Prevalence Patterns Research Articles

Cost Comparison and Spending on Tobacco Products: Evidence from A Nationally Representative Sample of Adult E-Cigarette Users.

Over 20 states and local jurisdictions in the U.S. have imposed e-cigarette taxes. It is important to evaluate how adult vapers, including those who also smoke respond to e-cigarette taxation. The purpose of this study is to examine factors associated with adult vapers' cost comparison between e-cigarettes and cigarettes (i.e., which one is perceived to be more expensive) and expenditures (i.e., dollars spent) on these two products. We recruited a nationally representative sample of 801 adult e-cigarette users in the U.S., who participated in an online survey in April-May 2023. Nested-ordered logit and ordinary least squares regressions were used in analysis. On average, adult vapers spent $82.22 per month on e-cigarettes, and dual users spent $118.77 per month on cigarettes. More frequent e-cigarette use, lower state-level e-cigarette taxes, age and exclusive use of rechargeable tank systems with e-liquids were associated with considering e-cigarettes as less expensive than cigarettes. Exclusive use of tank systems was associated with lower e-cigarette spending. Adults who used e-cigarettes more frequently preferred to report weekly (versus monthly) spending on e-cigarettes; among dual users, everyday smokers were more likely to think of weekly (versus monthly) spending on cigarettes compared to someday smokers. Among US adult vapers, tobacco use frequency and e-cigarette device type are closely related to cost measures; e-cigarette taxes are associated with cost comparison between e-cigarettes and cigarettes, suggesting potential financial disincentive for vaping. Policymaker may consider imposing differential taxes by e-cigarette product types due to their different costs to consumers. This study provides supportive evidence that e-cigarette taxes may impact how vapers compare the costs of e-cigarettes relative to cigarettes. Given different expenditures and cost comparisons by e-cigarette device types, tax and policy design may need to take into consideration of e-cigarette device types. We also found that indoor tobacco use restrictions in shared housing may reduce vaping, and future research is needed. The associations between socio-demographics and cost comparison and expenditures reflect known patterns in price responsiveness and vaping prevalence. Cost comparison and expenditures are related measures, which may further reflect product affordability.

Long-term outcome of interstitial lung disease in patients with primary Sjögren's syndrome: a retrospective observational study.

Interstitial lung disease (ILD) is a potentially serious but underdiagnosed manifestation of primary Sjögren's syndrome (pSS). This observational study investigated the prevalence and clinical course of ILD in pSS, together with prognostic factors. A multicenter, retrospective longitudinal study was performed using findings from baseline and follow-up pulmonary function tests and chest computed tomography. Predisposing factors for the development of ILD and acute exacerbation (AE) were identified using a logistic regression model. The risk factors for a significant decline of pulmonary function were determined by the Cox proportional hazard model. A total of 1,306 patients with pSS were included in this study (female, 98%; mean age, 54 years). Among them, 79 patients with pSS were comorbid with ILD. ILD was more frequently found in male, older patients. Nonspecific interstitial pneumonia was the most prevalent imaging pattern in pSS-ILD (51%), followed by usual interstitial pneumonia (22%). At diagnosis with pSS-ILD, 54% of patients had restrictive pulmonary function, and 41% of patients initiated pharmacological treatment. During the median 4-year follow-up period, AE, a significant decline in pulmonary function, and death occurred in 19%, 29%, and 9% of patients with pSS-ILD, respectively. The neutrophil-to-lymphocyte ratio (NLR) increased 3 months prior to AE, and it was associated with AE. Older age at pSS-ILD diagnosis was a prognostic factor for a significant decline in pulmonary function. ILD accounted for 6% of the comorbidity of pSS. AE was associated with a significant decline in pulmonary function, and the NLR may predict AE.

Prevalence and epidemic pattern of ecdemic multidrug-resistant tuberculosis during 2012–2022 in Hangzhou, China: implication for public health strategies

BackgroundTo assess the prevalence and epidemic pattern of multidrug-resistant tuberculosis in Hangzhou City, Zhejiang Province, China during 2012–2022.MethodsAll the tuberculosis cases undergoing drug susceptibility testing during 2012–2022 were included in this study. De-identified information was extracted from the electronic database Tuberculosis Information Management System for analysis of drug resistance prevalence in Hangzhou and ecdemic multidrug-resistant tuberculosis which originated from other regions. Chi-square tests were used to compare drug resistance rates between different groups, while Chi-square tests for trend were used to evaluate the change of drug resistance rates over the years of 2012–2022. The sources and destinations of ecdemic multidrug-resistant tuberculosis were illustrated using a Sankey diagram.ResultsOf 21,127 cases included in this study, 1119 (5.3%) were multidrug-resistant tuberculosis. A significant decline in multidrug-resistant tuberculosis rates was observed during 2012–2022. There was a significant difference in multidrug-resistant tuberculosis rates among immigrant population and local residents in Hangzhou City. Of 1119 multidrug-resistant tuberculosis cases, 515(46%) were ecdemic multidrug-resistant tuberculosis cases, of which 277(53.8%) were from other parts of Zhejiang Province and 238(46.2%) were from other provinces in China. Anhui, Jiangxi and Sichuan were among top three provinces which were the source of ecdemic multidrug-resistant tuberculosis cases. Three districts including Xiaoshan, Shangcheng and Linping districts had the most cases in Hangzhou. The proportion of ecdemic multidrug-resistant tuberculosis cases in Binjiang, Xiaoshan, Qiantang and Linping districtalso exceeded 30% of total cases.ConclusionsMultidrug-resistant tuberculosis prevalence has been declining in Hangzhou. Migrant population contributed to a significant potion of cases in Hangzhou. Interventions should be tailed to local and migrant residents.

Brucellosis Seroprevalence in Cattle in China During 2014–2024: A Systematic Review and Meta-analysis

Brucellosis, caused by several species of Brucella, continues to be a significant illness that poses a global threat to public health. China remains a persistent hotspot for brucellosis, despite the implementation of extensive control measures. This study aims to conduct a systematic review and meta-analysis of the seroprevalence of bovine brucellosis in different breeds and regions of China from 2014-2024, and to provide predictions on the future prevalence patterns of brucellosis in cattle and humans. The analysis comprised a total of 80 research studies, which consisted of 187 datasets and a combined sample size of 3,130,706. We estimated the overall pooled seroprevalence of bovine brucellosis in China to be 1.5% (95% CI: 0.6-2.6%). Subgroup analysis revealed that the seroprevalence in dairy cattle was 3.1%, surpassing the seroprevalence in beef cattle (1.3%) and yak (1.5%). Regions that had authorized vaccination programs exhibited higher seroprevalence (1.8%) compared to regions that did not have vaccination (0.5%). Notably, the study observed a simultaneous rise in both the prevalence of brucellosis in cattle and the number of human brucellosis cases. This suggests that high-quality routine surveillance of brucellosis in cattle will be essential for predicting and responding to cases in humans. Additionally, given the existing prevention and control measures, brucellosis will likely continue to be prevalent in both cattle and people. This systematic review will assist policymakers in adjusting animal surveillance and interregional livestock movement policies, ultimately contributing to the public safety goal of preventing brucellosis in humans by controlling it in animals.

Seropositivity of hepatitis A and E viruses in patients attending a tertiary care center in central India

Objectives: Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections are significant global health concerns that contribute to acute viral hepatitis. This study aimed to investigate the prevalence of HAV, HEV, and co-infections in a tertiary care hospital setting in central India. Materials and Methods: This retrospective observational study analyzed 987 clinical specimens collected from suspected acute viral hepatitis cases over 5 years (2019–2023). Commercially available enzyme-linked immunosorbent assay kits were used to detect HAV and HEV immunoglobulin M antibodies. Statistical analysis: Demographic data and clinical information were collected and analyzed using Chi-square tests. P < 0.05 was considered statistically significant, indicating a significant association between the variables under investigation. Results: Overall, 32.72% of patients were seropositive for either HAV, HEV, or both. The prevalence of HAV was 22.9%, HEV was 9.83%, and co-infection was 3.24%. HAV infection was more prevalent in children (0–14 years), whereas HEV was more prevalent in adults. Both HAV and HEV infections were associated with elevated liver function markers, with the highest levels observed in co-infected cases. The monsoon season had the highest number of cases. Conclusions: This study revealed a substantial burden of HAV, HEV, and co-infections in central India. The observed sex—and age-specific prevalence patterns warrant further investigation. Effective public health strategies addressing sanitation, hygiene practices, and HAV vaccination programs are crucial to reducing the disease burden.

Enhanced Understanding of Facial Nerve Anatomy and Arborization in the Indian Population: Implications for Surgical Procedures.

The anatomy and arborization patterns of the extraparotid facial nerve show considerable variation among different populations, impacting surgical approaches in plastic, head and neck, and ENT surgeries. This study focuses on the Indian population to provide a detailed understanding of these variations, specifically highlighting the Davis type IV arborization pattern's prevalence and its clinical relevance. We conducted a comprehensive dissection of 16 formalin-preserved Indian cadaveric hemifaces. The study meticulously mapped the facial nerve trunk (FNT), its furcation points, and branches. Key anatomical landmarks for locating these nerve structures were identified, including the tip of the mastoid process, the angle of the mandible, and a novel line between the lateral palpebral fissure and otobasion superioris. The most common arborization pattern observed was Davis type IV (31.3%). The study provided precise measurements for locating the FNT and its branches, using identifiable landmarks. These findings facilitate more accurate surgical planning, crucial for procedures involving nerve repair or grafting. This research offers vital insights into the facial nerve anatomy specific to the Indian population, with significant implications for surgical precision and patient outcomes. By establishing reliable anatomical landmarks and elucidating the predominant arborization pattern, the study enhances the understanding of facial nerve behavior during surgical interventions, particularly in the context of facial paralysis treatment and reconstructive surgeries. Due to the small sample size, however, this study only acts as a pilot for further research.

Mechanical, Adhesive and Surface Properties of a Zirconia-Reinforced Lithium Silicate CAD/CAM Ceramic Exposed to Different Etching Protocols.

The aim of this investigation was to evaluate the effect of etching protocols on bond strength, surface roughness, and mechanical properties of a zirconia-reinforced lithium silicate (ZLS) CAD/CAM-ceramic. In total, 100 bars (ISO 6872), 75 plaques, and 25 cubes were cut from ZLS blocks(Vita Suprinity®). The surfaces were standardized, crystallized and divided into five groups: 1. control (no/treatment-C), 2. 5%-Hydrofluoric-acid (HF)/20 s (HF5%20s), 3.HF5%60s, 4.HF10%20s, and 5.HF10%60s. Flexural strength (FS) (three-point bending test, 1 mm/min), roughness (Pa), and micro-shear bond-strength (µSBS) tests were performed. The data were statistically analyzed with one-way ANOVA, Tukey's test (p ˂ 0.05) and Weibull (FS data). C showed higher Pa (1.176 ± 0.370 µm) than HF10%60s (0.627 ± 0.236 µm) and all other groups. Groups C and 20 s showed the most irregular surface patterns. The FS results were not influenced by etching protocols, while the Weibull modulus was, with the 5%HF groups being the most reliable (m: 5.63/6.70), while C and HF10%60s (m: 2.78/2.73) were the least reliable. All fractures originated from surface defects on the treated side of specimens. The 5%HF groups showed higher µSBS (20 s: 21.35 ± 4.70 MPa; 60 s: 23.50 ± 4.27 MPa) than the 10%HF groups (20 s: 14.51 ± 2.47 MPa; 60 s: 16.54 ± 3.12 MPa) and C (6.46 ± 2.71 MPa). The most prevalent failure pattern was "mixed" for etched groups, and "adhesive" for C. Etching protocols affect the evaluated properties by roughening materials' surface and, in some cases, regularizing surface defects. The best overall outcomes were achieved when applying 5%HF.

Molecular epidemiology of diabetic foot ulcers

Abstract Introduction/Objective The study accessed the prevalence of Escherichia coli in diabetic diabetic foot infection(DFI) and diabetic foot osteomyelitis(DFOM).A single retrospective single centre was conducted on patients diagnosed with E.coli isolated from deep DFI and DFOM at Komfo Anokye Teaching Hospital over 2 year period. Methods/Case Report Phylogenetic backgrounds,virulence factors(VFs) and antibiotic resistance profiles were determined.Whole genome analysis of E.coli strains isolated from same periods were performed. From two years study period,35 E.coli strains isolated from 33 patients were analysed,73% were isolated from DFOM Results (if a Case Study enter NA) The majority of the strains belonged to the virulent B2 and D phylogenetic groups(82%).These isolates exhibited a significant higher average of VFs number greater than strains belonging to the other groups (p<0.0001).papG2 gene was significantly more detected in strains belonging to B2 phylogeny isolated from DFI compared to DFOM(p=0.003) The most prevalent antibiotic resistance pattern was observed for ampicillin(82%)cotrimoxazole(45%) and ciprofloxacin (33%).The genome analysis of strains isolated at two periods in DFOM showed a decrease of the genome size and this decrease was more important for the strains isolated at 9 months(versus 4 months) Conclusion Shared mutation on the putative acy-CoA dehydrogenase-encoding gene aidB was observed on both strains. E.coli isolated from DFOM werA shared highly genetically diverse with different pathogenicity traits.Their adaptation on the bone structure could require genome reduction and some important modifications in the balance virulence and resistance of the bacteria

Patterns of beverages consumption and prevalence of non-communicable chronic diseases.

Beverages consumption influences diet quality in general and has been associated with the development of non-communicable chronic diseases (NCCD). We aimed to verify the association between beverage consumption patterns and the prevalence of NCCD. A cross-sectional household and population-based study was conducted with 489 individuals aged 20 years and older. The presence of NCCD (arterial hypertension, diabetes, cancer and hypercholesterolemia) was obtained by self-report, while obesity was diagnosed by measuring body weight, height and waist circumference. Beverage consumption patterns were obtained by principal component analysis. The association between beverages patterns and the prevalence of NCCD was verified using Poisson regression, expressed as prevalence ratio (PR) and adjusted for potential confounding factors. Three beverage patterns were identified: ‘ultra-processed beverages’, ‘alcoholic beverages’ and ‘healthy beverages’. Individuals with greater adherence to the Ultra-processed Beverages Pattern had a 2·77 times higher prevalence of cancer (PR: 3·77; 95 % CI 1·57, 9·07). Higher adherence to the Alcoholic Beverages Pattern was associated with a higher prevalence of obesity (PR: 1·97; 95 % CI 1·13, 3·44). In contrast, individuals in the second tertile of adherence to the Healthy Beverages Pattern had a 39 % lower prevalence of hypercholesterolemia (PR: 0·61; 95 % CI 0·40, 0·92), and individuals in the third tertile had a 10 % lower prevalence of abdominal obesity estimated by the waist-to-height ratio (PR: 0·90; 95 % CI 0·83, 0·97). Beverage consumption patterns may be associated with a higher prevalence of NCCD, regardless of other risk factors. It is therefore important to conduct more studies investigating the impact of beverages patterns on health.

Prevalence and clinical patterns of urolithiasis in sub-saharan Africa: a systematic review and meta-analysis of observational studies

Background and objectiveUrolithiasis, the presence of stones in the urinary tract, has been linked to various clinical features and reported as a worldwide health concern. Its prevalence varies across different regions as well as populations. Several primary studies have been conducted in Sub-Saharan Africa on the situation. However, their reports are inconsistent. Hence, this review aimed to assess the pooled magnitude of urolithiasis and its clinical patterns among hospital-visiting patients in sub-Saharan Africa.MethodsOnline databases such as PubMed, Hinari, the African Journals online database, and Google Scholar were used to comprehensively search articles published until June 28, 2023, about the prevalence and clinical patterns of urolithiasis in Sub-Saharan Africa. All the included studies were conducted at hospital setting. The retrieved data was exported to STATA version 16 for final analysis. A random-effect meta-analysis model was computed to estimate the pooled results. The heterogeneity of the studies was assessed using I2 and Cochran’s Q. Publication bias was examined by observation using funnel plots and statistically by Egger’s tests. Subgroup analysis was performed based on the country where the studies have been conducted.ResultA total of 26 articles (11 reported both prevalence and clinical pattern, 5 reported only prevalence, and 10 reported only clinical patterns of urolithiasis) were included in the final systematic review and meta-analysis. The pooled prevalence of urolithiasis among hospital-visiting patients was 9.4% (95% CL = 4.9–14%), with significant heterogeneity. Most of the urolithiasis was located in the kidney, with an estimated pooled proportion of 4.6% (95% CI = 2.7, 6.5), followed by bladder stone-2.0% (95% CI = 0.7, 3.4), ureteral stone-1.8% (95% CI = 0.7, 2.9), and urethral stone-0.2% (95% CI = 0.00, 0.05). The subgroup analysis showed the highest prevalence of urolithiasis was found in Mauritian, 28.1% (95%CI 24.5, 31.7), followed by Ethiopia 18.1%, and the lowest was in Eritrea, 1.0%. A sensitivity analysis using the random-effects model found no influential study on the pooled prevalence of urolithiasis. Evidence of significant publication bias was observed and trim-fill analysis was conducted for adjustment. Accordingly, two missing studies were identified, and after adjustment, the combined prevalence of urolithiasis was estimated to be 10.7%. The study also found that urolithiasis prevalence per gender was 6.3% in males and 2.9% in females. The most common clinical presentation of urolithiasis was flank pain at 58.4% (95% CL=, 45.9, 70.8), followed by low back pain at 45.9% (95% CL=, 23.1, 68.8), and nausea/vomiting at 29.9% (95% CI: 1 1.1, 48.8).ConclusionThe prevalence of urolithiasis in Sub-Sahara African Countries is increasing even though a remarkable regional variation was observed, with higher predominance in males than females. Common clinical presentations of urolithiasis were flank pain, low back pain, and nausea/vomiting.

Prevalence and pattern of antibiotic use and resistance among Iraqi patients: a cross-sectional study

Background: According to The Centers for Disease Control and Prevention (CDC) 2019, around 32,000 deaths in addition 2.8 million infections occur annually in the US because of antibiotic-resistant bacteria. Objectives: To determine the prevalence and study pattern of antibiotic use and resistance among Iraqi patients. Methodology: We carried out a cross-sectional study from January 2021 to October 2022 including data of 850 patients at different private and general hospitals, primary health centers, and private clinics. The data was collected during the patient’s admission or visiting time using medical records and mini-interviews. Results: Escherichia coli and Staphylococcus aureus were the most detected pathogens in our sample in 14.5% and 11.29% of the patients respectively. Most patients (87.18%) had taken over-the-counter antibiotics previously. Around 55% of the antibiotics that were tested were resisted among our patients who were included in 2021. This percentage has increased to about 75% of the included patients in 2022. Amoxicillin was the most resistant antibiotic (77%) in our sample while meropenem was the least resistant among the tested antibiotic (5%). Conclusion: Antibiotic resistance is a major public health concern that is often caused by the overuse and misuse of antibiotics, as well as poor infection control practices. Keywords: Antibiotic; resistance; Iraq.

Spatio-temporal characterization of malaria prevalence in a peri-urban resource limited setting of Western Kenya Highlands

Background: Malaria is the main killer disease in sub-Sahara Africa. Objective: The study identified malaria prevalence patterns in relation to space and time trends in a peri-urban resource limited setting of Western Kenya highlands aimed at strengthening implementation of malaria control strategies. Method: A longitudinal study was carried out in Mbale town and its environs, Vihiga County, from December 2019 to November 2020. Among patients who presented themselves at Mbale Provincial Rural Training health center for different medical issues, 768 malaria confirmed patients were recruited and signed consent before the study commenced. Data was collected using questionnaire and microscopy which was presented through graphs, frequency, means and analyzed using linear regression. P-value ≤ 0.05 was considered statistically significant. Results: Plasmodium falciparum malaria constituted 98.7%,while P. malariae, P. vivax, and P. ovale constituted 1.3%. Linear regression analysis showed effect of age, gender and location on malaria prevalence as (R2 = 0.7, [F (3,764) = 1.854], p < 0136). Malaria prevalence varied in different months due to changes in amount of rainfall and temperatures received. Conclusion: Spatio-temporal characterization and many mosquito breeding grounds influenced malaria prevalence in the study area. Malaria control strategies should be strengthened in relation to space and time-trend. Keywords: Plasmodium species; space; time trend; malaria prevalence; socio-economic factors; demographic factors.

Enhancing antimicrobial management: A 5–year retrospective analysis of urinary pathogen susceptibility at a tertiary care centre from January 2018 to December 2022

Objective: The study aims to collect data on prevalence and antibiotic susceptibility patterns of uropathogens in a hospital in India, and to analyze any changes that have occurred over the past 5 years. Methods: This retrospective study was conducted over 5 years at Lady Hardinge Medical College & Associated Hospitals, New Delhi. Urine samples from patients who attended outpatient department or were admitted with diagnosis of urinary tract infection (UTI) were included in this study. Samples were cultured and tested to identify bacteria and determine antibiotic susceptibility using the Kirby-Bauer disc diffusion method. Results: A total of number of 151395 urine specimens were collected from January 2018 to December 2022. The prevalence of UTI was 7.5% (11372/151395) with the majority of patients being aged above 40 years (19.3%). The prevalence was higher in females (12.7%) as compared to males (3.2%). Escherichia (E.) coli was the predominant pathogen, accounting for 59.8% of cases, followed by Klebsiella spp. at 18.9%, and Enterococcus spp. at 8.3%. Gram-negative bacteria accounted for 89.5% of the isolates and exhibited good susceptibility to aminoglycosides and piperacillin-tazobactam, but showed resistance to fluoroquinolones. Methicillin-resistant Staphylococcus aureus (MRSA) was present in 35% of Staphylococcus (S.) aureus isolates with high susceptibility to glycopeptides and nitrofurantoin. Conclusions: The data suggest the need for careful selection of empirical therapy due to increasing resistance patterns. The stringent use of antimicrobial agents is pivotal to the control of antimicrobial resistance. Antibiotic susceptibility data contributes to tailoring the antibiotic stewardship programs to local needs.

Association Between Dietary Habits and the Semen Quality of South Asian Men Attending Fertility Clinic: A Cross-sectional Study.

The purpose of the study is to explore the impact of dietary habits, including daily intake of nutrients and dietary patterns, on the semen characteristics of South-Asian men. This cross-sectional study included 162 South-Asian men aged 21-40 years who were undergoing infertility evaluation.Based on semen analysis, men were grouped into categories of normal and abnormal semen characteristics. The participants' dietary habits were captured using '24-hour dietary recall' and 'Food Frequency Questionnaire (FFQ)'. Daily dietary intake of various nutrients and adherence to prevalent dietary patterns were compared between men with normal and abnormal semen characteristics. Six dietary patterns were identified following factor analysis of FFQ data. Men with normal semen characteristics showed significantly higher consumption of"coastal diet" rich in seafood, fish, cereals, beans, and coconut oil than those with abnormal semen characteristics. Further, themultivariable-adjustedmodel, adjusted for clinically relevant confounders, like age, body mass index (BMI), physical activity, smoking and sexual abstinence, also showed a lower risk of abnormal semen characteristics among men consuming "coastal diet" (odds ratio [OR] = 0.56, 95% confidence interval [CI] 0.37-0.82). In terms of daily nutrient intake, men with normal semen characteristics showed significantly lower consumption of monounsaturated fatty acids (MUFA) compared to men with abnormal semen characteristics (p = 0.008).Our findings suggest that higher consumption of "coastal pattern diet" lowers the risk of abnormal semen characteristics. Additionally, anegative association of MUFA consumption with semen quality was also identified, which needs cautious interpretation until replicated in future studies with biochemical validations.

A-283 Serologic and molecular testing for the diagnosis of Rickettsia, Ehrlicha, and Anaplasma infections in patients in Maryland

Abstract Background Rickettsia, Anaplasma, and Ehrlichia are underrecognized tick-borne pathogens of increasing human importance. As tick habitats are expanding and populations are increasing, human exposure to these pathogens is also increased in recent years. Unfortunately, while treatment is usually simple, diagnosis can be difficult as it requires specialized testing for clinical diagnosis - generally performed only at reference laboratories. Methods To better understand the prevalence, diagnosis, and testing patterns for Rickettisal infections, Anaplasmosis, and Ehrlichiosis in Maryland, a retrospective analysis of all serologic and molecular testing for Rickettsia, Anaplasma, and Ehrlichia species performed for the University of Maryland Medical System from 2018-2022 was conducted. Eight hospitals within the University of Maryland Medical System (Central Maryland and Maryland’s Eastern Shore) diagnose Rickettsia, Anaplasma, and Ehrlichia infections using serologic and molecular testing. Results Between 2018-2022, an average of 413 individuals were tested for Rickettsia, Anaplasma, and Ehrlichia each year. On average 315 serologic tests for Rocky Mountain Spotted Fever (RMSF) group Rickettsia, 195 serologic tests for Ehrlichia chaffeensis (Anaplasma serology is not available), and 165 molecular tests for the detection of Anaplasma and Ehrlichia species were ordered each year. Clinical indications for testing included tick bite, fever, chills, severe headaches, muscle aches, and rash. Overall, 17% of individuals tested were positive for IgG antibodies to RMSF group Rickettsia, however only 1% were positive for IgM antibodies. Further, 20% of individuals tested were positive for IgG antibodies to Ehrlichia chaffeensis, while <1% were positive for IgM. Acute and convalescent samples were not tested for any individuals. Molecular evidence of infection was found in 8% of individuals tested. Nineteen precent were positive for Anaplasma phagocytophilum and the remaining 81% were positive for Ehrlichia chaffeensis. Interestingly, only two individuals had positive results from both molecular and serologic testing. Conclusions Results from serologic and molecular testing show that Rickettsia, Anaplasma, and Ehrlichia are important human pathogens with the potential to cause significant morbidity. However, lack of follow-up serology, and laboratory tests that confirm acute infection make definitive diagnosis difficult. Increased awareness of Rickettsial diseases and appropriate diagnostics is needed.

Prevalence and Antimicrobial Susceptibility Patterns of Wound and Pus Bacterial Pathogens at a Tertiary Care Hospital in Central Riyadh, Saudi Arabia

The long history and extensive use of antibiotics have caused resistant bacterial pathogens to emerge, increasing mortality and morbidity. The current study was designed to see the prevalence of aerobic bacterial isolates with their antimicrobial resistance pattern from out- and inpatients requested for wound or pus culture. Retrospective study conducted at a tertiary care hospital in central Riyadh from January 2023 to December 2023. Samples were collected and inoculated onto the appropriate media following standard guidelines. Bacterial pathogens were identified by the Vitek2 compact system. Antimicrobial susceptibility was tested using the Kirby–Bauer disk diffusion method as well as by MIC determination through the Vitek2 compact. A total of 1186 subjects were included in the study with a bacterial isolation rate of 691 (58.3%). Out of these, 155 positive cultures had incomplete information or anaerobic or fungal growth and were excluded from the study. With a slight female predominance (54.9%), the majority of subjects (72.2%) were outpatients, and over half of the isolates (55.2%) were Gram-positive. The most common isolate was Staphylococcus spp. (44.4%), followed by E. coli (13.6%) and P. aeruginosa (12.9%). The highest resistance was reported against penicillin followed by fusidic acid against Gram-positive bacteria. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 40.5% of Staphylococcus aureus (S. aureus) isolates. Amikacin was the most susceptible antibiotic against all Gram-negative isolates. MDR Gram-negative bacteria accounted for 51.9% of wound infection isolates (95% CI: 45.95 to 58.33) while 6.3% (95% CI: 4.39 to 8.86) were XDR (nonsusceptibility to at least one agent in all but two or fewer antimicrobial categories). A high prevalence of bacterial isolates, with S. aureus as the predominant pathogen, showed high rates of multidrug resistance. This highlights the importance of monitoring antibiotic choices for prophylaxis and treatment in the study area.

A-290 Prevalence and Antimicrobial Resistance Pattern of Microorganisms Recovered From Bloodstream Infections From Public Hospitals of São Paulo City, Brazil

Abstract Background Nosocomial Bloodstream Infections (nBSI) are an important cause of morbidity and mortality. Brazilian studies concerning bloodstream infections are important tools that can bring specific issues related to antimicrobial resistance. The objective of this study was to describe the frequency and antimicrobial susceptibility profile of bacterial isolates from BSI in patients admitted to public hospitals in 2022 and 2023. Methods This study was a retrospective analysis from 12 hospitals (January 2022 to December 2023) based on BSI isolates laboratory data detected by the clinical microbiology department of a medical diagnostic laboratory. The identification and susceptibility tests were performed using MALDI-TOF mass spectrometry (Vitek MS) and Vitek®2 systems, according to the manufacture’s recommendations. Coagulase Negative Staphylococci (CoNS) BSI was only considered in the presence of at least two sets of positive blood cultures with the same organism. Results During the period (January 2022 to December 2023) a total of 19,588 microorganisms isolated from BSI were obtained from 12 hospitals. The frequency of organism group was Gram-positive (10,707; 54.7%), Gram-negative (7,874; 40.2%), yeasts (961; 4.9%) and filamentous (46; 0.2%). The order of prevalence (top ten) organisms was CoNS (5,149; 26.3%); Staphylococcus aureus (2,769; 14.1%); Klebsiella spp. (2,355; 12.0%); Escherichia coli (1,301; 6.6%); Acinetobacter spp. (1,293; 6.6%); Streptococcus spp. (1,125; 5.7%); Enterococcus spp. (1,112; 5.7%); Candida spp. (937; 4.8%); Pseudomonas spp. (749; 3.8%) and Proteus spp. (553; 2.8%). Extended spectrum beta-lactamase rates for E. coli and Klebsiella pneumoniae were 31.6% (268/848) and 74.9% (1027/1371), respectively. The resistance to carbapenems was detected mainly in 74.1% (661/892) of Acinetobacter spp. isolates, 60.7% (832/1371) of Klebsiella pneumoniae; 24.5% (114/465) of P. aeruginosa; 9.7% (34/349) of Proteus spp. and 1.4% (12/828) of Escherichia coli. Antimicrobial resistance was observed mainly in 87.2% of CoNS (2831/3247) and 44.5% of S. aureus (743/1669) to methicillin; 22.9% (146/637) of Enterococccus spp. to vancomycin. Conclusions The frequency of Klebsiella spp. isolates from nBSI has progressively increased and effective infection control measures should be taken to prevent them from spreading. The rates of antimicrobials resistance reported for Klebsiella pneumoniae, Acinetobacter spp., CoNS, S. aureus and Enterococcus spp. reinforce the high resistance rates to antimicrobials in São Paulo city.

Sex differences in gray matter, white matter, and regional brain perfusion in young, healthy adults.

Cerebrovascular and neurological diseases exhibit sex-specific patterns in prevalence, severity, and regional specificity, some of which are associated with altered cerebral blood flow (CBF). Females often exhibit higher resting CBF, but understanding the impact of sex per se on CBF is hampered by study variability in age, comorbidities, medications, and control for menstrual cycle or hormone therapies. A majority of studies report whole brain CBF without differentiating between gray and white matter or without assessing regional CBF. Thus fundamental sex differences in regional or whole brain CBF remain unclarified. While controlling for the above confounders, we tested the hypothesis that females will exhibit higher total gray and white matter perfusion as well as regional gray matter perfusion. Adults 18-30 yr old (females = 22 and males = 26) were studied using arterial spin labeling (ASL) magnetic resonance imaging (MRI) scans followed by computational anatomy toolbox (CAT12) analysis in statistical parametric mapping (SPM12) to quantify CBF relative to brain volume. Females displayed 40% higher perfusion globally (females = 62 ± 9 and males = 45 ± 10 mL/100 g/min, P < 0.001), gray matter (females = 75 ± 11 and males = 54 ± 12 mL/100 g/min, P < 0.001), and white matter (females = 44 ± 6 and males = 32 ± 7 mL/100 g/min, P < 0.001). Females exhibited greater perfusion than males in 67 of the 68 regions tested, ranging from 14% to 66% higher. A second MRI approach (4-dimensional flow) focused on large arteries confirmed the sex difference in global CBF. These data indicate strikingly higher basal CBF in females at global, gray, and white matter levels and across dozens of brain regions and offer new clarity into fundamental sex differences in global and regional CBF regulation before aging or pathology.NEW & NOTEWORTHY MRI used to measure cerebral blood flow (CBF) in gray matter, white matter, and 68 regions in healthy men and women. This study demonstrated that CBF is 40% higher in women, the highest sex difference reported, when controlling for numerous important clinical confounders like age, smoking, menstrual cycle, comorbidities, and medications.

Integrated analyses of the transmission history of SARS-CoV-2 and its association with molecular evolution of the virus underlining the pandemic outbreaks in Italy, 2019-2023

BackgroundItaly was significantly affected by the COVID-19 pandemic, experiencing multiple waves of infection following the sequential emergence of new variants. Understanding the transmission patterns and evolution of SARS-CoV-2 is vital for future preparedness. MethodsWe conducted an analysis of viral genome sequences, integrating epidemiological and phylodynamic approaches, to characterize how SARS-CoV-2 variants have spread within the country. ResultsOur findings indicate bidirectional international transmission, with Italy transitioning between importing and exporting the virus. Italy experienced four distinct epidemic waves, each associated with a significant reduction in fatalities from 2021 to 2023. These waves were primarily driven by the emergence of VOCs such as Alpha, Delta, and Omicron, which were reflected in observed transmission dynamics and effectiveness of public health measures. ConclusionsThe changing patterns of viral spread and variant prevalence throughout Italy's pandemic response underscore the continued importance of flexible public health strategies and genomic surveillance, both of which are crucial for tracking the evolution of variants and adapting control measures effectively to ensure preparedness for future outbreaks.

Pattern Of Antibiotic Resistance In Urinary Tract Infections: Insights From A Tertiary Care Hospital In Bangladesh

Background: Urinary tract infections (UTIs) are one of the most common bacterial infections, with increasing rates of antibiotic resistance complicating treatment. This study aimed to assess the prevalence and antibiotic resistance patterns of uropathogens in patients with UTIs at a tertiary care hospital in Bangladesh. Methods: A cross-sectional, retrospective study was conducted from June, 2023 to July, 2024 involving 60 UTI patients. Clinical and microbiological data, including urine cultures and antibiotic susceptibility tests, were collected. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using SPSS version 26.0. Results: Escherichia coli was the most frequently isolated pathogen (50.0%), followed by Klebsiella spp. (20.0%). Both pathogens exhibited high resistance to ciprofloxacin (66.7%) and amoxicillin (83.3%) (p &lt; 0.05). Pseudomonas spp. showed 66.7% resistance to ceftriaxone, and Proteus spp. exhibited 75.0% resistance to nitrofurantoin. However, E. coli and Klebsiella spp. demonstrated higher susceptibility to nitrofurantoin and gentamicin, with 50.0% and 66.7% susceptibility, respectively. Conclusion: The findings indicate a high prevalence of antibiotic-resistant uropathogens, particularly E. coli and Klebsiella spp., in the study population. Nitrofurantoin and gentamicin remain effective treatment options. These results highlight the urgent need for updated empirical treatment protocols and regular monitoring of resistance patterns to guide UTI management in Bangladesh.