal swabs were collected according to the inclusion criteria. Positive results were reportedin 7%, 4%, and 44% for nasal, axilla, and perianal specimens, respectively. Regarding the distribution of bacterial colonization in the nasal swab, 73% were MRSA; for the axial, 29% were Pseudomonas; and from the perianal swab, the most prevalent pathogen was ESBL (56%) (Figs. 1–3). A discrepancy between the number of nasal or axilla and perianal swabs was observed, which was mainly due to the refusal of many patients to have the sample collected by the nurse. Conclusions: Colonization of the skin and mucous membranes of inpatients with MDROs is considered a risk factor for developing future infections. Therefore, active screening for those pathogens is critical for infection prevention and control programs and patient safety in acute-care settings.Funding: NoneDisclosures: None

PERSONAL HYGIENE AND ANTHELMINTIC CONSUMPTION IN PREVENTION OF ENTEROBIASIS AMONG PRIMARY SCHOOL CHILDREN

Background: Pinworm infection remains a global public health problem in Indonesia, with the highest prevalence in primary school–aged children. The government has made helminthiasis control efforts through annual deworming every six months, yet data on the enterobiasis prevalence and its risk factors are still limited. Purpose: This research aimed to determine the role of personal hygiene and anthelmintic or worm medicine consumption in the prevention of enterobiasis among primary school children. Methods: This research employed an analytic observational method with a cross-sectional design. The population used was primary school children in the Public Health Center (PHC) of Kaliwungu area, Kendal District, Central Java Province. The research sample was 150 students from first grade to third grade at 1 Primary Elementary School 1 Kutoharjo. The data sources were obtained from interviews of risk factors and perianal swab examinations. The data were analyzed by a chi-square test and multiple logistic regression. Results: The prevalence of pinworm infection among primary school children remains high (37.33%). The results of the multivariate analysis showed that there are three determinant variables of pinworm infections: not washing hands with soap before eating (p &lt; 0.01; Prevalence Odds Ratio (POR) = 6.47; 95% Confidence Interval [CI] = 2.87 &lt; POR &lt; 14.59); not washing hands with soap after defecation (p = 0.01; POR = 3.36; 95% CI = 1.40 &lt; POR &lt; 8.05); and not consuming anthelmintic drugs within the past six months (p = 0.03; POR = 2.43; 95% CI = 1.08 &lt; POR &lt; 5.50). Conclusion: Hand washing habits and annual deworming are important factors to prevent pinworm infections.

Epidemiology of the colonization and acquisition of methicillin-resistant staphylococci and vancomycin-resistant enterococci in dogs hospitalized in a clinic veterinary hospital in Spain

Antibiotic resistance is one of the biggest threats to human and animal health. Methicillin-resistant Staphylococcus spp. (MRS) and vancomycin-resistant Enterococcus spp. (VRE) are of increasing importance in hospital and/or nosocomial infections and represent a potential risk of transmission to humans from infected or colonized companion animals. Studies on the risk factors associated with colonization by multiresistant bacteria in animals are scarce. The present study aimed to estimate the prevalence and incidence of MRS and VRE in canine patients hospitalized in a veterinary hospital and to identify the risk factors for its acquisition and persistence.Nasal and perianal swabs were obtained from 72 dogs. Antimicrobial susceptibility assays and molecular detection of mecA and van genes were performed.A prevalence of 13.9% and incidence of 26.5% was observed in dogs colonized by MRS at hospital admission and release, respectively, higher values than those described in most veterinary studies. Thirty-five Staphylococcus isolates had mecA gene and showed higher resistance levels to most of the antimicrobials evaluated. Previous and concomitant use of antibiotics and corticosteroids has been associated with an increase in MRS colonization. The use of antibiotics in other animals living with the canine patients has also been identified as an associated factor, suggesting cross transmission. The presence of van-resistant genes from Enterococcus spp. was not detected.Pets should be considered possible vehicles of transmission and reservoirs for MRS bacteria and veterinary hospitals should be considered high-risk environments for the occurrence and spread of nosocomial infections and resistant bacteria.

Assessment of the prevalence of intestinal parasite infections among patients at the Laboratory of Department of Biology and Medical Parasitology of the Pomeranian Medical University in Szczecin in the years 1983–2012

Abstract Introduction: Intestinal parasitoses are among the most common parasitic diseases in Poland. The aim of this study was to assess their prevalence in patients of the Laboratory of the Department of Biology and Medical Parasitology (LDBMP) of the Pomeranian Medical University in Szczecin (PMU) in the years 1983–2012. Materials and methods: The analysis concerned the results of parasitological surveys conducted between 1983–2012 in 9760 patients. Parasitological diagnosis was performed by standard faecal examination method (direct swab) and/or perianal swab. Results: During the study period, 486 cases of infection with intestinal parasites were recorded. The mean prevalence of intestinal parasites was 4.98%, and the percentage of infected patients ranged from 8.8% in 1993 to 0% in 2002. The most frequently detected parasitic species were: Entamoeba coli (1.52%), Giardia lamblia (0.95%), Blastocystis spp. (0.89%), Enterobius vermicularis (0.79%), and Taenia saginata (0.36%). In the period 2003–2012 the most prevalent parasites were Blastocystis spp., E. coli, and E. vermicularis. An increase in the prevalence of intestinal parasitic infections from 2009–2012 was associated with an increase in the prevalence of Blastocystis spp. Conclusions: The prevalence of intestinal parasites among the patients of the LDBMP in the years 1983–2012 was lower in comparison with other Polish regions. The high prevalence of 2 protozoan species – potentially pathogenic Blastocystis spp. and non-pathogenic E. coli – among intestinal parasites detected in the years 2003–2012 may indicate improvement in the epidemio-logical situation regarding intestinal parasitoses in patients of the LDBMP in comparison to the 1980s and 1990s.

Acquisition of Antibiotic-Resistant Gram-negative Bacteria in the Benefits of Universal Glove and Gown (BUGG) Cluster Randomized Trial.

BackgroundThe Benefits of Universal Glove and Gown (BUGG) cluster randomized trial found varying effects on methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus and no increase in adverse events. The aim of this study was to assess whether the intervention decreases the acquisition of antibiotic-resistant gram-negative bacteria.MethodsThis was a secondary analysis of a randomized trial in 20 hospital intensive care units. The intervention consisted of healthcare workers wearing gloves and gowns when entering any patient room compared to standard care. The primary composite outcome was acquisition of any antibiotic-resistant gram-negative bacteria based on surveillance cultures.ResultsA total of 40 492 admission and discharge perianal swabs from 20 246 individual patient admissions were included in the primary outcome. For the primary outcome of acquisition of any antibiotic-resistant gram-negative bacteria, the intervention had a rate ratio (RR) of 0.90 (95% confidence interval [CI], .71–1.12; P = .34). Effects on the secondary outcomes of individual bacteria acquisition were as follows: carbapenem-resistant Enterobacteriaceae (RR, 0.86 [95% CI, .60–1.24; P = .43), carbapenem-resistant Acinetobacter (RR, 0.81 [95% CI, .52–1.27; P = .36), carbapenem-resistant Pseudomonas (RR, 0.88 [95% CI, .55–1.42]; P = .62), and extended-spectrum β-lactamase–producing bacteria (RR, 0.94 [95% CI, .71–1.24]; P = .67).ConclusionsUniversal glove and gown use in the intensive care unit was associated with a non–statistically significant decrease in acquisition of antibiotic-resistant gram-negative bacteria. Individual hospitals should consider the intervention based on the importance of these organisms at their hospital, effect sizes, CIs, and cost of instituting the intervention.Clinical Trials RegistrationNCT01318213.

National surveillance on Enterobius vermicularis infections among children at ages of 3 to 9 years in China from 2016 to 2018

To understand the epidemic status of Enterobius vermicularis infections among children aged 3 to 9 years in China, so as to provide scientific basis for the formulation of the prevention and control strategies for enterobiasis. The national surveillance of enterobiasis was performed in 736 national surveillance sites (counties) from 30 provinces (municipalities/autonomous regions) in China from 2016 to 2018. All surveillance sites were classified into parts according to the geographical directions, including the eastern, western, southern, northern and middle parts, and a township was randomly selected from each part. Then, an administrative village was randomly selected from the township, and 200 permanent residents at ages of over 3 years living in the administrative village were randomly selected using the cluster sampling method. A total of 1 000 residents were examined in each surveillance site. E. vermicularis infections were detected among children at ages of 3 to 9 years using the modified Kato-Katz technique and the adhesive cellophane-tape perianal swab method, and the prevalence of infections was calculated and compared. The prevalence of E. vermicularis infections was 2.50%, 2.84% and 2.46% among children at ages of 3 to 9 years in the 736 surveillance sites from 30 provinces (municipalities/autonomous regions) in China from 2016 to 2018, and there was no gender-specific prevalence of E. vermicularis infections (P > 0.05). Enterobiasis was main prevalent in the southern and southwestern part of China (Jiangxi, Guangxi, Guangdong, Sichuan, Fujian, Chongqing and Hainan), with 5.00% prevalence and greater, and the highest prevalence was seen in Jiangxi and Guangxi for successive 3 years. In addition, the prevalence of E. vermicularis infections was higher in children with the Han ethnicity than in those with the minority ethnicity, and a high prevalence was found in children at ages of 4 to 7 years, and a low prevalence seen in children at ages of 3, 8 and 9 years. The prevalences of E. vermicularis infections have not changed much among children at ages of 3 to 9 years in China from 2016 to 2018, and high prevalence is seen in southern and southwestern China, which should be given a high priority.

Detection of sexually transmitted disease-causing pathogens from direct clinical specimens with the multiplex PCR-based STD Direct Flow Chip Kit.

Pathogens causing sexually transmitted diseases (STDs) include viruses, bacteria, and parasites. The ability to rapidly and efficiently detect these pathogens in a single reaction still remains a health challenge. The aim of this study was to evaluate the clinical reliability and accuracy of the STD Direct Flow Chip Kit (Vitro, IVD-EC approved), which can simultaneously detect up to 9 different species of STD pathogens at once. This kit enables direct analysis-direct-PCR-of clinical specimens (urine, semen, endocervical, urethral, nasopharyngeal, and perianal swabs) without DNA purification for the following pathogens: Chlamydia trachomatis (serovars A-K and L1-L3), Haemophilus ducreyi, Herpes Simplex Virus (Types I and II), Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and Ureaplasma. The Anyplex™ II STI-7 Detection Kit (Seegene, IVD-EC) was used as the reference's method. Existing discordances were resolved using either a third molecular assay or DNA sequencing. Clinical performance was evaluated at two different stages: (i) from purified DNA of three hundred and fifty-eight clinical specimens with a diagnostic sensitivity (SE) and specificity (SP) of 99.4% and 100%, respectively, and an agreement of 99% (kappa index, κ = 0.97) with the reference's method and; (ii) by direct-PCR from six hundred and thirty-three specimens rendering SE, SP, and agreement values of 98.4%, 99.9%, and 98.0% (κ = 0.95), respectively. The STD Direct Flow Chip Kit constitutes a promising alternative to routine procedures in diagnostic, allowing direct analysis of specimens and enabling the detection of a broad panel of pathogens.