Prevalence Of Infection Research Articles

Investigating the Prevalence of Bacterial Infections in Patients with Coronavirus Disease 2019 Hospitalized in Intensive Care Unit and Determining their Antibiotic Resistance Patterns.

COVID-19 patient hospitalization, particularly in intensive care units, exposes them to bacterial and fungi co-infections, which can have very serious consequences, including increased mortality. In addition, antibiotic resistance among pathogens is a hidden threat behind COVID-19. In the period from 2020 September to 2021 August, bacterial isolates from COVID-19 patients admitted to the ICU of Sina Hospital in Hamadan, Iran, were collected and identified based on standard biochemical tests. COVID-19 cases were confirmed based on clinical symptoms, computed tomography, and polymerase chain reaction. Antimicrobial susceptibility tests were conducted using disc diffusion and broth microdilution methods. In total, 207 bacterial isolates were collected, with Klebsiella pneumoniae account-ing for 69 (33.33%) and Acinetobacter baumannii accounting for 59 (28.15%). The frequency and percentage of isolated bacteria were as follows: Alcaligenes species 28 (13.59%), Staphylococcus aureus 18 (8.73%), Pseudomonas aeruginosa 15 (7.28%), Escherichia coli 11 (5.33%), Stenotrophomonas maltophilia 3 (1.45%), Enterococcus species 3 (1.45%), and Serratia species 1 (0.48%). About 95.38% resistance to ceftazidime and cefotaxime and 92.31% resistance to ciprofloxacin and cefepime were found in K. pneumoniae isolates. A. baumannii isolates were 100% resistant to cefotaxime, ceftriaxone, and cefepime. About 22.22% resistance to vancomycin and 66.67% resistance to clindamycin, erythromycin, and cefoxitin were seen in S. aureus isolates. Knowledge of bacterial co-infections and their antibiotic resistance pattern in COVID-19 patients can help in choosing effective antibiotics for the treatment and prevention of antibiotic resistance.

Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study

BackgroundThe World Health Organization has set ambitious goals to eliminate cervical cancer, necessitating evidence on increasing coverage and access to screening and treatment in high-burden areas. We implemented a pilot program to assess the feasibility of obtaining self-collected specimens for high-risk human papillomavirus (hr-HPV) testing in Nzulezo stilt village, a hard-to-reach community in Ghana, and inviting only hr-HPV-positive women to a central location for colposcopy and possible treatment. Subsequently, this study aimed to investigate the prevalence of hr-HPV infection and cervical lesions among the women and to explore factors potentially associated with hr-HPV infection among them.MethodsThis pilot community-based cross-sectional study utilized data from screening sessions held from 2 to 20 November 2021 with specimens collected by participants using Evalyn brushes. HPV DNA testing was performed using the Sansure MA-6000 platform, while visual inspection utilized the Enhanced Visual Assessment (EVA) mobile colposcope. Univariate and multivariable nominal logistic regression was employed to explore factors associated with hr-HPV positivity.ResultsAmong 100 women screened (mean age, 43.6 ± 14.5 years), the overall hr-HPV prevalence rate was 39.0% (95% CI, 29.4–49.3). The prevalence rates of hr-HPV genotypes were stratified as follows: HPV16–8.0% (95% CI, 3.5–15.2), HPV18–5.0% (95% CI, 1.6–11.2), and other genotype(s) – 31.0% (95% CI, 22.1–41.0). Single-genotype infections with HPV16 and HPV18 were found in 4.0% (95% CI, 1.1–9.9) and 3.0% (95% CI, 0.6–8.5) of women, respectively. Mixed infections were observed in 1.0% (95% CI, 0.0–5.4) for HPV16 + 18, 3.0% (95% CI, 0.6–8.5) for HPV16 + other type(s), and 1.0% (95% CI, 0.0–5.4) for HPV18 + other type(s). The prevalence of cervical lesions among hr-HPV-positive women screened via colposcopy was 11.4% (95% CI, 3.2–26.7). In the multivariable model, reliance on other sources for medical bill payment was associated with hr-HPV infection (aOR, 0.20; 95% CI, 0.04–0.93), whereas age was not (aOR, 1.02; 95% CI, 0.99–1.05).ConclusionsA high hr-HPV infection prevalence was recorded among the women. Utilizing technologies such as self-sampling, HPV DNA testing, and mobile colposcopy enables screening and treatment in remote and hard-to-reach communities where access to cervical cancer screening and treatment would otherwise be limited. Further research is warranted to assess the value and scalability of this approach in similar remote areas and its potential implementation in future programs.

Current water contact and Schistosoma mansoni infection have distinct determinants: a data-driven population-based study in rural Uganda

Water contact is a key element of the system of human-environment interactions that determine individual exposure to schistosome parasites and, in turn, community transmission. Yet, there is a limited understanding of the complexity of water contact. We characterised patterns and determinants of water contact within the large-scale SchistoTrack study on 2867 individuals aged 5-90 years in Eastern and Western Uganda, employing Bayesian variable selection and advanced statistical modelling. We found a 15-year gap between the population-level peak in water contact (age 30) and infection (age 15) with practically no correlation (ρ = 0.03) between individual-level water contact and infection. Adults had higher water contact than children, and 80% of individuals with water contact lived within 0.43 km of water bodies. Domestic water contact was most common for children and women, while occupational water contact was most common for men. Water contact was positively associated with older age, fishing or fish mongering occupations, the number of water sites, and type (beach/pond/swamp), and lower village-level infection prevalence. Only older age and fishing were positively, though inconsistently, associated with infection status/intensity. By providing profiles of at-risk groups, and suitable water contact metrics, our research opens avenues for spatially-targeted interventions and exposure monitoring in endemic countries.

Serologic Evidence of Recent Infection with Highly Pathogenic Avian Influenza A(H5) Virus Among Dairy Workers - Michigan and Colorado, June-August 2024.

Since April 2024, sporadic infections with highly pathogenic avian influenza (HPAI) A(H5) viruses have been detected among dairy farm workers in the United States. To date, infections have mostly been detected through worker monitoring, and have been mild despite the possibility of more severe illness. During June-August 2024, CDC collaborated with the Michigan Department of Health and Human Services and the Colorado Department of Public Health and Environment to implement cross-sectional serologic surveys to ascertain the prevalence of recent infection with HPAI A(H5) virus among dairy workers. In both states, a convenience sample of persons who work in dairies was interviewed, and blood specimens were collected. Among 115 persons, eight (7%; 95% CI=3.6%-13.1%) had serologic evidence of recent infection with A(H5) virus; all reported milking cows or cleaning the milking parlor. Among persons with serologic evidence of infection, four recalled being ill around the time cows were ill; symptoms began before or within a few days of A(H5) virus detections among cows. This finding supports the need to identify and implement strategies to prevent transmission among dairy cattle to reduce worker exposures and for education and outreach to dairy workers concerning prevention, symptoms, and where to seek medical care if the workers develop symptoms. Timely identification of infected herds can support rapid initiation of monitoring, testing, and treatment for human illness, including mild illness, among exposed dairy workers.

BACTERIOLOGICAL PROFILE OF SURGICAL SITE INFECTIONS AND THEIR ANTIBIOGRAM: A STUDY IN A TERTIARY CARE HOSPITAL

Objective: To ascertain the frequency of surgical site infection (SSI) occurrences and the prevalence of aerobic bacterial infections associated with their antibiogram. Methods: For 1 year, a tertiary care hospital affiliated with Government Medical College, Amritsar, served as the site of this cross-sectional study. Pus aspirates were aseptically taken from 86 consecutive individuals suspected of having SSI using a sterile surgical syringe with a needle and sterile cotton surgical swabs. The specimens were cultivated and placed in an incubator at 37°C for 24 h. The individual strains were then identified using traditional techniques. The Kirby–Bauer’s Disc Diffusion Method was employed to conduct antimicrobial susceptibility testing. Results: Among 1021 patients, 86 were clinically suspected of SSI, and 64 were culture-positive. The incidence of SSI was 8.42%. The most common organisms were Klebsiella pneumoniae 34% (17/50) and Escherichia coli 32% (16/50), whereas Staphylococcus aureus 100% (14/14) was the only organism found among Gram-positive cocci. The antimicrobial Profile of Gram-positive isolates showed maximum sensitivity to linezolid (100%), followed by erythromycin (85.7%). The antimicrobial profile of lactose fermenters revealed maximum sensitivity to polymyxin (100%). Antibiogram of Proteus species showed maximum sensitivity to meropenem (100%) and ceftazidime tazobactam (100%). Non-fermenters showed 100% polymyxin and 80% sensitivity to aztreonam. Conclusion: Our study has revealed significant findings. The incidence of SSI was found to vary between 8% and 12% in our tertiary care center. K. pneumoniae 26.5% (17/64) and E. coli 25% (16/64) were the most common organisms isolated. S. aureus 21.2% (14/64) was the only organism found among Gram-positive cocci. SSI below waist surgery was far more 75% (48/64) than above waist surgery of 25% (16/64).

Viral Hepatitis B and C Prevalence and Related Risk Factors Among Prisons in Duhok City, Kurdistan Region, Iraq.

Background Infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) are major public health problems worldwide. Public health services are still confronted with the problem of HBV and HCV infections, which calls for targeted preventative measures, especially for critical groups such as prisoners. Therefore, the study aims to measure the prevalence of HBV and HCV infections and to investigate their risk factors among prisoners in Duhok City, Kurdistan, Iraq. Methods A cross-sectional study was performed at the two main prisons inside Duhok city. There were a total of 1,013 inmates: at the Zerka jail, there were 945 male inmates, and at the Etiti jail, there were 50 adult females and 18 adolescent male inmates. Data collection was performed by a direct interview using a structured questionnaire on sociodemographic characteristics and risk factors. Serum samples were tested for HBV surface antigen (HBsAg) and HCV antibody (HCV-Ab) by enzyme-linked immunosorbent assay. Results The mean age of the participants was 35.9 years. The prevalence of HBV and HCV infections was 1.28% and 0.09%, respectively. HBV infection was significantly associated with occupation and marital status. The main risk factors were previous history of surgery and tooth extraction. Conclusions In conclusion, the prevalence of HBV was low while that of HCV was very low. It is usually recommended to take steps to screen for and treat HBV and HCV in patients.

Prevalence of intestinal parasites in street dwellers attending a shelter in Cali, Colombia.

Intestinal parasitic infections represent a public health problem, especially among vulnerable populations. There are few studies on the prevalence and determinants of intestinal parasites infections in street dwellers, who may experience significant health and socioeconomic implications. Understanding the prevalence and associated factors of intestinal parasites in this population is crucial for targeted interventions to mitigate the spread of these infections. To determine the prevalence of intestinal parasites in street dwellers attending a shelter in Cali, Colombia. We selected 66 participants who met the inclusion criteria. We collected serial stool samples for laboratory evaluation and sociodemographic data, and information on their hygiene habits and addictions. Seventy-six percent of the participants had intestinal parasites or commensals, with 30% presenting monoparasitism, 46% polyparasitism, and 20% eosinophilia. Blastocystis spp. was the most common organism (68.18%), followed by Endolimax nana (34.85%) and Entamoeba coli (18.18%). The most common pathogens were the Entamoeba histolytica/E. dispar/E. moshkovskii complex (10.61%) and hookworms (9.09%). We evaluated prevalence-related determinants. Intestinal parasitism is a health problem among street dwellers in Cali. A serial examination is recommended for diagnosing intestinal parasitic infection, especially in cases of low parasite loads. Campaigns should be established to reduce the prevalence of these parasites in populations at risk of complications.

Prevalence and Sociodemographic Risk Factors of Soil-Transmitted Helminths in Rural Communities Living in Endemic Foci of Onchocerciasis in Southern Gabon

This prospective survey determined the prevalence and intensity of infections due to geohelminths and the associated risk factors in five onchocerciasis-endemic communities in Gabon between January and February 2020. Onchocerciasis endemicity was confirmed by Ov16 IgG testing. STHs were detected using the Kato–Katz techniques. Prevalence and parasite density were analyzed according to age, sex, and onchocerciasis endemicity. STHs were found in 64.8% of participants and were more common in hypoendemic (80.9%) and hyperendemic (63.9%) onchocerciasis communities (p < 0.01). Ascaris lumbricoides (65.5%), Trichuris trichiura (57.1%), and hookworms (17.3%) were prevalent in areas hypoendemic for onchocerciasis (p = 0.04). Male participants were more often infected by hookworms. Adults were more frequently infected by STHs (75.9%) than elders, who were the least infected (39.3%) (p < 0.01). Participants living in sporadic onchocerciasis areas frequently but not significantly harbored a moderate ascariasis load (6960.0 (1068.0–9492.0) eggs per gram) (p = 0.4). The highest parasite density was observed among participants aged 20–45 years (15,336.0 (3888.0–35,028.0)). A low T. trichiuria prevalence was found in all communities. STHs are highly prevalent in hypoendemic and hyperendemic areas and adults. An integrated combined approach of STH and onchocerciasis elimination through efficacious mass drug administration targeting all age groups should be considered.

Prevalence of vaginal and cervical HPV infection among 35-year age cohort ever-married women in Kalutara district of Sri Lanka and the validity of vaginal HPV/DNA specimen as a cervical cancer screening tool: a cross-sectional study.

Cervical cancer is the 2nd most common female cancer among Sri Lankan females and is almost associated with sexually transmitted cervicovaginal human papillomavirus (HPV) infection. The study objectives were to determine the prevalence of vaginal and cervical HPV infection among 35year old ever-married women and assess the validity of primary healthcare provider-collected vaginal HPV/DNA specimens as a cervical cancer screening tool to improve the coverage of the programme. A descriptive cross-sectional study was carried out from the 1st of September 2018 to the 31st of January 2019. Ever-married women 35 years of age in Kalutara district were the study population. Two women from each Public Health Midwife area (n = 413) were selected randomly from the relevant area eligible families register/s. HPV/DNA cervical specimen and vaginal specimen collection (n = 621) were carried out. Specimens were screened by the Cobas 4800 HPV/DNA automated Polymerase Chain Reaction (PCR) machine. Participants' profiles were recorded by the research assistants using an interviewer-administered questionnaire. The overall prevalence of vaginal and cervical HPV infection was 7.08% (95% CI; 5.2-9.4%) and 6.12% (95% CI; 4.26-8.3%) respectively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and the kappa coefficient of the vaginal HPV/DNA screening method vs. cervical HPV/DNA screening method were 100%, 98.9%, 86.4%, 100%, 99% and 0.92 respectively. Vaginal HPV/DNA specimen screening method can be used as a cervical cancer screening tool due to its high validity. Pilots of the feasibility should be set up before the regional or national rollout of vaginal sampling strategies.

Prevalence of Superficial Dermatophyte Fungal Infections in a Tertiary Care Hospital in Fez, Morocco: An 8-Year Retrospective Study

Prevalence of Superficial Dermatophyte Fungal Infections in a Tertiary Care Hospital in Fez, Morocco: An 8-Year Retrospective Study

Unveiling the potential of parasites as proxy bioindicators for water quality assessment in river Jhelum Kashmir, India.

This study aimed to evaluate the effects of deteriorated physicochemical conditions in the river Jhelum on parasitic infestations and to investigate the potential of fish parasites as bioindicators of water quality. All the physicochemical parameters exhibited statistically significant differences based on both site and season (p < 0.01).The interaction term (Site × Season) was also kept in the model since it was statistically significant (p < 0.01). A parasitological survey of 360 schizothoracine fish revealed a 30.3% prevalence (109/360) of endohelminth infection. The study identified four predominant parasitic taxa across two distinct classes: Cestoda, including Adenoscolex oreini and Schyzocotyle acheilognathi, and Acanthocephala, comprising Pomphorhynchus kashmirensis and Neoechinorhynchus manasbalensis. For the assessment of parasitic load, we calculated the prevalence, mean intensity, mean abundance, and index ofinfection for each sampling period. Correspondence analysis identified associations between parasite occurrence and specific water quality parameters. Regression analysis, including R2 and p values, demonstrated a positive correlation between the number of parasites and both the proportion of infected fish and the ratio of infected to examined fish. Given that parasitic load is significantly influenced by a range of water quality parameters, fish parasites can serve as a robust indicator of declining water quality. Fish parasites are highly sensitive to water quality changes such as pollutants, toxins, and fluctuations in pH, temperature, and oxygen levels. Deteriorating water quality can stress fish, compromising their immune systems and increasing their susceptibility to parasitic infections. Additionally, complex life cycles of parasites can be disrupted by poor water conditions, making them indicators of water quality issues.

Insights into the role of Streptococcus oralis as an opportunistic pathogen in infectious diseases

Streptococcus oralis, belonging to the viridans group streptococci (VGS), has been considered a member of normal flora mainly inhabiting the oral cavity. However, more recently, there has been growing recognition of its role as a causative agent in various life-threatening infectious diseases such as infective endocarditis (IE) and meningitis. Additionally, the differences in the prevalence, clinical features, and prognosis of opportunistic infections between S. oralis and other VGS species have been addressed. Particularly the predominance of S. oralis in IE has drawn critical attention. In potentially fatal infections, clinical neglect of S. oralis as an instigating agent might significantly impede early diagnosis and treatment. Nevertheless, to date, the infectious diseases associated with S. oralis have not yet been comprehensively described. Therefore, this review will give an overview of infectious diseases caused by S. oralis to uncover its hidden role as an opportunistic pathogen.

Prevalence of Malaria Infection among Pregnant Women Attending Antenatal Clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Malaria is a major health problem affecting people in the tropics and sub-tropical regions of the world. This cross-sectional hospital-based study was carried out to determine the prevalence of malaria infection among pregnant women attending a tertiary hospital in Nnewi, Anambra State, Nigeria. A total of 100 venous blood samples were collected from pregnant women into EDTA tubes and examined using field-stained thick and thin films for identification of malaria parasites. Demographic information such as age, trimester and insecticide-treated nets usage was obtained using a structured questionnaire. Data was analyzed using Statistical Package for the Social Sciences version 22. The chi-square test was used to determine the difference among the variables studied and P≤ 0.05 were considered significant. Out of the 100 blood samples examined, 27 were infected and had an overall prevalence of 27%. Women within the age bracket of 31-35 years had the highest prevalence rate 11(36.7%) while no infection was recorded in the 41-45 years age group 0(0.0%). Pregnant women in their first trimester had the highest infection prevalence of 13(35.1%) while those in their third trimester had the least prevalence of 5(17.9%). In relation to ITN’s usage, pregnant women who don’t normally sleep under ITNs had the highest infection prevalence 23(31.5%) while those who usually sleep under ITNS had the least prevalence rate 4(14.8%). It is pertinent to periodically check the malaria infection status of pregnant women attending antenatal services. Prophylactic treatment should be routinely administered to avoid pregnancy complications due to malaria infection.

Temporal increase in ticks and pathogen prevalence in the small mammal part of the Lyme disease cycle in northern Europe

AbstractLyme disease is an emerging infectious disease and the most common vector‐borne zoonosis in the northern hemisphere. The pathogen that causes Lyme disease in Europe is vectored by the generalist tick Ixodes ricinus, and the emergence of Lyme disease is partly linked to how climate warming affects tick distribution and abundance. However, we lack long‐term data on tick infestations and infection prevalence in the main hosts involved in the transmission cycle. Here, we quantified the temporal trends (2014–2022) of I. ricinus infestations and the prevalence of Borrelia burgdorferi sensu lato in small mammalian hosts and linked annual variation to host abundance and climate in Norway. We found that tick infestations for both larvae (21% per year [95% CI 18–25]) and nymphs (18% [11–26]), and infection prevalence (14% [8–20]) increased over the period and were negatively associated with rodent abundance. Additionally, warmer years were associated with increased larval tick infestations on hosts. The combination of a temporal increase in both larval tick infestation and infection prevalence in hosts likely results in increased production of infected nymphs. Thus, we provide one mechanistic step toward understanding the Lyme disease emergence at northern latitudes of Europe.

Host-Parasite Interaction Between the Nematoda Procamallanus (Spirocamallanus) paraensis and Fish Hoplias malabaricus From the Natural Environment in the Brazilian Amazon.

Histopathological studies of parasitic infections in fish from the natural environment of Brazilian Amazon, are quite scarce. In this study, we investigated the histopathological changes of the proximal intestine of specimens of the Amazonian fish Hoplias malabaricus infected by the hematophagous nematode Procamallanus (Spirocamallanus) paraensis. The prevalence of the infection was 60%, with an average abundance of 1.46 and an average intensity of 2.43 parasites/fish. No significant difference was observed in the prevalence of infection and fish size or sex, but larger fish showed greater infection intensity, which was also significantly higher in male hosts. Histological sections of the proximal intestine showed reduction and loss of the epithelial lining, exposure of the lamina propria where the nematode interacts with the intestine wall, through the insertion of the buccal capsule and fish cellular debris in the intestinal lumen. In addition, areas with bleeding and inflammatory infiltrate were observed, but no changes or presence of parasite structures were observed in the other tunics of the intestinal wall.

Hepatitis B virus infection among hemodialysis patients in Aden-Yemen

HBV infection is one of major global health problems worldwide. It increases the morbidity and mortality rates among hemodialysis patients which make the management process more complicated. This study was aimed to determine the prevalence of HBV infection among hemodialysis patients and assessment the risk factors associated with infection. An analytical cross-sectional study was conducted on 50 HD patients. Blood samples were collected and serum HBsAg was analyzed using ELISA technique. The overall prevalence of HBV was 6 (12.0%). The males had highest rate. There were statistically significant recorded between the prevalence of HBV infection and age group 30 – 39 years and duration of hemodialysis from 1-2 years and more than 2 years (p=0.02, 0.001 and 0.001) respectively. It can be concluded that the HBV prevalent rate among HD patients was common and lower than that reported among most general population in Yemen. Increasing of the duration and long standing in hemodialysis unit may increase the risk of HBV infection. Hepatitis B vaccine should be given to all HBV negative HD patients before HD process and health education programs about the transmission routes of HBV and preventive measures should be implemented for general population.

HPV infection status among women of all ages in Jinshan District, Shanghai.

We explored the prevalence of human papillomavirus (HPV) infection among women in Jinshan District, Shanghai. We analyzed all HPV testing samples sent from our unit between December 2023 and April 2024. We reported the HPV prevalence overall, by age, and by subtype. In total, 3788 women aged 16 to 90 years had HPV test results. The prevalence of infection with any HPV subtype was 17.9%. The HPV prevalence by age group was: ≤30 years, 15.4%; 31-40 years, 14.7%; 41-50 years, 17.0%; 51-60 years, 22.4%; >60 years, 31.0%. Among HPV-positive women, 80.6% had infection with one subtype, 16.4% had dual infection, and 3.1% had three or more subtypes detected. We found 640 cases (16.9%) of infection with high-risk HPV subtypes and 139 cases (5.04%) of infection with low-risk HPV subtypes. The most common high-risk subtypes were HPV 52, 53, 58, and 16; the most common low-risk subtypes were HPV 81, 70, and 42. We detected ≥1 HPV subtype among most women in our study. The prevalence of HPV was lowest in younger women and highest in women age >60 years. Tailored strategies for older women are needed to prevent HPV infection and cervical cancer.

Biofilm Production in Intensive Care Units: Challenges and Implications

The prevalence of infections amongst intensive care unit (ICU) patients is inevitably high, and the ICU is considered the epicenter for the spread of multidrug-resistant bacteria. Multiple studies have focused on the microbial diversity largely inhabiting ICUs that continues to flourish despite treatment with various antibiotics, investigating the factors that influence the spread of these pathogens, with the aim of implementing sufficient monitoring and infection control methods. Despite joint efforts from healthcare providers and policymakers, ICUs remain a hub for healthcare-associated infections. While persistence is a unique strategy used by these pathogens, multiple other factors can lead to persistent infections and antimicrobial tolerance in the ICU. Despite the recognition of the detrimental effects biofilm-producing pathogens have on ICU patients, overcoming biofilm formation in ICUs continues to be a challenge. This review focuses on various facets of ICUs that may contribute to and/or enhance biofilm production. A comprehensive survey of the literature reveals the apparent need for additional molecular studies to assist in understanding the relationship between biofilm regulation and the adaptive behavior of pathogens in the ICU environment. A better understanding of the interplay between biofilm production and antibiotic resistance within the environmental cues exhibited particularly by the ICU may also reveal ways to limit biofilm production and indivertibly control the spread of antibiotic-resistant pathogens in ICUs.

Retrospective Evaluation of C-reactive Protein for Ruling Out Infection After Cesarean Section.

Infection after cesarean section is a major contributor to maternal morbidity. Measurement of C-reactive protein (CRP) is a laboratory test frequently conducted to rule out or confirm postoperative infection. The present study aimed to evaluate whether CRP is a suitable tool for ruling out infection after cesarean section and whether there are any reliable cut-off values. 2056 patients with cesarean section (CS) over a 3-year period were included in a retrospective analysis. Outcome parameters and risk factors for postoperative infection were collected. CRP values from preoperative and postoperative tests were compared. Cut-offs for ruling out infection were assessed. Among 2056 CSs, postoperative infection occurred in 78 cases (3.8%). The prevalence of infection in emergency CS was lowest, at four out of 134 (2.9%), and the highest prevalence was seen in secondary CS, at 42 of 903 (4.6%; p=0.35). CRP values in the infection group were significantly higher (preoperative, 1.01mg/dl vs. 0.62mg/dl; day 1 postoperative, 7.91mg/dl vs. 6.44mg/dl; day 4 postoperative, 8.44mg/dl vs. 4.09mg/dl; p=0.01). A suitable cut-off value for ruling out infection was not identified. Although CRP values were significantly higher in the infection group, the clinical relevance of this appears to be negligible. CRP testing does not appear to be a reliable tool for diagnosing or ruling out postoperative infection.

Antimicrobial and antibiofilm potential of α-MSH derived cationic and hydrophobic peptides against Escherichia coli: Mechanistic insight through peptide-lipopolysaccharide interactions

The prevalence of infections caused by various Gram-negative pathogens specifically Escherichia coli continuously poses a significant challenge in health care as well as community settings owing to their ability to form biofilm and escalating tolerance towards available antibiotics. While most treatment regimes are targeted at eliminating the E. coli cells, the pathogenicity factors called endotoxin (lipopolysaccharides), associated with the sepsis initiation and the leading cause of death in intensive care units globally, are often ignored. In this study, the potency of alpha-Melanocyte Stimulating Hormone based-peptides, particularly Ana-9 and Ana-10 against E. coli was investigated through microbiological, biophysical, and microscopic assays. Both Ana-9 and Ana-10 demonstrated enhanced activity against planktonic E. coli cells, and retained their activity against biofilm, which was supported by confocal microscopy. From the mechanistic perspective, spectroscopic studies indicated that the binding of peptides with LPS led to structural alteration of peptides due to their insertion into the hydrophobic environment of LPS. The electrostatic interaction of the peptide with LPS leads to outer membrane disorganization, allowing the peptide to access the inner membrane, depolarize it and ultimately inhibit the bacterial cells within the biofilm. These observations were further confirmed by atomic force and scanning electron microscopy. Thus, this study deepens our understanding of the structural characteristics of peptides attached to LPS, which could lead to the gradual improvement in developing more potent, broad-spectrum endotoxin neutralizers.