Regional Surveillance Research Articles

Etiological analysis of acute respiratory infections in hospitalized children after the relaxation of COVID-19 non-pharmacological interventions in Quzhou, China

BackgroundAcute respiratory infections (ARIs) can cause morbidity and mortality in children. This study was to determine the characteristics of pathogens in hospitalized children with ARIs after the relaxation of COVID-19 non-pharmacological interventions (NPIs) in Quzhou, China.MethodsHospitalized children with ARIs were enrolled between May and October 2023, and thirteen common respiratory pathogens were tested by fluorescent quantitative polymerase chain reaction. Mono- and co-infections were assessed, and the association between pathogens and age was explored using restricted cubic spline analysis.ResultsA total of 1225 children were included, 820 of them detected one pathogen and 238 of them detected two or more pathogens. The dominant pathogen varies monthly. Mycoplasma pneumoniae (Mp) was the most common pathogen in monoinfection, followed by respiratory syncytial virus (RSV) and human rhinovirus (HRV), while influenza virus was detected at a lower rate. Mp + HRV was the most common combination of coinfections. The detection rates of Mp and HRV were higher in coinfections than in monoinfection, but there was no difference in the detection rate of RSV. Children aged 1–3 years had the highest positive detection rates and were more likely to be infected with multiple pathogens, with 40% of respiratory pathogen monoinfection and 47.48% of coinfections (χ2 = 4.245, P = 0.039). In the restricted cubic spline models, a J-shaped association was consistently observed between age and Mp infection, the risk of HRV first increased and then decreased, the risk of RSV was relatively flat until 1.5 years and then decreased rapidly.ConclusionOur study revealed the epidemiological characteristics of ARIs pathogens after the relaxation of NPIs. The positivity rates of Mp, RSV, and HRV are the highest, while those of influenza virus are still low. Additionally, age and season affect the distribution of respiratory pathogens. These findings underscore the importance of ongoing regional pathogen surveillance to guide local public health responses.

An Overview of a Re-Emerging Disease in Italy: Bovine Tuberculosis Outbreaks in Cattle from MTBC-Free Territories.

Bovine tuberculosis (bTB) is a zoonotic disease with consequences for public health as well as the economy. In the EU, compulsory eradication programmes have been applied, and most territories in Italy have been reported as disease-free (FTs). However, outbreaks (OBs), i.e., an officially confirmed occurrence of bTB in one or more animals in an establishment, have continued to be reported. In this study we provide an overview of bTB in terms of OB numbers in cattle from Italian FTs. Legislative sources were collected to find the FTs, the relevant declaration of free status year (FSY), and regional control and surveillance plans. Then, descriptive and statistical analyses were applied to the collected OBs. A total of 12 regions and 19 provinces were declared FTs in the 20 years from 2003 to 2023. Differences in regional plans were observed with respect to the percentages of herds that were annually controlled (control frequency). Overall, 370 OBs were recorded. A non-statistically significant decrease in the OB incidence rate after the FSY was declared. However, a notable increase in OBs detected at slaughterhouses after the FSY suggests that control systems (serological tests) at the herd level are not completely effective. Differences in the herds' control frequencies among FTs seem to not have had a significant influence on the observed OB number. The Tuscany region was the most affected FT based on the OB numbers after the FSY (especially in the last year). Epidemiologically relevant primary determinants seem to be the farming system (semi-extensive and adjacent herds) and the cattle movements from positive incidence areas (trade and animal fairs). The role of wild boars in the disease maintenance cannot be excluded. The results of this study stress the need to revise bTB eradication and surveillance plans based on risk analysis.

Unveiling environmental transmission risks: comparative analysis of azole resistance in Aspergillus fumigatus clinical and environmental isolates from Yunnan, China.

Azole resistance in Aspergillus fumigatus poses a significant clinical challenge globally. Our previous epidemiological analysis revealed a remarkably high frequency (~80%) of azole-resistant A. fumigatus in Yunnan's greenhouse environments, prompting increased local and regional research for targeted control strategies. In this study, we analyzed 94 clinical A. fumigatus isolates from Yunnan, comparing their susceptibility profiles and genotypic characteristics with environmental strains previously isolated. While the overall frequency of azole resistance in clinical isolates was lower than that in environmental samples, a significant prevalence of cross-resistance, with varying resistance patterns based on minimum inhibitory concentration (MIC) levels was observed, which exceeded rates in other regions of China. Specific mutation combinations in the cyp51A gene were linked to elevated MIC values in clinical and/or environmental samples, while some resistant strains with wild-type cyp51A remain unexplained, indicating a need for further investigation into their resistance mechanisms. The differences in unique genetic elements and the distinct genetic differentiation observed between clinical and environmental isolates can be attributed to Yunnan's unique geomorphology and potential genotype importation from other provinces and abroad. Extensive allele exchanges and sharing contributed to the selection of azole-resistant clinical isolates, suggesting a common environmental origin, and the transmission routes of local drug-resistant strains cannot be excluded. These findings emphasize the imperative for regional and targeted surveillance to monitor resistance trends and guide effective antifungal therapy, and management strategies to mitigate invasive aspergillosis risk in this region.IMPORTANCEAzole resistance in Aspergillus fumigatus is a major global health concern, with particularly high rates (~80%) observed in Yunnan's greenhouse environments. This study compares azole resistance in 94 clinical isolates from Yunnan with environmental strains, revealing lower clinical resistance but significant cross-resistance and distinct resistance patterns. Specific mutations in the cyp51A gene were associated with elevated minimum inhibitory concentration values, though some resistant strains had wild-type cyp51A, highlighting the need for further research. The unique genetic profiles and potential external genotype influences in Yunnan emphasize the need for targeted regional surveillance. Effective monitoring and control strategies are essential to manage and mitigate the risk of invasive aspergillosis.

Determining diagnostic sensitivity loss limits for sample pooling in duplex rtPCR surveillance testing: Theileria orientalis and Anaplasma marginale.

To expand surveillance testing capacity through sample pooling, a thorough understanding is needed of how sample dilution through pooling affects the sensitivity of candidate assays. We validated a robust and representative framework for assessing the dilution effect of sample pooling using duplex rtPCR surveillance of Theileria orientalis and Anaplasma marginale, both of which are causative agents of severe anemia in cattle and a serious threat to the cattle industry in Virginia and many other states. We used 200 known-positive samples with Ct values representative of typical surveillance results in a series of pools in which we re-tested each sample individually, followed by each sample diluted in equal volumes with negative samples to make pools of 2, 4, 6, 8, and 10 total samples. We compared the Ct values of the individual positives with the Ct values of each pool size to determine if Ct values increase past the limit of detection in the 45-cycle assay. We observed a maximum of 2% sensitivity loss (no more than 2 of 100 samples returned a false-negative result) for both T. orientalis and A. marginale during the pooling series, with lower-than-expected average Ct increase and sensitivity loss. We conclude that pooling up to 10 samples would be acceptable for regional surveillance of T. orientalis and A. marginale using our rtPCR assay. The described strategy is applicable to validate pooling for a wide range of single and duplex rtPCR assays, which could expand efficient disease surveillance.

Invasive Pneumococcal Diseases in People over 65 in Veneto Region Surveillance.

Elderly individuals over 65, along with children under 5, are the most affected by invasive pneumococcal diseases (IPDs). Monitoring vaccination coverage and conducting surveillance are essential for guiding evidence-based prevention campaigns and public health measures. Since 2007, the Veneto Region has relied on three sources for surveillance of invasive bacterial infections, contributing to an increase in reported IPD cases. This study analyzed notifications related to individuals aged ≥65 years from 2007 to 2023. A total of 1527 cases of IPDs in elderly individuals were reported between 2007 and 2023. The notification rate significantly increased from 5.61 to 14.63 per 100,000 inhabitants, despite underreporting during the COVID-19 pandemic. Cases associated with sepsis increased from 3.89 to 9.58 per 100,000, while notifications of meningitis and case fatality rates remained stable at 1.5 per 100,000 and 11.8%, respectively. Serotyping was not performed in 52% of the notifications. The most common serotypes were 3 (21.6%), 8 (11.1%), and 19A (5.0%), with fluctuations over time. There was a significant decline in serotypes covered by PCV7 and PCV13 and an increase in non-vaccine serotypes. The regional surveillance system allows for an increasingly comprehensive profile of the epidemiological landscape of IPDs in Veneto. However, the surveillance of pneumococcal infections still presents challenges. The currently available data are likely to be underestimated, mainly referring to the most severe cases, and the serotyping necessary to identify the etiological agent is still not often performed.

Assessment of antibiotic consumption patterns in hospital and primary healthcare using WHO Access, Watch and Reserve classification (AWaRe) in Sichuan Western China: 2020

BackgroundThe Access, Watch, and Reserve (AWaRe) classification of antibiotics was a useful tool to support antibiotic stewardship. However, the AWaRe patterns of antibiotic consumption in Western China were unclear. We aimed to assess the antibiotic consumption patterns using the AWaRe Classification of public hospitals in Sichuan Province Western China.MethodsAntibiotic consumption data of year 2020 were obtained from the Sichuan Province Drug Use Monitoring Platform. We measured the antibiotic consumption (DDDs per 1,000 inhabitants per day, DIDs), calculated the proportion of antibiotic use, the ratio of Access to Watch antibiotics and patterns of antibiotic use by using drug utilization 90%.ResultsThis analysis included 4452 public health institutions. The antibiotic consumption rate was 10.39 DIDs (Median 8.50, IQR 7.71–12.96). The proportions of Access antibiotic use and Watch antibiotic use were 46.83% (Median 47.49, IQR 44.16–52.02) and 51.20% (Median 51.43, IQR 45.42–54.61), respectively. The Access-to-Watch index was 0.91 (Median 0.92, IQR 0.81–1.15). Amoxicillin (16.85%), cefuroxime (9.21%), cefixime (8.60%%), levofloxacin (8.11%) and metronidazole (6.16%) were the most consumed antibiotics.ConclusionsThe proportion of Access antibiotic consumption in Sichuan Western China has not achieved the WHO target of 60%. Overuse of antibiotic is serious in Sichuan. National and regional antibiotics management systems, stewardship programs and surveillance of antibiotic consumption based on AWaRe classification are needed to improve antibiotic consumption patterns, curb antibiotic overuse and combat antimicrobial resistance in Western China.

A-254 Increase of Stenotrophomonas maltophilia Isolates Non-Susceptible to Trimethoprim-Sulfamethoxazole and/or Levofloxacin at Brazilian Hospitals

Abstract Background Stenotrophomonas maltophilia is an emerging multidrug-resistant pathogen that exhibits intrinsic and acquired resistance to a wide variety of antimicrobial agents such as β-lactams, aminoglycosides, quinolone, tetracyclines and disinfectants. In addition to that, the increased resistance to sulfamethoxazole/trimethoprim (SMX/TMP) and Levofloxacin has been reported in the past few years, leading to few therapeutic options. This study aimed to describe the increase of Stenotrophomonas maltophilia clinical isolates recovered from Brazilian hospitals over a 6-year analysis (January 2018 to December 2023). Methods This study design was a retrospective, observational analysis based on microbiological data of emergent BGN-NF isolates detected in several Brazilian tertiary hospitals. The bacterial identification was performed by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF/MS) and the antimicrobial susceptibility profile to trimethoprim-sulfamethoxazole and levofloxacin was determined using disk-diffusion method and epsilometer method, respectively. Only one sample per patient was considered in this analysis. Results During the 6 year period, a total of 1,706 (2018; 221), (2019; 203), (2020; 294), (2021; 276), (2022; 294) and (2023; 418) Stenotrophomonas maltophilia strains were isolated from blood (n=626), respiratory tract (n=365), fluid and secretion (n=235), skin and soft tissue (n=162), urine (n=132), catheter tip (n=112), swab (n=36), bone fragment (n=29) and cerebrospinal fluid (n=9). The major frequency of S. maltophilia isolation occurred among man (52.6%) and the main age range was over 60 years (42.7%), while 0-10 comprised 16.6% of cases. Compared the 6-years period, the resistance rate to trimethoprim-sulfamethoxazole was 2.7%; 5.4%; 5.8%; 2.2%; 5.8%; 7.9% and levofloxacin was 3.6%; 3.4%; 3.1%; 3.3%; 1.7%; 2.9%, respectively. The resistance rate to trimethoprim-sulfamethoxazole and levofloxacin, simultaneously, was 0.23%. Conclusions The incidence rate of S. maltophilia infections has increased significantly, especially in the last year, followed by an increase in the pattern of resistance to trimethoprim-sulfamethoxazole. Regarding trimethoprim-sulfamethoxazole and levofloxacin co-resistance, very low rates were detected in our analysis. Our data point to a scenario wherein the presence of S. maltophilia may have been intensified by the covid-19 pandemic. Regional surveillance reports are extremely important and should be out to understand some aspects of the dynamics of bacterial resistance in both hospital and community settings.

Presumed Transmission of 2 Distinct Monkeypox Virus Variants from Central African Republic to Democratic Republic of the Congo.

We linked 4 mpox cases in South Ubangi, Democratic Republic of the Congo, to transboundary transmission from Central African Republic. Viral genome sequencing demonstrated that the monkeypox virus sequences belonged to distinct clusters of subclade Ia. This finding demonstrates the borderless nature of mpox and highlights the need for vigilant regional surveillance.

The spatiotemporal analysis of SARS-CoV-2 transmission in China since the termination of the dynamic zero-COVID policy

China's dynamic zero-COVID policy has effectively curbed the spread of SARS-CoV-2, while inadvertently creating immunity gaps within its population. Subsequent surges in COVID-19 cases linked to various SARS-CoV-2 lineages post-policy termination necessitate a thorough investigation into the epidemiological landscape. This study addresses this issue by analyzing a comprehensive dataset of 39,456 high-quality genomes collected nationwide over an 11-month period since policy termination. Through lineage assignment, phylogenetic analysis, pandemic pattern comparison, phylodynamic reconstruction, and recombination detection, we found that China's post-epidemic period could be divided into three stages, along with dynamic changes in dominant lineages. Geographical clustering of similar lineages implies the importance of cross-border cooperation among neighboring regions. Compared to the USA, UK, and Japan, China exhibits unique trajectories of lineage epidemics, characterized by initial lagging followed by subsequent advancement, indicating the potential influence of diverse prevention and control policies on lineage epidemic patterns. Hong Kong, Shanghai, and Hubei emerge as pivotal nodes in the nationwide spread, marking a shift in the transmission center from east to central regions of China. Although China hasn't experienced significant variant emergence, the detection and validation of the novel recombination event, XCN lineage, underscore the ongoing virus evolution. Overall, this study systematically analyzes the spatiotemporal transmission of SARS-CoV-2 virus in China since the termination of the dynamic zero-COVID policy, offering valuable insights for regional surveillance and evidence-based public health policymaking.

Applying MALDI-TOF MS to resolve morphologic and genetic similarities between two Dermacentor tick species of public health importance

Hard ticks (Acari: Ixodidae) have been historically identified by morphological methods which require highly specialized expertise and more recently by DNA-based molecular assays that involve high costs. Although both approaches provide complementary data for tick identification, each method has limitations which restrict their use on large-scale settings such as regional or national tick surveillance programs. To overcome those obstacles, the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been introduced as a cost-efficient method for the identification of various organisms, as it balances performance, speed, and high data output. Here we describe the use of this technology to validate the distinction of two closely related Dermacentor tick species based on the development of the first nationwide MALDI-TOF MS reference database described to date. The dataset obtained from this protein-based approach confirms that tick specimens collected from United States regions west of the Rocky Mountains and identified previously as Dermacentor variabilis are the recently described species, Dermacentor similis. Therefore, we propose that this integrative taxonomic tool can facilitate vector and vector-borne pathogen surveillance programs in the United States and elsewhere.

Resurgence of Kawasaki Disease Following Relaxation of Coronavirus Disease 2019 Pandemic Restrictions in Japan

ObjectivesTo compare the number and incidence of Kawasaki disease (KD) patients in years 2 through 4 of the coronavirus disease 2019 (COVID-19) pandemic, and determine the impact of 3 years of implementation infection control measures and their subsequent relaxation on the epidemiology of KD in Japan. Study designWe conducted a population-based, cohort study including consecutive KD patients in Kobe City between 2021 and 2023. We compared the incidence of KD cases, in relation to timing of infection control measures, as well as infectious disease cases based on a regional surveillance system. Data from a previous 2016 through 2020 study were used for comparison. ResultsA total of 566 children with KD were identified during the study period. During the infection control period in 2021 to 2022, the incidence of KD remained low compared with the pre-pandemic level (281.3 and 327.5/100,000 children aged 0-4 years in 2021to 2022 and 2016 through 2019, respectively), but a recovery trend began in the 0-1-year age group. During the relaxation period in 2023, the incidence of KD increased across a wide age range, reaching the highest recorded in Japan (426.7/100,000 children aged 0-4 years), and the median age of onset increased to age 30 months. The resurgence of KD coincided with the patterns for multiple infectious diseases in 2023. The seasonality of KD observed before the pandemic was altered. ConclusionsKD resurged in 2023 after relaxation of the prolonged COVID-19 pandemic restrictions in Japan. This phenomenon coincided with the rise of multiple infectious diseases, and supports the pathogenesis of KD being triggered by infectious agents.

Perspectives on donor-derived infections from the Notify Library.

It is impossible to eliminate the potential for transmission of donor-derived infections (DDI) when using medical products of human origin (MPHO). However, a thoughtful and systematic approach to donor evaluation can mitigate the risk. Prevention is a key issue, and physicians must maintain a high index of suspicion and remain vigilant in evaluating MPHO donors or recipients, as well as stay current on emerging infections. Biovigilance is the systematic monitoring of serious adverse reactions and events (SARE) that ensures the quality and safety of MPHO in transplantation. The Notify Library with its 2808 references is an available didactic tool that could support physicians in donor or recipient evaluation, inform biovigilance activity, and benefit the international scientific community. It provides free access to a large collection of many different types of SARE, identified mainly through the review of published articles and case reports from national or regional surveillance programs. The Notify Library includes many well-documented records of SARE in the field of DDI, representing a useful tool for assessing SARE associated with transplantation. It is continuously updated with new records, especially when a new type of incident is first reported. All types of described incidents may have educational value while guiding detection, investigation, or risk management. Sharing the lessons learned from these incidents represents an important educational opportunity that can help improve organ donation processes and achieve higher standards of quality and safety.

Heavy metals and trace elements in milk and dairy products in the Lazio region (Central Italy)

ABSTRACT A study was carried out to determine the concentration of heavy metals and trace elements in milk and dairy products collected from local farms, supermarkets, or food retailers in the region of Lazio (Central Italy). Persistent exposure to metal contamination is of particular concern for human health, as it can cause different serious disorders. The monitoring of the matrices studied is therefore important, given their high consumption in the daily diet. The elements determined by ICP-MS (Inductively Coupled Plasma – Mass Spectrometry) were lead (Pb), arsenic (As), mercury (Hg), cadmium (Cd), chromium (Cr), nickel (Ni), molybdenum (Mo) and thallium (Tl), for a total of 151 measurements in 98 samples. The results showed that 11.3% of the measurements were quantifiable but below the legal maximum limits (MLs) set by EU regulations. The data obtained may be useful for dietary exposure information, inter-regional comparisons and for planning regional surveillance strategies.

Three-year Profile of COVID-19 Cases in Eastern Visayas, the Philippines (2020–2023)

This paper presents a three-year profile of laboratory-confirmed COVID-19 cases in Eastern Visayas, the Philippines, from 23 Mar 2020–31 Mar 2023 – with descriptive data on temporal trends, geographical variations, demographic factors, clinical characteristics, transmission patterns, and outcomes for vaccinated and unvaccinated cases. We analyzed data from the Regional Epidemiology and Surveillance Unit, Department of Health–Eastern Visayas Center for Health and Development to identify associations between COVID-19 severity and mortality and demographic and clinical factors. Moreover, we examined significant differences across gender cohorts and between vaccinated and unvaccinated individuals. During the three-year period, Eastern Visayas recorded 64,740 confirmed cases, with 98.93% recovery and 1.07% mortality. Most cases (61.72%) occurred in 2021 – with Tacloban, Ormoc, and Leyte having the highest attack rates per 100,000 population. Infections were asymptomatic (70.40%) or mild (21.83%), and 82.7% of deaths were linked to severe infections. Females accounted for 52.6% of the patients, with a lower mortality rate (44.5%) than males (55.5%). The 20–29 age group had the highest count (22.57%), whereas the 70–79 age group recorded the highest number of deaths (25.94%). The vast majority (93.6%) had no comorbidities. Comorbidities reported among deaths included kidney disease (11.3%), heart disease (7.6%), and hypertension (3.9%). Notably, no significant differences in recoveries and deaths were found between vaccinated and unvaccinated groups (p-value = 0.304). Logistic regression analysis showed that gender, age group, place of residence, comorbidity, and vaccination status were significantly associated with disease severity and mortality. Eastern Visayas demonstrated a relatively low COVID-19 caseload (1.59%) within the cumulative Philippine count. This is the most extensive COVID-19 case profile in the Philippines to date, hence providing essential data for pandemic preparedness, enhanced response strategies, and regional health crisis resilience.

Tracking the prevalence and emergence of SARS-CoV-2 variants of concern using a regional genomic surveillance program.

In our manuscript, we describe the results of SARS-CoV-2 genomic surveillance from February 2021 to June 2022 at a metropolitan hospital in the United States. We demonstrate that consistent daily sampling is sufficient to track the regional prevalence and emergence of variants of concern (VOCs). Similar sampling efforts should be considered a viable option for local SARS-CoV-2 genomic surveillance at other regional laboratories. While the SARS-CoV-2 pandemic has evolved into a more endemic form, we still believe that additional real-world information about sampling, procedures, and data interpretation is valuable for ongoing as well as future genomic surveillance efforts. Our study should be of substantial interest to clinical virologists.

Antimicrobial Resistance Profiles of Pseudomonas aeruginosa in the Arabian Gulf Region Over a 12-Year Period (2010-2021).

To evaluate literature from a 12-year period (2010-2021) on the antimicrobial resistance profile of Pseudomonas aeruginosa from the Arabian Gulf countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). An electronic literature search was conducted for articles on antimicrobial resistance in P. aeruginosa and associated phenotypes, covering the period of 1st January 2010 to 1st December 2021. Antimicrobial resistance in the Arabian Gulf was highest to meropenem (10.3-45.7%) and lowest to colistin (0.0-0.8%), among the agents tested. Annual data showed that ceftazidime resistance (Kuwait), piperacillin-tazobactam non-susceptibility (Qatar), and aztreonam, imipenem, and meropenem resistance (Saudi Arabia) increased by 12-17%. Multiple mechanisms of carbapenem resistance were identified and multiple clones were detected, including high-risk clones such as ST235. The most common carbapenemases detected were the VIM-type metallo-β-lactamases. Among P. aeruginosa in the Arabian Gulf countries, resistance to meropenem was higher than to the other agents tested, and meropenem resistance increased in Saudi Arabia during the study period. Resistance to colistin, a classic antibiotic used to treat Pseudomonas spp. infections, remained low. The VIM-type β-lactamase genes were dominant. We recommend local and regional antimicrobial resistance surveillance programs to detect the emergence of resistance genes and to monitor antimicrobial resistance trends in P. aeruginosa.

Regional Differences in the Spread of Pneumonia in Russia: A Comparative Spatiotemporal Analysis of the Situation in 2017–2021

Introduction: Pneumonia remains a respiratory disease of concern that keeps influencing morbidity and mortality throughout the world in the 21st century. Increased incidence rates of pneumonia have been registered in Russia for a long time. In this regard, regional surveillance seems relevant across the country for a better understanding of recent spatial differences in the disease spread and their fluctuations. Objective: To carry out a spatiotemporal analysis of regional differences in pneumonia prevalence in the adult population of Russia in 2017–2021 with a focus on pre- and COVID-19 pandemic periods, given the Russian long-term dynamics for 2010–2022. Materials and methods: The study covers the years 2017–2021 with sufficient data on pneumonia prevalence collected. Static and dynamic parameters were calculated for the compared pre- and pandemic periods. A series of cartograms developed using GIS tools made it possible to visualize the information obtained and assess the spatiotemporal situation of the process under study. Results: The long-term dynamics of pneumonia prevalence rates in the adult population in Russia was examined with the regional trends in 2017–2021 assessed. In 2017–2019, they rose in most regions of Russia but the growth rate did not exceed 30 %. In 2019–2021, in the context of the COVID-19 pandemic, the pneumonia situation changed dramatically and the disease rates increased in most regions. A significant deterioration of the situation was observed in most of the European part of Russia with the growth rates ranging from 70 % to 90 %. The number of regions with a null increase in the pneumonia prevalence dropped from 25 to five. Conclusions: Changes in the regional differences in the disease prevalence in the adult population of Russia for 2017–2021 were assessed. The uneven interregional spread of pneumonia complicated during the pandemic compared with the pre-pandemic period. Increased growth rates of the disease prevalence of varying intensity were observed in 80 Russian regions.

One Health Landscape of Antimicrobial Resistance in Bacteria Isolated from Virginia between 2007-2021.

The emergence of antimicrobial-resistant (AMR) bacteria has become a critical global One Health issue, mainly attributed to the extensive use of antimicrobial agents in human and agricultural settings. Regional and local AMR surveillance data is essential for implementing awareness and mitigation strategies. This article assesses AMR frequency in 1604 bacterial isolates consisting of Escherichia coli (E. coli) and Salmonella spp. isolated from diverse sources in Virginia, including farm animals, wildlife, environment, and food samples from 2007 to 2021. The results are based on the Kirby-Bauer disc diffusion assessment method of susceptibility to select antimicrobial agents, spanning nine distinct categories approved by the US Food and Drug Administration for clinical use. Streptomycin (STR) and tetracycline (TCY) exhibited the highest frequency of resistance in E. coli (39.1%) and Salmonella (25.2%), respectively. Multidrug resistance (MDR) was evident in 6.6% of E. coli and 10.9% of Salmonella isolates. Notably, 51% of E. coli and 36% of Salmonella isolates demonstrated resistance to more than one antimicrobial. None of the tested antimicrobials guaranteed effectiveness against the bacteria isolated from the surveyed sources and regions. The study found heightened MDR and distinct AMR patterns in bacteria isolated from food products compared to other sampled sources. These findings are vital for comprehending the current AMR landscape, prompting the development of strategies to mitigate the emergence of AMR bacteria, and advocating prudent antimicrobial use from a One Health perspective.

The state of cancer care in Russia: liver cancer - (From 22). Age-related features of the observed and relative one-year and five-year survival of patients. (clinical and population-based study). Part 2.

Survival rate calculations for liver cancer patients at the federal level in the Russian Federation are only conducted in the North-Western Federal District and a few other individual administrative territories. In the first part of our study, we presented a detailed analysis of the prevalence of liver cancer, noting that the levels of standardized incidence and mortality rates in Russia and the North-Western Federal District are virtually identical, allowing us to consider the results of our study as nationally representative. The conducted research confirmed the seriousness of the issue of liver cancer among the population. However, certain advancements in patient treatment were recorded, with a significant increase in survival rates, primarily for one-year survival. For example, in the North-Western Federal District, one-year survival increased from 13.6% in 2000 to 23.1% in 2022, representing a 69.8% increase. At the same time, five-year survival rates remained largely unchanged. Increases in survival rates were observed in most age groups. A significant deficiency in the initial patient record-keeping was identified - insufficiently accurate determination of the stage of liver cancer. One-year survival rates for male and female liver cancer patients (22.7% and 22.1%) were nearly equal, as were the survival rates for liver cancer patients residing in urban and rural areas. Therefore, further improvement in the outcomes of treatment for this complex patient group can only be achieved through the implementation of regional and federal screening and epidemiological surveillance programs among populations at high and extremely high risk of developing hepatocellular carcinoma.

Abstract LB139: Disparities in oral precancerous lesion surveillance in the United States upper Midwest

Abstract Objective: To determine whether geographic representation and race of patients in a regional oral cancer surveillance program (University of Minnesota Cancer Active Surveillance Population (UMN CASP)) mirror characteristics in the corresponding National Cancer Institute (NCI) designated comprehensive cancer center catchment. Introduction: Oral cancer poses a significant public health concern that may be mitigated through lesion surveillance. Representation of patients for clinical trials throughout an NCI cancer center catchment area is a crucial goal to promote improved health outcomes. This study investigates the demographic landscape of patients with preneoplastic oral lesions seen at the CASP. Methods: Through the UMN Clinical and Translational Sciences Institute, we queried 30 International Classification of Disease (ICD) 9 and 10 codes corresponding to 120 unique mucosal oral precancerous lesion descriptors of CASP patients. Automated extraction of electronic medical record (EMR) data for 4,496 patients treated by the senior author between 2011 and 2023 identified 1,375 patients with preneoplastic lesions. The proportion of patients residing in three-digit zip code regions of Minnesota were compared to 2021 American Community Survey state population data. Additionally, race data were compared between CASP patients and the UMN Masonic Cancer Center (MCC) patient catchment data. Results: CASP patients were over-represented relative to state population distributions within the Minneapolis-St. Paul metropolitan area and surrounding suburbs (region 554 p<0.0001 and region 551 p<0.0001). Under-representation of CASP patients was observed in all western and southern border regions (regions 559 p<0.0001, 560 p<0.0001, 561 p<0.0001, 562 p=0.0037, 565 p<0.0001, and 567 p=0.0006) as well as portions of central (563 p<0.0001), northern (566 p=0.0015), and north-eastern (558 p<0.0001) Minnesota. Proportional representation was observed in several regions of central (553 and 564), eastern (550), and north-eastern (557 and 556) Minnesota. Comparisons of CASP race data revealed a higher proportion of black patients (CASP 8.59% [95% CI 7.17-10.27%] vs. MCC 7.16% [95% CI 7.14-7.17%]) and a lower proportion of Asian/Pacific Islander patients (CASP 3.74% [95% CI 2.82-4.94%] vs. MCC 5.32% [95% CI 5.30-5.34%]) relative to MCC catchment patients. White, American Indian/Alaskan Native, and mixed-race groups were proportionally represented in both data sets. Conclusions: These data show that system wide EMR searches can be implemented to identify patients in an NCI cancer center catchment area with precancerous or other at-risk conditions for cancer. Importantly, Native patients were proportionally represented in the screening program while several rural locations were under-represented. This information can instruct the expenditure of additional resources for under-represented groups and permit streamlined enrollment of patients for cancer prevention clinical trials. Citation Format: Alexander J. Dwyer, Lindsey Mortensen, Beverly R. Wuertz, Frank G. Ondrey. Disparities in oral precancerous lesion surveillance in the United States upper Midwest [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB139.