Infection Rate Research Articles

Clearing the Air: Acute Invasive Fungal Rhinosinusitis in Hematologic Cancer Patients.

Air quality has been shown to impact the rates of fungal infection of the airway, causing diseases such as acute invasive fungal rhinosinusitis (AIFRS), particularly in immunocompromised patients. We theorize that patients with hematologic malignancies in units with aging air handling units (AHUs) have a higher attack rate of AIFRS. Retrospective chart review identified patients with hematologic malignancy and AIFRS in two distinct and equal time periods between 2013 and 2022, representing the presence of aging AHUs and new AHUs, respectively. Cubic feet per minute (CFM) air flows, AIFRS attack rates, and clinical data were compared between the two groups and statistical analyses performed. The older AHUs produce air flow of 27,610 CFM and the newer AHUs produce air flow of 80,000 CFM. There were 18 patients with air supplied by older AHUs and 7 patients with air supplied by new AHUs who developed AIFRS. There was a significantly higher AIFRS attack rate for patients supplied by the older AHUs compared with patients supplied by newer AHUs (p = 0.033). The patients supplied by the older AHUs tended to be younger. The white blood cell counts, absolute neutrophil counts, and the mean time to diagnosis did not differ between the two groups. To our knowledge, this is the first study to examine AIFRS in immunocompromised patients' inpatient environment. Further research should explore whether higher CFM AHUs can decrease this disease among our most vulnerable patients. 3 Laryngoscope, 134:4466-4470, 2024.

Provider Education to Increase Sexually Transmitted Infections Screening Rates Among Older Adults Seen in Primary Care Practice

Sexually transmitted infection (STI) rates among older adults have increased significantly due to insufficient sexual health care. To address this, a quality improvement project educated providers at a primary care site using American Academy of Family Physicians guidelines. In a pre-/post-implementation design, 10 providers attended a 45-minute session. STI screening and positivity rates were assessed 8 weeks before and after the intervention. Screening rates increased from 2% to 10% (P < .0001), and positivity rates rose from 7% to 8% (P = .0035), indicating the effectiveness of provider education in enhancing STI screening and identifying more cases.

SARS-CoV-2 Infection in School Settings, Okinawa Prefecture, Japan, 2021-2022.

During the COVID-19 pandemic, widespread school closures were implemented globally based on the assumption that transmission among children in the school environment is common. However, evidence regarding secondary infection rates by school type and level of contact is lacking. Our study estimated the frequency of SARS-CoV-2 infection in school settings by examining the positivity rate according to school type and level of contact by using data from a large-scale school-based PCR project conducted in Okinawa, Japan, during 2021-2022. Our results indicate that, despite detection of numerous positive cases, the average number of secondary infections remained relatively low at ≈0.5 cases across all types of schools. Considering the profound effects of prolonged closures on educational access, balancing public health benefits against potential long-term effects on children is crucial.

Efficacy and safety of onabotulinumtoxinA for the treatment of overactive bladder in men and women: A pooled analysis.

This pooled analysis of randomized controlled studies investigated the safety and efficacy of onabotulinumtoxinA in male and female patients with overactive bladder (OAB). Data were pooled from four similarly designed trials in North America and Europe. Adults with idiopathic OAB for ≥6 months inadequately managed by at least one anticholinergic were randomized 1:1 or 2:1 to receive onabotulinumtoxinA 100 U or matched placebo in Cycle 1 and could request open-label retreatment with onabotulinumtoxinA 100 U at ≥12 weeks. Efficacy outcomes at Week 12 included the primary endpoint of mean urinary incontinence (UI) episodes per day and other variables, such as the proportion of patients with ≥50% reduction in daily UI episodes. Safety was assessed by monitoring treatment-emergent adverse events (TEAEs). Analyses by sex were descriptive. Males were further analyzed by benign prostatic hyperplasia (BPH) diagnosis status. In the pooled population (N = 1564), there were 194 males (12.4%) and 1370 females (87.6%). Mean number of baseline UI episodes per day was 4.9 in males and 5.5 in females. At Week 12, numerically greater mean reductions from baseline in number of daily UI episodes were observed with the onabotulinumtoxinA 100 U group (females: -3.0; males: -2.2) versus placebo (females: -1.1; males: -1.3). Achievement of ≥50% reduction in daily UI episodes was numerically greater with onabotulinumtoxinA 100 U (females: 64.8%; males: 61.2%) versus placebo (females: 30.6%; males: 44.8%), and numerically higher in males without BPH (onabotulinumtoxinA: 65.1%; placebo: 50.9%) versus with BPH (onabotulinumtoxinA: 54.3%; placebo: 36.6%). A total of 34.7% of males and 39.4% of females experienced at least one TEAE in the first 12 weeks during treatment Cycle 1. Urinary tract infection rate was 13.1% in females and 4.2% in males; incidence of hematuria was 6.8% in males and 1.1% in females. Incidence of urinary retention (defined as incomplete emptying, requiring catheterization) was 2.7% in females and 4.7% in males. OnabotulinumtoxinA 100 U was efficacious and well tolerated in men and women with OAB, including in males with and without BPH. No new safety findings were identified when data were analyzed by sex.

An Updated Review on the Spatial Distribution of Borrelia burgdorferi Sensu Lato Across Ticks, Animals and Humans in Northeastern China and Adjacent Regions.

Lyme disease is a tick-borne zoonotic disease caused by Borrelia burgdorferi sensu lato and is prevalent in northeastern Asia, particularly in the forested area of Northeastern China. However, a lack of systematic data on the spatial distribution of B. burgdorferi in this region hinders the prediction of its transmission risk across the landscape. To provide an updated overview and establish a comprehensive spatial distribution database, we conducted a systematic review of literature published between 2000 and 2022. We collected and compiled relevant data on B. burgdorferi in Northeastern China and its neighbouring regions, outlining its distribution in ticks, wild animals, livestock and humans. Spatial analysis was performed to identify spatial clusters of tick positivity and host infection rates. From a total of 1823 literature, we selected 110 references to compile 626 detection records of B. burgdorferi, including 288 in ticks, 109 in wildlife, 111 in livestock and domestic animals and 100 in humans. The average detection rate of B. burgdorferi in ticks was approximately 20%, with wildlife, livestock and domestic animal host positivity rates below 50% and human seroprevalence rates varying from 0.94% to 44.18%. The study identified the presence of 17 tick species and ten genotypes of B. burgdorferi in the region, indicating a broad distribution. Notably, B. burgdorferi exhibited notable clustering, particularly in the central and eastern areas of Jilin Province, warranting further investigation.

Ramming the parasites: Evaluation of quarantine procedures against Haemonchus contortus at sheep markets in Sweden

In Sweden, it is recommended to treat rams at sheep markets with ivermectin and then keep them in quarantine to minimise the risk of transmission of Haemonchus contortus between farms. The aim of this study was to evaluate the effectiveness of this practise. Accordingly the gastrointestinal parasite status of 50 rams purchased at two sheep markets in central Sweden in autumn 2019 was investigated using faecal samples collected on the day of sale (test 1), 12 ± 3 days after ivermectin injection (test 2, in quarantine) and a few months later before inclusion in the new flocks (test 3). We used both traditional diagnostic methods (i.e. identification of nematode eggs in faeces or larvae in cultures when H. contortus eggs could not be identified) and a molecular test based on the digital droplet PCR platform to further identify positive samples. In test 1, conducted in autumn, 40 % of rams were FEC-positive, but only 12 % (six rams) were infected with H. contortus according to conventional routine diagnostics. In test 2, 8 % (four rams) were FEC-positive, including one with 1050 eggs, 90 % of which were identified as H. contortus. This ram was therefore returned to the supplier. However, ivermectin was found to be effective when this animal and a group of lambs from the same farm were treated and tested again. Test 3 was performed on 44 of the same rams (in addition to the returned ram, two rams died in quarantine and the samples from three rams were never provided by the owners). The proportion of FEC-positive animals was 42 %, with an even higher proportion (27 %) of animals being H. contortus-positive than in test 1. The corresponding results for tests 1, 2 and 3 with the ddPCR assay were 18 %, 4 % and 76 %, respectively. This study demonstrates the superiority of DNA detection over microscopy, which is the mainstay in most diagnostic laboratories. Although the combined results confirm that H. contortus survived quarantine in two rams, in the other cases it is not clear whether the spring infection rates are due to re-emergence of persistent larvae from quarantine or reinfection on the new farm. These results suggest not only that we should recommend that sheep farmers use a more sensitive molecular test when purchasing and introducing new animals to their flock, but also that the reliability of injectable ivermectin as a quarantine treatment for removal of adult and larval stages needs further investigation.

Societal Adaptation to Pandemic Challenges: Analysing the Role of Local Governance and Healthcare Systems in Madhya Pradesh

The COVID-19 pandemic posed unprecedented challenges, compelling communities globally to adapt rapidly to protect lives and maintain societal functions. This study examines the role of local governance and healthcare systems in Madhya Pradesh in addressing these challenges and fostering societal resilience. Drawing on quantitative data from government health agencies and qualitative insights from community feedback, this research explores how local governance structures facilitated public health response, resource allocation, and pandemic preparedness. Findings indicate that decentralized decision-making and robust healthcare infrastructure were instrumental in managing health crises, providing essential services, and supporting economic resilience at the grassroots level. Key results show that regions with stronger local governance exhibited a 30% lower infection rate compared to less governed areas, while areas with well-resourced healthcare systems saw a 20% higher recovery rate. Resource distribution, however, varied significantly, with urban areas receiving 60% more medical supplies than rural regions, creating disparities in healthcare access. Data analysis revealed that healthcare facilities that integrated digital solutions, such as telemedicine, were able to serve 45% more patients remotely, mitigating the risk of virus spread and reducing hospital overload. The study identifies the need for capacity-building initiatives, infrastructure strengthening, and data-driven decision-making to enhance future pandemic preparedness. Future prospects include continuous training programs for healthcare workers, increasing community awareness of health protocols, and leveraging technology for real-time data monitoring. These insights contribute to a comprehensive framework for building resilient healthcare systems in Madhya Pradesh, better prepared for future public health crises.

Gastrointestinal helminths of Cattle slaughtered at Gwagwalada abattoir, federal capital territory, Nigeria

Gastrointestinal parasites are widespread in cattle worldwide, causing both clinical and sub-clinical infections that can lead to significant financial losses. This study investigated the prevalence of gastrointestinal helminths infection in cattle slaughtered in the abattoir at Gwagwalada area council, federal capital territory, Nigeria. A total of 120 faecal samples were collected and analysed by flotation and sedimentation methods. The results revealed an overall prevalence of 26.67%. The helminths identified were Toxocara sp (5.00%), Schistosoma sp (10.83%), and Fasciola sp (10.83%). These findings were compared to existing studies, with variations attributed to differences in climatic conditions, management practices, and seasonal factors. Age, breed, and sex-specific analyses revealed significant differences in infection rates. While no helminth infection was found in young adult cattle (1≤3 years), a 31.37% prevalence was recorded in older adult cattle (≥3 years). Among the breeds examined, Sokoto Gudali showed the highest prevalence (100%), followed by White Fulani (26.42%) and Red Fulani (16.67%). A significant breed-related difference (p = 0.0001) was recorded. Additionally, male cattle exhibited a higher prevalence (31.37%) compared to (0.00%) in females. The study highlighted the impact of geographical, ecological, and environmental factors on helminths infection, as well as the need for strategic anthelmintic treatment, improved livestock management, and educational programs to control these infections. Regular monitoring and selective breeding may further contribute to long-term infection control in cattle populations.

Bacterial etiology, antibiotic susceptibility pattern, and treatment modality of surgical site infections among post-caesarean delivery women: A 2019 cross-sectional study conducted in Iringa, Tanzania

Background: Surgical site infection (SSI) is a common complication after cesarean section in Tanzania, with high rates of infection and multidrug-resistant isolates reported. Understanding bacterial etiology and antibiotic susceptibility patterns is crucial for effective treatment and prevention. Therefore, this study aimed to determine the bacterial etiology, antibiotic susceptibility patterns, and treatment modalities of SSI among post-cesarean delivery women in the Iringa region. Methods: A cross-sectional study involving 162 women with SSI was conducted across five hospitals in Iringa. Data on demographics were collected using a structured questionnaire, and wound discharge samples were taken for culture and sensitivity testing. Definitive treatment modalities were identified from patients’ files. Data analysis was performed using SPSS version 20, with chi-square tests used to identify associations, and a p-value &lt; 0.05 considered significant. Results: Among 162 participants, 59.7% had superficial SSIs and 35.2% had deep SSIs. Culture positivity was 96.3%, with 53.2% being gram-positive and 37.2% gram-negative. Staphylococcus aureus was the most commonly isolated pathogen (40.1%), with 64.6% of cases being methicillin-resistant (MRSA). Resistance to vancomycin and chloramphenicol among gram-positive isolates was 3.1% and 13.8%, respectively. Non-surgical management was provided to 58% of the participants, while Staphylococcus aureus infections were significantly associated with surgical intervention (OR = 1.38, p = 0.001). Conclusion: Staphylococcus aureus, particularly MRSA, was the most prevalent pathogen in post-cesarean SSIs. Antibiotic resistance was common, and surgical intervention was significantly associated with Staphylococcus aureus infections.

The effects of maternal voice on pain during placement of peripherally inserted central catheter in neonates

BackgroundPeripherally inserted central catheter (PICC) are a necessary procedure for preterm newborns care. Despite the use of analgesic treatments, its insertion can be painful. Our objective was to study the effect of maternal voice on pain during PICC insertion.MethodWe conducted a pre post study for 2 years. Pain was compared between the two groups (with/without maternal presence) using a neonatal pain scale (FANS). Infection rate, procedure time, number of failures, mothers’ anxiety and caregivers’anxiety were compared between the two groups.ResultsNinety neonates were eligible. Finally, 63 neonates were included. Thirty-four placements were realized without maternal voice (first period) and 29 with maternal voice (second period). Mean FANS during PICC placement was lower in the maternal voice group than in the control group (1.15 ± 1.27 vs. 1.41 ± 1.49, p = 0.033). The FANS was also lower in the maternal voice group during the time of the first cutaneous effraction (p = 0.032). There was no significant difference between the two groups concerning the other outcomes.ConclusionMaternal voice added to conventional care decreased acute pain during PICC insertion without increasing infection rate, number of failures or procedure time.

Morphological and molecular identification of Eimeria rajasthani (coccidia: Eimeriidae) in the dromedary camel (Camelus dromedarius) in Riyadh, Saudi Arabia

IntroductionCoccidiosis is a serious parasitic disease in camels caused by an intestinal protozoan parasite of the genus Eimeria, which is linked to significant causes of reduced milk and meat production. In Saudi Arabia, scare literature focused on the coprological investigation of dromedary camels (Camelus dromedarius). To determine the taxonomic status of camel parasite species, we performed morphological characterization of oocysts and genetic analysis (18S rRNA and ITS-1 gene regions) of Eimeria species collected from camels in Riyadh, Saudi Arabia.MethodsA total of 150 faecal samples were obtained from camels at the old camel market. These samples were tested for the presence of Eimeria oocysts using the conventional floatation technique before being sporulated in a 2.5% potassium dichromate solution. Eimeria oocysts were morphologically and molecularly examined and identified, and the infection rate of parasitic infections was determined.ResultsOur findings revealed that the overall frequency of oocysts was 30%. The identified species was Eimeria rajasthani, which had a typical ellipsoidal oocyst shape. Oocystic polar granule, micropyle, micropylar cap, and oocyst residuum are not visible. Sporocysts are oval with stieda body. Sporocyst residuum contains many granules and sporozoites with refractile bodies and nuclei. Genetic analyses of the sequence data from the partial 18S rRNA and ITS-1 gene regions revealed that the sequences obtained from E. rajasthani oocysts are related to DNA sequences reported from E. lamae from the Alpaca from China, particularly the 18S rRNA sequences.ConclusionThis study emphasized the need to use molecular phylogenetic tools to describe camel intestinal coccidian parasites with traditional morphology-based approaches to better understand their biology. For camel husbandry and disease control, more studies should be conducted to better understand the epidemiology of these protozoan parasites.

Involvement of E3 Ubiquitin Ligases in Viral Infections of the Human Host.

Viral infections are one of the principal causes of global primary health crises, with increased rate of infection and mortality demonstrated by the newer progeny of viruses. Viral invasion of the host involves utilization of various cellular machinery. Ubiquitination is one of a few central regulatory systems used by viruses for establishment of the infections in the host. Members of the ubiquitination system are involved in carrying out proteasomal degradation or functional modification of proteins in numerous cellular processes. E3 ubiquitin ligases play a major role in this system through recognition and recruitment of protein substrates and catalyzing the transfer of ubiquitin to these substrates. The versatility of ubiquitin ligases frequently makes them useful tools for the viruses, for either utilizing or degrading other cellular machineries, for carrying out their multiplication or inactivating the defensive strategies of the host. Therefore, these ligases are important targets for aiming at major pathways causing viral protein degradation or functional modification of the infection process. In this review, we have discussed the role and mechanism of different types of ubiquitin ligases in the context of infections of mainly human viruses, highlighting the viral proteins directly interacting with the ligases. Knowledge about these direct interactions is central in understanding the ubiquitin-dependent processes. This comprehensive account may also be beneficial for pharmaceutical exploration of E3 ligase-based broad-spectrum antiviral treatment.

Epidemiology of Sandfly-Borne Phleboviruses in North Africa: An Overview

Eight sandfly-borne phleboviruses were found to circulate in North Africa. Phleboviruses detected in sandflies were Toscana (TOSV), Sandfly Fever Sicilian (SFSV), Sandfly Fever Naples (SFNV), Cyprus (CYPV), Punique (PUNV), Utique, Saddaguia, and Medjerda Valley (MVV) viruses, yielding an overall infection rate of 0.02–0.6%. Phlebotomus perniciosus and Phlebotomus longicuspis were the most common vector species in the region. TOSV seroprevalence in dogs from Algeria (4.56%) and Tunisia (7.5%) was low and close, unlike SFSV (38.1%) and PUNV (43.5%), which were restricted to Tunisia. SFSV (1.3–21%) and TOSV (3.8–50%) were the most prevalent among humans. TOSV was frequently detected and symptomatically confirmed in both Algeria (3.8%) and Tunisia (12.86%). Other sandfly-borne phleboviruses have also been detected but less importantly, such as SFNV in Morocco (2.9%) and Tunisia (1.1%) and PUNV (8.72%), CYPV (2.9%), and MVV (1.35%) in Tunisia. Their distribution was mainly northern. Overall, 15.9% of the healthy population were seropositive for sandfly-borne phleboviruses, with evidenced cocirculation. Noticeably, studies conducted in Morocco were mostly interested in TOSV in sandflies. Available data from Libya and Egypt were scant or historical. Further elaboration is required to check the sporadic detection of less-prevalent phleboviruses and fully elucidate the epidemiological situation.

Predictive value of a positive pocket swab for the occurrence of device infection in implantable cardioverter defibrillator patients undergoing generator replacement or lead revision

Abstract Introduction Bacterial colonization of generator pockets in implantable cardioverter defibrillator (ICD) patients plays a key role in the development of device infection after revision surgery. Pocket swabs taken at revision may be useful for predicting device infection, but their prognostic value is not precisely known. Aim of the study was to evaluate the predictive value of positive pocket swabs for cardiac device infection in ICD patients undergoing revision surgery. Methods A total of 646 consecutive ICD patients from a prospective single-centre ICD-registry who underwent elective device replacement, system upgrade or lead revision between 2014 and 6/2023 were analyzed. Independent predictors for device infection were evaluated by a Cox regression analysis adjusting for age, gender, EF, insulin dependent diabetes, anticoagulation, multiple leads, revision surgery and the PADIT score. Results Positive pocket swabs were obtained in 12% of patients. The baseline characteristics of ICD patients with positive versus negative pocket swabs were similar (Table 1). With an average follow-up of 3 years, the infection rate in patients with positive pocket swabs was around 5 times higher than in patients with negative swabs (19% versus 4%, p &amp;lt; 0.001). In a Cox regression analysis, a positive pocket swab was the strongest independent predictor for device infection during follow-up (hazard ratio 4.26, 95% confidence interval 2.15 – 8.45, Table 2). Conclusion A positive swab from ICD-pockets in patients undergoing generator replacement or lead revision is an independent predictor of device infection during follow-up. These results support the routine collection of pocket swabs from patients undergoing revision surgery.Table 1Table 2

Laparoscopic-Assisted Peritoneal Access in Ventriculoperitoneal Shunt Placement: Systematic Review and Meta-Analysis.

The most common treatment of hydrocephalus is ventriculoperitoneal (VP) shunting. Peritoneal access is commonly conducted through an open laparotomy, but laparoscopic peritoneal access is gaining popularity. Many studies have reported the benefits of minimally invasive laparoscopic peritoneal access, but there is no consensus on its use. We conducted a systematic review and meta-analysis to compare open laparotomy vs laparoscopic peritoneal access in VP shunting. A systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using 3 databases. Twelve studies included only adults, 3 included only pediatric patients, and 3 included both adults and pediatric patients. Compared with open laparotomy, laparoscopic peritoneal access was associated with a reduction in distal shunt failure (6.1% vs 2.2%, P = .01), operative time (69.4 vs 56.3 minutes, P < .001), and length of stay (LOS) (9.6 vs 7.3 days, P < .001). There were no differences in proximal shunt failure, total shunt failure, intraoperative complications, or infection rate. In the pediatric population, laparoscopic access was associated with a reduced LOS (7.8 vs 5.9 days, P < .001). Heterogeneity was high but explained by the varying study populations and techniques. Laparoscopic peritoneal access for VP shunt insertion is associated with improved outcomes, including reduced distal shunt failure, reduced operative time, and reduced hospital LOS, when compared with open laparotomy and should be considered for shunt insertion. Additional studies are necessary to further determine the benefit of laparoscopic access, especially in the pediatric population.

Boosting influenza vaccination rates through policy gamification: the ‘Let’s Control Flu’ project

Abstract Background Influenza remains a public health challenge globally, leading to substantial morbidity and mortality, particularly among vulnerable groups. Despite the benefits of vaccination, achieving the desired vaccination coverage rates (VCR) proves challenging across Europe. The ‘Let’s Control Flu’ (LCF) tool emerges as a new contribution, merging gamification with epidemiological data and public health policies to help increase influenza VCR. Methods The LCF tool, developed from an extensive literature review and validated by a National Advisory Board, initially showcased its capabilities in Sweden. Offering an interactive simulation, it allows stakeholders to explore the outcomes of implementing 13 targeted public health policies (PHP) on influenza VCR and health outcomes such as infection rates, hospitalizations, and mortality. This approach simplifies epidemiological complexities, paving the way for informed decision-making. Results Following its success in Sweden, the LCF tool was extended to Germany and Czechia, underlining the value of gamified tools in public health decision-making. The application across these new countries not only resulted in paths to improve VCR but also provided insights into the tool’s scalability and adaptability different landscapes. Conclusions The LCF project underscores the efficacy of integrating gamification into health policy decision-making, offering a replicable model for enhancing influenza vaccination uptake across Europe. With the tool now successfully applied in multiple countries, its potential for broader European and global application is evident. This initiative aligns with WHO’s objectives, spotlighting gamification as a relevant component in improving vaccination strategies and readiness for influenza and other preventable diseases, thereby reinforcing the importance of innovative approaches in public health policy development. Key messages • The LCF tool integrates gamification with public health strategies to help effectively raise influenza vaccination coverage. • By merging gamification and epidemiological insights, the LCF tool also serves as a scalable model for Europe, supporting WHO’s goals to improve vaccine strategies and preparedness.

A propensity-matched cohort study examining the impact of gentamycin-collagen sponge on the prevention of infections in patients with implantable cardioverter defibrillator undergoing revision surgery

Abstract Introduction Despite the obvious benefits, the use of implantable cardioverter defibrillators (ICDs) is associated with serious complications, including infections. In particular, device replacement or revision procedures are associated with an increased risk of infection. Aim of the study was to compare the cardiac device infection rate with and without the use of the gentamycin-collagen sponge (GCS) in patients undergoing device replacement or revision procedures of implanted ICDs. Methods This cohort study analyzed ICD patients from a prospective single-centre ICD-registry who underwent elective device replacement, system upgrade or lead revision between 2014 and 6/2023. From September 2020 onwards, a GCS was inserted into the device pocket (GCS group, n = 204). Each patient of the GCS group was matched to a control without GCS. Results The baseline characteristics and the PADIT score were well matched except for the rate of submuscular device pockets which was lower in the GCS group (Table 1). The GCS was well tolerated and there were no complications associated with the GCS. The Kaplan-Meier estimated infection rate after one year was 1.0% in the GCS group and 6.5% in the control group (p &amp;lt; 0.001, Figure 1). Time from revision to infection was 144 + 134 days in the GCS group vs. 334 + 261 days in the control group. Conclusion Adjunctive use of a GCS was associated with a lower incidence of device infections than standard-of-care infection-prevention strategies alone.Table 1Figure 1

Report of cardiac electronic device implant complications over a 7-year study period

Abstract Background The global placement of cardiac implantable electronic devices (CIEDs) is on the rise. Complications linked to device implantation present a substantial burden on healthcare systems and patients alike. It is imperative to comprehend the complication rates associated with CIED procedures, enabling informed decision-making and strategic planning for patients, thereby enhancing the overall quality of care. Purpose We sought to determine post CIED implantation complication rates and provide operator specific complication data for quality assurance at our institution. Methods A comprehensive audit of all procedures completed between April 2016 to March 2023 by 14 high volume operators at a single academic center was completed. Complications and device data were extracted using electronic medical records. Complications evaluated include pneumothorax, infections, hematomas, venous thrombosis, lead perforation, and dislodgement using standardized definitions. Results During the 7-year period, a total of 9,467 procedures were completed. Among the cohort, 62% were male, with an average age of 74.6 ± 15.2 years. The procedural breakdown comprised 60% pacemakers, 19% ICDs, 16% CRTs and 3% ILRs. A total of 11,616 leads were implanted (3,644 RA leads and 1,110 LV leads). The overall complication rate was 3.1% (n=316): device pocket infection 0.68%, superficial infection 0.19%, lead dislodgement 0.53%, lead perforation 0.24%, pericardial effusion 0.1%, pneumothorax 0.15%, pocket hematoma 0.83%, DVT 0.36%, and hemothorax 0.02%. Complication rates per operator are shown in Figure-1. Conclusion Our findings indicate that the overall complication rates for CIED implants are lower than previously reported rates, and there is no significant difference between operators in overall rates of complication. This observation can be attributed to operator experience, advancements in peri-operative care and guideline-directed post-operative protocols. However, notable variations exist among operators in rates of pocket infection. The ongoing monitoring of CIED complications as a quality indicator remains a crucial benchmark, meriting annual assessments for ongoing evaluation.

European guidelines for the management of tuberculosis screening in migrants: a systematic review

Abstract Background This systematic review assesses the current available evidence across the WHO European region on the effectiveness and cost-effectiveness of the different approaches used for TB screening and also explores the facilitators and barriers that migrants face during screening programs. Methods We conducted an extensive, comprehensive, and systematic literature search across multiple databases, including MEDLINE, Cochrane, Scopus, and ISI Web of Knowledge, without any restrictions on publication date or language. In addition, we reviewed grey literature and reports from WHO. The data were meticulously analyzed using RStudio, with a focus on screening effectiveness indicators, such as infection and disease detection rates, uptake, coverage, and cost-effectiveness economic analyses. Results Our review included 43 studies covering over 8 million migrants from 11 countries. The findings demonstrate that while screening uptake was high, coverage varied, and completion rates for preventive treatments were low. Economic analyses supported the high cost-effectiveness of the screening programs, particularly when integrating both active TB and LTBI screening strategies. Conclusions The implementation of uniform screening protocols could potentially streamline efforts, reduce TB transmission, and offer substantial public health and economic benefits, making this research highly relevant for policymakers and healthcare providers. Key messages • An important strength of this study lies in its pioneering approach of current recommendations regarding screening for latent tuberculosis infection and active TB within the WHO European region. • This is the first study that provides a comprehensive overview of screening interventions across 11 countries and incorporates studies with large sample sizes (n &amp;gt; 8 million migrants).

Risk factors for COVID-19 among healthcare workers: a hospital-based cohort study in Portugal

Abstract Background Healthcare workers (HCWs) have an increased risk of transmitting SARS-CoV-2 infection to frail patients and are also at higher risk of exposure. Hence, it is essential to understand the risk factors for infection of HCWs to limit adverse events occurring in healthcare facilities. This study aimed to identify risk factors for symptomatic COVID-19 infection among HCWs in the hospital context. Methods We used data from a hospital-based cohort study followed between December 2020 and January 2022 in three central Portuguese hospitals. Following the study protocol, RT-PCR testing was performed whenever an HCW reported any symptom compatible with COVID-19. Characteristics of infected (at least one positive RT-PCR with symptoms) versus non-infected HCW were compared using the Chi-square test. Results A total of 3034 HCWs were followed during 13 months and 533 had a positive test for SARS-CoV-2. A higher percentage (&amp;gt; 40 %) of infections were in individuals without a primary vaccination scheme. Other than age, no differences were found regarding individual characteristics: infected HCWs had a higher percentage of individuals aged 18 to 50 years old compared to the non-infected HCWs (74.7 % versus 66.2 %, p &amp;lt; 0.001). Regarding work functions, no differences were found for self-report of working in direct contact with COVID-19 patients. Additionally, the percentage of HCWs who declared to perform tracheal intubation procedures was similar in infected versus non-infected HCWs (6.2 % versus 8.9 %, p = 0.080). Conclusions Infected HCWs were younger than the non-infected. HCWs working in direct contact with patients or performing tracheal intubations didn’t exhibits increased rates of infection suggesting the success of preventive measures and other standard procedures in limiting infection transmission in healthcare facilities. Key messages • HCWs working in direct contact with COVID-19 patients or performing tracheal intubations were not the most infected personnel. • Preventive measures and other standard procedures were successful in limiting COVID-19 infection transmission in healthcare facilities.