Risk Factors For Infection Research Articles

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 (> 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 < 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.

Risk factors for COVID-19 infection among the German older adult population

Abstract Background There are scarce analyses on COVID-19 infection risk factors for the older adult population. This study aims to examine COVID-19 infection risk factors in the older adult general population. Methods The data for this analysis came from the population-representative Study on Health of Older People in Germany (Gesundheit65+) conducted by the Robert Koch Institute from 10/2021 to 08/2022. We considered information on COVID-19 infection status (self-reported infection confirmed by PRC test at least once vs. never), socio-demographic factors, health risk factors, and different face-to-face interactions. The analysis was restricted to 2,976 individuals aged 65+ years with complete infection status information. We assessed weighted prevalences and used univariable and multivariable logistic regressions to evaluate infection risk factors. Results The overall prevalence of infection was 7.2% (95% confidence interval, 6.0-8.7). Infection prevalences were significantly higher (compared to their respective reference group) among participants living in assisted living facilities (24.7% vs. 6.7%), individuals who got help to perform basic activities of daily living (10.8% vs. 6.8%), COVID-19 unvaccinated individuals (25.2% vs. 6.9%), individuals who did not meet family or friends in the last month (12.7% vs. 6.7%), and participants who did not smoke (7.8% vs. 2.6%). No other variable was significantly related to COVID-19 infection. In multivariable analysis, variables independently associated with higher odds ratio (OR) of COVID-19 infection were: living in an assisted living facility OR 3.6 (1.8-7.2), not being vaccinated against COVID-19 OR 4.6 (1.5-14.1), and not smoking OR 1.6 (1.1-2.6). Conclusions The preliminary results of this study align with the prevalence of COVID-19 infection found in concomitant studies. A noteworthy element of our study is the vaccine’s protective effect. The pandemic had a particularly detrimental effect on residents of assisted living facilities Key messages • Improvement in quality of care and infection preventive measures in nursing homes is necessary. • Pandemic preparedness must consider the need for help in the daily life of the older population.

Statistical analysis of seroprevalence and risk factors of hepatitis C in Nowshera District, Pakistan

Hepatitis C virus (HCV) transmission remains a significant public health concern. It is well documented globally, however, Nowshera district, Pakistan, is lacking such profile. This study aims to explore the relationship between HCV infection and several risk factors, including socio-demographic, clinical and personal life-style factors. This study using a cross-sectional design, examined 606 randomly selected individuals visiting the Pathology department at Qazi Hussain Medical Complex and District Headquarter (DHQ) Hospital Nowshera between May 1, 2022 and Jun 30, 2023. This research investigation employed a methodical approach involving formal interviews in conjunction with structured questionnaires to gather comprehensive information related to socio-demographic characteristics, clinical history, and personal hygiene practices. We collected 10 ml of blood samples and tested the separated serum to identify markers using the Immuno-Chromatographic Test (ICT) and the Enzyme-Linked Immunosorbent Assay (ELISA). IBM SPSS Statistics version 27 was used for data analysis. To measure the association between dependent variable and independent variables, a chi-square and risk analysis was carried out; multiple logistic regression was employed for modeling the risk factors associated with independent variable. A statistical significance level was established at a P-value of less than 0.05. In present study, which included 606 participants, 12% were found to be infected with HCV. Importantly it revealed that facial shave at barber (adjusted odds ratio, aOR = 40.65, p = 0.000) represents the most prevalent mode of HCV transmission. Additionally, a strong association was observed between HCV infection and history of past surgery (RR = 2.98, p = 0.001), HCV infected family member (aOR = 4.28, p = 0.001), workplace injuries (aOR = 6.68, p = 0.000), history of hospital admission (RR = 2.09), practicing ear and nose piercing (aOR = 5.01, p = 0.001), dental treatment (RR = 2.31) and the frequency of injections (aOR = 8.607, p = 0.000). These findings underscore the pressing need for targeted interventions. This study highlights the paramount importance of understanding the modes of HCV transmission and their associated risk factors. The results emphasize the need for educational initiatives, both within the healthcare sector and among the general public, to combat HCV transmission effectively. By implementing sterilization procedures and increasing awareness, we can make significant strides in reducing the burden of HCV infection. Moreover, proactive measures within families can help contain the spread of the virus, ultimately contributing to improved public health.

Prevalence and risk factors of Acinetobacter baumannii infection in Pediatric Intensive Care Unit at Thammasat University Hospital

Prevalence and risk factors of Acinetobacter baumannii infection in Pediatric Intensive Care Unit at Thammasat University Hospital

Impact of smoking habits on cardiovascular and neoplastic events and all-cause death in people living with HIVfrom the STOPSHIV cohort.

The study aimed to assess the impact of smoking exposure on major clinical events (MCE) in a real-life setting of people living with HIV (PWH). Observational longitudinal multicentre cohort study from Italy. Consecutive 983 PWH were enrolled in "STOP Smoking in HIV people" (STOPSHIV) projects and followed from July 2014 until September 2023. The observed MCE defined as cardiovascular (CV) events, neoplastic diseases or death for any reason was assessed according smoking status and related variables (number of cigarettes smoked daily, pack-years, Fagerström test) in participants. The association between exposure variables and the event was evaluated using the Cox proportional hazard model (hazard ratios, HR, and 95% CI). Over 6997.6 person-years of follow-up (PYFU), we found a total of 49 CV events, 61 neoplastic events, and 47 deaths. The overall incidence rate of MCE was 17.6 /1000 PYFU (95% confidence interval 14.7-21.0). All-cause death rate was 6.7 (95% CI 5.0-8.9)/1000 PYFU. In a multivariate analysis, older age (HR 1.07, CI 1.05-1.09), high Fagerström Test for Nicotine Dependence (HR 1.09, CI 1.03-1.15), a low nadir CD4 <200 cells/mm3 (HR 1.63, CI 1.10-1.41), history of previous neoplasm (HR 2.41; CI 1.34-4.43) and intravenous drug use as risk factor for HIV infection (HR 2.36; CI 1.52-3.68) were independent predictors of any MCE. Non-AIDS clinical conditions are the most observed clinical events in PWH from Italy. Smoking exposure significantly increases the risk of MCE in PWH and a high Fagerström Test for Nicotine Dependence is a predictor of MCE.

The Staphylococcus aureus-antagonizing human nasal commensal Staphylococcus lugdunensis depends on siderophore piracy

BackgroundBacterial pathogens such as Staphylococcus aureus colonize body surfaces of part of the human population, which represents a critical risk factor for skin disorders and invasive infections. However, such pathogens do not belong to the human core microbiomes. Beneficial commensal bacteria can often prevent the invasion and persistence of such pathogens by using molecular strategies that are only superficially understood. We recently reported that the commensal bacterium Staphylococcus lugdunensis produces the novel antibiotic lugdunin, which eradicates S. aureus from the nasal microbiomes of hospitalized patients. However, it has remained unclear if S. lugdunensis may affect S. aureus carriage in the general population and which external factors might promote S. lugdunensis carriage to enhance its S. aureus-eliminating capacity.ResultsWe could cultivate S. lugdunensis from the noses of 6.3% of healthy human volunteers. In addition, S. lugdunensis DNA could be identified in metagenomes of many culture-negative nasal samples indicating that cultivation success depends on a specific bacterial threshold density. Healthy S. lugdunensis carriers had a 5.2-fold lower propensity to be colonized by S. aureus indicating that lugdunin can eliminate S. aureus also in healthy humans. S. lugdunensis-positive microbiomes were dominated by either Staphylococcus epidermidis, Corynebacterium species, or Dolosigranulum pigrum. These and further bacterial commensals, whose abundance was positively associated with S. lugdunensis, promoted S. lugdunensis growth in co-culture. Such mutualistic interactions depended on the production of iron-scavenging siderophores by supportive commensals and on the capacity of S. lugdunensis to import siderophores.EJt4aqYa_PFzdC4ihACHg3Video ConclusionsThese findings underscore the importance of microbiome homeostasis for eliminating pathogen colonization. Elucidating mechanisms that drive microbiome interactions will become crucial for microbiome-precision editing approaches.

A predictive model for secondary central nervous system infection after craniotomy based on machine learning

To analyze the risk factors of secondary Central nervous system infections (CNSIs) after craniotomy, and to establish an individualized predictive model for CNSIs risk. The independent risk factors were screened by univariate and multivariate logistic regression analysis. Logistic regression, naive bayes, random forest, light GBM and adaboost algorithms were used to establish predictive models for secondary CNSIs after craniotomy. The predictive model based on the Adaboost algorithm demonstrated superior prediction performance compared to the other four models. Under 5-fold cross validation, the accuracy was 0.80, the precision was 0.69, the recall was 0.85, the F1-score was 0.76, the area under the ROC curve was 0.897,and the average precision was 0.880. The top 5 variables of importance in Adaboost model were operation time, indwelling time of lumbar drainage tube, indwelling lumbar drainage tube during operation, indwelling epidural drainage tube during operation, and GCS score. In addition, Adaboost model with the best prediction performance was used for clinical verification, and the prediction results were compared with the actual occurrence of CNSIs after surgery. The results showed that the accuracy of Adaboost model in predicting CNSIs was 60%, the accuracy of Adaboost model in predicting non-CNSIS was 92%, and the overall prediction accuracy was 76%.

Serological evidence of tick-borne Crimean-Congo haemorrhagic fever and Dugbe orthonairovirus infections in cattle in Kwara State in northern Nigeria indicate independent endemics.

Crimean-Congo haemorrhagic fever orthonairovirus (CCHFV) and Dugbe orthonairovirus (DUGV) are zoonotic viruses transmitted by ticks. Whereas CCHFV has caused numerous human cases, DUGV, although less reported, shares ticks and ruminants as hosts. Since its first discovery in Nigeria in 1964, there has been no detailed sero-epidemiological investigation on DUGV in sub-Saharan Africa. This study is aimed at assessing the current seroprevalence and associated risk factors of CCHFV and DUGV infections in Nigerian cattle. Using a cross-sectional design with random sampling method, blood samples were collected from 877 cattle on pastoralist farms and at abattoirs in Kwara State, North-Central Nigeria. CCHFV IgG antibodies were detected in extracted sera using three panels of in-house indirect enzyme-linked immunosorbent assay (ELISA) based on bacteria-expressed recombinant nucleoprotein (rNP), the cattle-adapted VectoCrimean ELISA and the ID Screen CCHF double antigen multi-species ELISA, while DUGV IgG antibodies were detected using in-house indirect ELISA with bacteria-expressed rNP, indirect immunofluorescence assay and micro-Virus Neutralization test. Overall seroprevalence rates of 71.9% (631/877) and 52.8% (451/854) were obtained for CCHFV and DUGV, respectively. It was observed that 37.9% (314/829) of the cattle were co-exposed to both CCHFV and DUGV while 34.5% (286/829), 14.8% (123/829) and 12.8% (106/829) were exposed to single infections with CCHFV, DUGV or none of the two viruses, respectively. Multivariate analysis showed that only location, sex, age and tick infestation score were the risk factors that significantly affected CCHFV seroprevalence in cattle, while DUGV seroprevalence was significantly influenced by month of the year, location, cattle breed and sex (p<0.05). This is the first comprehensive sero-epidemiological surveillance for DUGV in sub-Saharan Africa. Our findings reveal widely distributed independent CCHFV and DUGV infections in cattle in Kwara State, Nigeria.

Infectious complications of Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review and meta-analysis.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe cutaneous adverse reactions to medications characterized by keratinocyte necrosis leading to loss of protective barrier function and increased susceptibility to infection. Infection is a major cause of morbidity, and septicemia is the leading cause of mortality in this population. This systematic review and meta-analysis aimed to determine infectious complications' prevalence and risk factors in adults with SJS and TEN. This review was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Thirty-six articles describing results from 1446 cases were included. Skin infection was the most commonly diagnosed infection. The pooled prevalence of sepsis, respiratory tract infection, skin infection, and urinary tract infection was 27.3%, 21.5%, 37.5%, and 21.8%, respectively. Staphylococcus aureus was the most commonly identified organism. The overall quality of the studies was suboptimal, and the level of heterogeneity was high. The skin, bloodstream, respiratory, and urinary tracts are most commonly infected in the course of adult SJS and TEN. During hospitalization, clinicians should closely monitor and promptly investigate for these as well as several other infectious complications. More research is needed, with greater attention to the risk factors and causative organisms that cause these infections.

Infection risk factor measurement based on spatial and temporal distribution of COVID-19 nucleic acid test sites: an example from Shenzhen

COVID-19 has profoundly impacted global daily life, emphasizing the need for effective virus suppression strategies. In response, China has established numerous nucleic acid testing sites to facilitate rapid testing and curb outbreaks. However, these sites often experience congestion, increasing transmission risks and reducing testing efficiency. This study focuses on the spatial–temporal analysis of testing site distribution and associated infection risks in Shenzhen, China. Data from all Shenzhen testing sites were analyzed for the week of October 24–30, 2022, noting the percentage of busy hours per site and incorporating a population size factor by district to assess regional infection risks. Findings indicate three daily peak testing times—primarily in the evening—with the highest risk of transmission in Longgang District, followed by Yantian and Luohu, and the lowest in Futian. The risk coefficient varied from 0.040 to 0.349, with most areas showing stable risk levels between 0.06 and 0.20. This research underlines the necessity for policymakers to alleviate congestion at testing sites and suggests increasing site availability in Longgang District to mitigate COVID-19 spread, offering methodological guidance for managing infection risks in other major Chinese cities.

Concomitant Cervical and Anal Screening for Human Papilloma Virus (HPV): Worth the Effort or a Waste of Time?

This study represents a follow-up analysis of the AnusGynecology (ANGY) study. This prospective, cross-sectional, single-center study recruited women for concomitant cervical and anal screening of HPV genotypes and cytology during a single appointment. All women with findings of either HPV or any type of dysplastic lesions on anal smears were offered follow-up in a specialized high-resolution anoscopy (HRA) outpatient clinic, representing the study cohort for this follow-up study. Overall, 275 patients (mean age 42 ± 12) were included. Among them, 102 (37%) had cervical high-risk (HR) HPV. In total, HPV was (incidentally) revealed in 91 patients (33%) on anal smears, while any degree of anal squamous intraepithelial lesion (SIL) was found in 30 patients (11%), 6 if which were high-grade SIL (H-SIL). Furthermore, 10 out of 19 biopsies were positive (3 H-SIL lesions). Only half (48/91, 53%) of the women agreed to undergo the recommended specialized follow-up evaluation. Of them, 18 (38%) were diagnosed with dysplastic lesions (9 low grade (L-SIL) and 9 H-SIL, respectively) on biopsies, while the remaining visits revealed no abnormalities. Multivariable analysis revealed cervical HR-HPV infection (OR 4, 95% CI 2.2-7.5) and anal intercourse (OR 3.1, 95% CI 1.7-5.9) as independent risk factors for anal HR-HPV infection. Close follow-up of these women is hence strongly recommended.

Recovery from rituximab-associated persistent hypogammaglobulinaemia in children with nephrotic syndrome.

There are limited data on the long-term outcomes and risk factors for non-recovery after development of rituximab (RTX)-associated persistent hypogammaglobulinaemia among children with idiopathic nephrotic syndrome (NS). A nationwide Japanese survey was conducted to determine the prognosis of patients with childhood-onset idiopathic NS who developed persistent hypogammaglobulinaemia after RTX administration. Specifically, predictors of IgG level recovery and risk factors for serious infection were examined. The cohort comprised 118 patients (66.1% boys; median age at initial RTX administration, 7.5 years). Among the 121 patients diagnosed with persistent hypogammaglobulinaemia, only 31 (26.3%) recovered within a median observation period of 2.8 years; approximately 70% of patients continued to exhibit persistent hypogammaglobulinaemia. Among the patients who recovered from hypogammaglobulinaemia, the median time to recovery was 14.1 months. Patients with a history of steroid-resistant NS were less likely to recover from persistent hypogammaglobulinaemia (hazard ratio, 0.28; 95% CI, 0.09-0.87). In addition, of the 118 eligible patients, 18 (15.3%) developed serious infections requiring hospitalization, and the main risk factor for infection during hypogammaglobulinaemia was agranulocytosis (a well-known adverse effect of RTX in children). A significant portion of patients with RTX-associated persistent hypogammaglobulinaemia did not exhibit recovery even after 1 year. Moreover, the data indicate that patients with a history of steroid-resistant NS have a significantly lower probability of recovering from this condition. Agranulocytosis under hypogammaglobulinaemia was significantly associated with an elevated risk of serious infections.

The association of serum level and polymorphisms of IFN-γ (rs2069705) with the susceptibility to cutaneous leishmaniasis

Leishmaniasis, a broad range of parasitic diseases, caused by Leishmania which is a flagellated intracellular protozoan parasite of the family Trypanosomatidae. The severity of leishmaniasis diseases ranges from minor cutaneous lesions to severe visceral illnesses that can be disfiguring and life-threatening. Cytokines are glycoprotein molecules produced by various cells in response to various immunological triggers. They regulate the body’s innate and adaptive immunological responses. The aim of this study was to clarify the association of serum level and polymorphisms of IFN-γ with susceptibility to cutaneous leishmaniasis (CL). The whole blood 200 samples were collected from patients and controls from Diyala Governorate/ Iraq from October 2022 to February 2023 which were used to measure IFN-γ polymorphisms using High Resolution Melting technique. Enzyme-linked immunosorbent assay was used to detect the serum level of IFN-γ. The findings of this investigation showed that the IFN-γ serum concentration elevated significantly in patients compared to controls (P < 0.01). Also, the study found that the highest mean level IFN-γ concentrations were found in adults aged 46–55 years old for patients compared with controls with significant differences (P < 0.01). While, no significant differences were observed in the rest age groups except children aged 5–15 years old. Additionally, significant differences between patients and controls were revealed by polymorphisms data in all genetic models for genotypes GA, AA, (GA + AA) and allele A with (P < 0.01) and OR > 1. However, the distribution of IFN-γ serum levels by SNP (rs2069705) demonstrated no differences between genotypes except GG genotype which has significant differences for patients comparing to the same genotype in controls. Taking together, the SNP for IFN-γ (rs2069705) could be a risk factor for susceptibility infection with CL. Also, considered the mutant allele A as a risk allele and genotype AA in codominant genetic model as more risk factor than the genotype GA.

Cumulative rabbit anti-human thymocyte globulin dose to recipient weight during the peri-operative period is an independent risk factor for early postoperative urinary tract infection after kidney transplantation

Anti-human thymocyte globulin-Fresenius (ATG-F) is frequently utilized to achieve successful induction for kidney transplantation recipients. This study aimed to examine the association between the ATG-F dose-to-recipient-weight ratio (ADR) and the risk of developing urinary tract infections (UTIs) following kidney transplantation. Data of kidney transplant recipients who underwent ATG-F-induction peri-operatively in a medical center were retrospectively collected, and the incidence of UTIs during the first postoperative year was also recorded. The risk of UTI associated with ADR was analyzed, and receiver operating characteristic curves were drawn to determine the optimal ADR, followed by Cox regression models. In total, 131 recipients were included, with an UTI incidence of 19.08% and a mean interval of 3.08 months. The optimal ADR was 6.34, involving 41 and 90 patients in the low ADR and high ADR groups, respectively. The UTI-free rate in the low ADR group was significantly higher than that in the high ADR group (p = 0.007). Cox regression analysis indicated that a high ADR independently increased the risk of UTI following kidney transplantation (hazard ratio: 5.306, 95% confidence interval: 1.243–22.660, p = 0.024). There was no significant difference in rejection rate between the high ADR and low ADR groups. In conclusion, a high ADR increased the incidence of early postoperative UTI among kidney transplant recipients.

Suppurative Granulomatous Osteomyelitis with Microcystic Changes Due to Mycobacterium chelonae- abscessus Complex

Abstract Introduction/Objective Mycobacterium chelonae and Mycobacterium abscessus are rapidly growing non-tuberculous mycobacterium found in soil and water, and represent rare causes of skin and soft tissue infection. Treatment typically involves an extended course of antimicrobial therapy and occasionally surgical debridement. Previous reports have described a distinctive pattern of suppurative granulomatous inflammation with microcystic changes in skin biopsies; however, the morphologic changes of M. chelonae-abscessus complex as a cause of osteomyelitis have not been well-documented in the literature. Methods/Case Report We searched our database from 2013 to 2024 for bone samples diagnosed as granulomatous inflammation in which M. chelonae or M. abscessus were identified on concurrent microbiology studies. Patient demographics, risk factors for infection, and treatment data were collected. Results (if a Case Study enter NA) Three patients with culture- or PCR-confirmed M. chelonae (2) or M. abscessus (1) were identified. All infections involved bones of the distal extremities. Patients were 57 years and older with risk factors for infection that included: diabetes (1), intravenous drug use (1), and long-term immunosuppressive therapy (1). All patients presented with osteomyelitis refractory to antibiotic therapy for which bone biopsy, bone resection, or amputation was performed. All cases showed suppurative granulomatous inflammation with microcystic changes. Cystic spaces were markedly enriched for acid-fast bacilli on Fite and/or Ziehl-Neelsen stains. In two patients, the antimicrobial regimen was changed as a result of the pathologic findings and microbiologic testing that provided additional information about speciation and susceptibilities. Conclusion Suppurative granulomatous inflammation has a broad differential that includes blastomycosis, sporotrichosis, cat scratch disease, non-tuberculous mycobacterial infection, and granulomatosis with polyangiitis, for which there are substantial treatment differences. When this pattern of microcystic suppurative granulomatous inflammation is encountered, it is important to perform special stains for acid-fast bacilli, particularly when seen in distal extremity lesions from patients with infections that are refractory to empiric antibiotic therapy.

Infection prevention in home dialysis

Purpose of review Among patients with kidney failure, home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis (HHD) provide several individual and healthcare system benefits over in-center hemodialysis (HD). Infection remains a major source of morbidity and mortality in this population, and a core outcome of critical importance to patients, caregivers, and kidney health professionals. This narrative review provides evidence-based measures for infection prevention among individuals receiving home dialysis, with a particular emphasis on dialysis and access-related infections. Recent findings Patient and care partner education and training is an important and major theme for infection prevention in home dialysis. In PD, identifying and managing modifiable risk factors for infections such as hypokalemia, constipation, use of gastric acid suppressants, and domestic pets, along with the use of antimicrobial prophylaxis, when indicated, can substantially reduce peritonitis risk. Reducing the use of central venous catheters (CVC), and duration of CVC dependence is the most effective means of prevention of HD access-related bloodstream infections in individuals receiving HHD. For arteriovenous fistula cannulation, rope ladder technique is associated with lower risk of infection compared to buttonhole cannulation. Summary Developing and instituting a well structured and evidence-based patient training and education program within home dialysis units is the most important measure in preventing and reducing dialysis and access-related infections. Kidney care providers should be familiar with different infection risk factors among individuals receiving home dialysis.

Clinical Features and Risk Factors of COVID-19-Associated Fungal Infections in Kidney Transplant Recipients

Objective: To investigate the clinical features, outcomes, and risk factors of fungal infections in kidney transplant recipients (KTRs) as a result of coronavirus disease 2019 (COVID-19). Methods: We retrospectively analyzed 54 KTRs with COVID-19 who were hospitalized at the China-Japan Friendship Hospital from December 1, 2022, to April 1, 2023. With a mean age of 50 ± 12 years, there were 43 men and 11 women participated. For KTRs with COVID-19, we employed multivariate logistic regression analysis to identify the risk factors. Results: Twenty (37.0%) patients in this study had fungal infections as a result of COVID-19. Patients with fungal infections had significantly higher rates of mortality (50.0%, 10/20 vs. 2.9%, 1/34, P &lt; 0.001), acute respiratory distress syndrome (ARDS) (65.0%, 13/20 vs. 26.5%, 9/34, P = 0.005), and acute kidney injury (AKI) (60%, 12/20 vs. 23.5%, 8/34, P = 0.007) than those without fungal infections. The result of the multivariate analysis showed that the incidence of fungal infections in KTRs with COVID-19 was independently correlated with age (increased by 10 years, OR = 2.221), history of diabetes mellitus (OR = 12.293), ARDS (OR = 12.849), and bacterial co-infections (OR = 30.461). Conclusion: Compared to KTRs without fungal infections, those with COVID-19-related fungal infections had worse clinical courses and less favorable results. The conditions including bacterial co-infections, ARDS, older age, and comorbidity of diabetes mellitus increased the incidence of secondary fungal infections.

25 years of experience on the management of enterococcal infective endocarditis an observational study.

As they are effective and well tolerated, aminopenicillins are still the cornerstone for the treatment of enterococcal infections. Current treatment guidelines for infective endocarditis (IE) recommend combination treatments, which carry a higher risk of adverse effects and are based on limited in vitro and experimental data. The aim of this study was therefore to evaluate the treatments of enterococcal IE in real-life practice. A total of 4121 episodes of enterococcal bloodstream infections, occurring between 1994 and 2019, were screened for the evidence of IE. Baseline characteristics, risk factors for complicated infections and treatment information were assessed and analyzed using Cox regression analysis. Overall, 80 (3.9%) IE episodes were identified of which 78 were included in the final analysis. Treatment regimens in our cohort comprised aminopenicillin-monotherapy (n = 20), teicoplanin-monotherapy (n = 26), other monotherapies (OMT) (n = 8), as well as combinations of ampicillin plus daptomycin (n = 8), ampicillin plus gentamicin (n = 4) or other combinations (n = 9). Overall mortality at 28-days was low (9 of 75) and increased to (19 of 75) after 6-months. Frequency of moderate to severe valve regurgitation (p = 0.89), or signs of uncontrolled infection (p = 0.5) and vegetation size ≥ 10mm (p = 0.11) were similar in the treatment groups. None of the treatment groups was associated with increased hazard for IE-related mortality. This retrospective study complements previous evidence, demonstrating that monotherapy regimens may be a suitable and effective option for the treatment of IE and supports the need for a prospective evaluation of aminopenicillin-monotherapy for initial and subsequent therapy in these patients.

Analysis of multi-site HPV infection and vaccination willingness among men who have sex with men in Tianjin, China.

Men who have sex with men (MSM) are vulnerable to HPV infection. This study aims to explore the HPV infection status at different sites among HIV-positive MSM, HIV-negative MSM, and men who have sex with women (MSW), and to investigate their willingness to receive HPV vaccination. From September 2023 to April 2024, three groups were recruited in Tianjin, China. Participants completed an electronic self-administered questionnaire, which included demographic information, knowledge related to sexually transmitted diseases, behavioral information, and willingness to receive the HPV vaccine. Samples were collected from the anal region, genitals, and oral cavity for HPV typing. A total of 1,559 participants were recruited, including 300 HIV-positive MSM, 600 HIV-negative MSM, and 659 MSW. The HPV infection prevalence for any site were 62.0, 53.7 and 8.3%, respectively (p < 0.001). The infection prevalence for HPV genes covered by the 9-valent vaccine were 47.0, 36.8, and 3.5%, respectively (p < 0.001). Co-infection prevalence at anal and genital were 20.3, 14.2, 0.6%, respectively. Co-infection prevalence at anal and genital and oral were 1.3, 0.3%, 0, respectively. A total of 77.0% HIV-positive MSM and 75.3% HIV-negative MSM expressed willingness to receive the HPV vaccine, whereas 58.9% of MSW were unwilling (p < 0.001). Being HIV-positive (aOR, 3.119; 95% CI, 2.213-4.395), being over 46 years old (aOR, 1.994; 95% CI, 1.266-3.142), with an occupation classified as "white collar workers" (aOR, 1.620; 95% CI, 1.111-2.362) and "freelancing" (aOR, 2.025; 95% CI, 1.371-2.993) and a history of homosexual behavior in the past 6 months (aOR, 5.338; 95% CI, 3.802-7.495) were risk factors for HPV infection among men in Tianjin. Consistently using condoms in the past 6 months (aOR, 0.667; 95% CI, 0.513-0.867) were protective factors. The HPV infection prevalence among MSM in Tianjin is significantly higher than among MSW, with higher prevalence in the anal region compared to the genital and oral region. HPV infection is associated with HIV infection, older age, and homosexual behavior. Most MSM showed a positive willingness to receive the HPV vaccine, indicating the necessity to implement targeted HPV vaccination programs for MSM and to enhance necessary preventive knowledge and behavioral interventions.

Prevalence and Associated Risk Factors of Helminth Infections in the Digestive Tract of Camels in Xinjiang, China.

Camels, vital to economies in Asia, Africa, and the Arabian Peninsula, have been domesticated for over 4000 years. They thrive in arid regions like Xinjiang, China, but face challenges from internal and external parasites, particularly gastrointestinal parasites, which impact health, meat and milk quality, and production efficiency. This study investigates the prevalence of gastrointestinal helminth infections in camels from five major regions in Xinjiang. We collected 435 fresh fecal samples and used the saturated saline flotation method and McMaster's method for detection. Molecular examination followed. The overall prevalence was 18.2% (95% confidence interval [CI]: 14.7-22.2%), with Urumqi showing the highest prevalence (29%, 95% CI: 23.4-35.1%) compared to other regions (odds ratio [OR]: 4.62, 95% CI: 2.63-8.41%). Younger camels (≤3 years old) were more likely infected by the parasites after adjusting for the region differences (OR: 10.53, 5.12-24.65%). However, we found no evidence that the prevalence was different between male and female camels. PCR analysis identified Trichostrongylus spp., Chabertia ovina, and Haemonchus contortus as predominant parasites, with observed co-infections indicating a complex parasitic landscape. The findings provide essential epidemiological data for effective parasite control strategies.