Risk Of Bacterial Infections Research Articles

A non-contact interactive system for multimodal surgical robots based on LeapMotion and visual tags.

In recent years, the integration of robots in minimally invasive surgery has gained significant traction in clinical practice. However, conventional contact-based human-computer interaction poses the risk of bacterial infection, significantly limiting the role of robots in surgery. To address this limitation, we propose an innovative interaction method rooted in gestures and visual tags, allowing surgeons to control and fine-tune surgical robots without physical contact with the environment. By encoding the six gestures collected using LeapMotion, we can effectively control the surgical robot in a non-contact manner. Moreover, utilizing Aruco technology, we have accurately identified the 3D spatial position of the visual label, and developed 12 fine-tuning operations to refine surgical instruments. To evaluate the applicability of our proposed system in surgery, we designed a relevant experimental setup. In the experiment, we achieved enough precision. These results demonstrate that our system meets the clinical standard, providing doctors with a non-contact and flexible means of interacting with robots during surgery.

Is Ophthalmia Neonatorum Associated With Invasive Bacterial Infection? A Single-Center Retrospective Study.

Ophthalmia neonatorum (ON) is a conjunctivitis occurring in neonates and can be caused by multiple bacterial pathogens. The risk of invasive bacterial infection (IBI) in neonates with ON is poorly known. Our objectives were to document the association of ON with IBI in term neonates and to investigate practice variation. This was a retrospective observational study of all neonates who presented to a single emergency department (ED) between January 2018 and December 2019. Participants were all children with a final diagnosis of ON according to the treating physician as registered in the ED computerized database. Newborns with craniofacial malformations and premature infants were excluded. The primary outcome was IBI as defined by growth of any bacterial pathogen in the blood or cerebrospinal fluid. Perinatal risk factors, ED visit details (symptoms on presentation, management, and treatment plan) as well as complications (ocular morbidity, death, and unscheduled return visits) were collected. Data were analyzed using descriptive statistics. Fifty-two term neonates were included. There were no cases of IBI associated with ON (0%; 95% confidence interval [CI], 0%-6.9%). Six ocular bacterial infections were identified, one of which was Chlamydia trachomatis. Although there were no IBIs, ocular complications, deaths, or unscheduled return visits to the ED, there was a wide variation in physician's management of ON. Physicians ordered investigations in 49% (95% CI, 34%-62%) of neonates, prescribed antibiotics to 87% (95% CI, 74%-94%), and involved specialists in 39% (95% CI, 27%-52%) of cases. Emergency department presentations of term neonates with ON are associated with a low risk of IBI. A better understanding of the current practice variation is needed to inform clinical guidelines for the management of neonates with ON presenting to the ED.

Effect of incarceration and opioid agonist treatment transitions on risk of hospitalisation with injection drug use-associated bacterial infections: A self-controlled case series in New South Wales, Australia

BackgroundTransitional times in opioid use, such as release from prison and discontinuation of opioid agonist treatment (OAT), are associated with health harms due to changing drug consumption practices and limited access to health and social supports. Using a self-controlled (within-person) study design, we aimed to understand if these transitions increase risks of injection drug use-associated bacterial infections. MethodsWe performed a self-controlled case series among a cohort of people with opioid use disorder (who had all previously accessed OAT) in New South Wales, Australia, 2001-2018. The outcome was hospitalisation with injecting-related bacterial infections. We divided participants’ observed days into time windows related to incarceration and OAT receipt. We compared hospitalization rates during focal (exposure) windows and referent (control) windows (i.e., 5-52 weeks continuously not incarcerated or continuously receiving OAT). We estimated adjusted incidence rate ratios (aIRR) using conditional logistic regression, adjusted for time-varying confounders. ResultsThere were 7590 participants who experienced hospitalisation with injecting-related bacterial infections (35% female; median age 38 years; 78% hospitalised with skin and soft-tissue infections). Risk for injecting-related bacterial infections was elevated for two weeks following release from prison (aIRR 1.45; 95%CI 1.22–1.72). Risk was increased during two weeks before (aIRR 1.89; 95%CI 1.59–2.25) and after (aIRR 1.91; 95%CI 1.54–2.36) discontinuation of OAT, and during two weeks before (aIRR 3.63; 95%CI 3.13–4.22) and after (aIRR 2.52; 95%CI 2.09–3.04) OAT initiation. ConclusionRisk of injecting-related bacterial infections varies greatly within-individuals over time. Risk is raised immediately after prison release, and around initiation and discontinuation of OAT. Social contextual factors likely contribute to excess risks at transitions in incarceration and OAT exposure.

167 Risk of Serious Bacterial Infections in Febrile Infants Aged 7-90 Days With COVID-19

167 Risk of Serious Bacterial Infections in Febrile Infants Aged 7-90 Days With COVID-19

Respiratory viral infection and resolution of inflammation: Roles for specialized pro-resolving mediators.

Respiratory viral infections with influenza A virus (IAV) or respiratory syncytial virus (RSV) pose a significant threat to public health due to excess morbidity and mortality. Dysregulated and excessive inflammatory responses are major underlying causes of viral pneumonia severity and morbidity, including aberrant host immune responses and increased risk for secondary bacterial infections. Currently available antiviral therapies have not substantially reduced the risk of severe viral pneumonia for these pathogens. Thus, new therapeutic approaches that can promote resolution of the pathogen-initiated inflammation without impairing host defense would represent a significant advance. Recent research has uncovered the potential for specialized pro-resolving mediators (SPMs) to transduce multipronged actions for the resolution of serious respiratory viral infection without increased risk for subsequent host susceptibility to bacterial infection. Here, we review recent advances in our understanding of SPM production and SPM receptor signaling in respiratory virus infections and the intriguing potential of harnessing SPM pathways to control excess morbidity and mortality from IAV and RSV pneumonia.

Invasive Bacterial Infections in Children With Sickle Cell Disease: 2014-2019.

Children with sickle cell disease (SCD) are at a high risk of invasive bacterial infections (IBI). Universal penicillin prophylaxis and vaccination, especially against Streptococcus pneumoniae, have deeply changed its epidemiology. Analysis of IBI in children with SCD in a post-13-valent pneumococcal vaccine era is limited. Twenty-eight pediatric hospitals from 5 European countries retrospectively collected IBI episodes in SCD children aged 1 month to 18 years between 2014 and 2019. IBI was defined as a positive bacterial culture or polymerase chain reaction from a normally sterile fluid: blood, cerebrospinal, joint, or pleural fluid and deep surgical specimen. We recorded 169 IBI episodes. Salmonella spp. was the main isolated bacteria (n = 44, 26%), followed by Streptococcus pneumonia (Sp; n = 31, 18%) and Staphylococcus aureus (n = 20, 12%). Salmonella prevailed in osteoarticular infections and in primary bacteremia (45% and 23% of episodes, respectively) and Sp in meningitis and acute chest syndrome (88% and 50%, respectively). All Sp IBI occurred in children ≤10 years old, including 35% in children 5 to 10 years old. Twenty-seven (17%) children had complications of infection and 3 died: 2 because of Sp, and 1 because of Salmonella. The main risk factors for a severe IBI were a previous IBI and pneumococcal infection (17 Sp/51 cases). In a post-13-valent pneumococcal vaccine era, Salmonella was the leading cause of bacteremia in IBI in children with SCD in Europe. Sp came second, was isolated in children ≤10 years old, and was more likely to cause severe and fatal cases.

Febrile infants risk score at triage (FIRST) for the early identification of serious bacterial infections

We aimed to derive the Febrile Infants Risk Score at Triage (FIRST) to quantify risk for serious bacterial infections (SBIs), defined as bacteremia, meningitis and urinary tract infections. We performed a prospective observational study on febrile infants < 3 months old at a tertiary hospital in Singapore between 2018 and 2021. We utilized machine learning and logistic regression to derive 2 models: FIRST, based on patient demographics, vital signs and history, and FIRST + , adding laboratory results to the same variables. SBIs were diagnosed in 224/1002 (22.4%) infants. Among 994 children with complete data, age (adjusted odds ratio [aOR] 1.01 95%CI 1.01–1.02, p < 0.001), high temperature (aOR 2.22 95%CI 1.69–2.91, p < 0.001), male sex (aOR 2.62 95%CI 1.86–3.70, p < 0.001) and fever of ≥ 2 days (aOR 1.79 95%CI 1.18–2.74, p = 0.007) were independently associated with SBIs. For FIRST + , abnormal urine leukocyte esterase (aOR 16.46 95%CI 10.00–27.11, p < 0.001) and procalcitonin (aOR 1.05 95%CI 1.01–1.09, p = 0.009) were further identified. A FIRST + threshold of ≥ 15% predicted risk had a sensitivity of 81.8% (95%CI 70.5–91.0%) and specificity of 65.6% (95%CI 57.8–72.7%). In the testing dataset, FIRST + had an area under receiver operating characteristic curve of 0.87 (95%CI 0.81–0.94). These scores can potentially guide triage and prioritization of febrile infants.

Plateau pika fecal microbiota transplantation ameliorates inflammatory bowel disease manifestations in a mouse model of colitis.

Inflammatory bowel disease (IBD) is a serious global public health concern. Although the pathogenesis of the disease is currently unknown, it has been reported to be associated with both intestinal microbiota and inflammatory mediators. There is evidence suggesting that the feces of the Plateau pika is useful for treating gastrointestinal injuries and pain. Although fecal microbiota transplantation is highly efficacious intervention for IBD prevention, however, potential the transfer of pathogenic microbes or toxic substances is potentially hazardous. Fortunately, micropore filtering of the donor feces can minimize the risk of bacterial infection allowing retention of the therapeutic effects of the residual bacteriophages. Here, we demonstrated that Plateau pika feces not only alleviated the IBD symptoms but also promoted optimal structure and composition of the intestinal microbiota. Additionally, Plateau pika feces transfer also enhanced phenotypic features, such as, body-weight, disease activity index, and histological scores. In conclusion, Plateau pika feces was found to protect mice against colitis induced by dextran sodium sulfate by reducing inflammation and regulating microbial dysbiosis. These findings suggest the potential of Plateau pika feces as an alternative therapy for IBD.

Empiric antimicrobial therapy in the intensive care unit based on the risk of multidrug-resistant bacterial infection: a single-centre case‒control study of blood culture results in Japan

BackgroundInfections and sepsis are the leading causes of death in intensive care units (ICUs). Antimicrobial agent selection is challenging because the intervention is directly related to the outcome, and the problem of antimicrobial resistance (AMR) must be considered. Therefore, in this study, we aimed to clarify the epidemiological data and examine whether the detection rate of multidrug-resistant (MDR) bacteria differed depending on the presence or absence of the risk of MDR bacterial infections to establish guidance regarding the choice of antimicrobial therapy for ICU patients.MethodsThis retrospective case‒control study was performed in a single ICU in Japan. Patients admitted to the ICU who underwent blood culture (BC) analysis were considered for inclusion in this study; patients were at risk of MDR bacterial infections, and controls were not. The primary outcome measure was the detection rate of MDR bacteria in BCs collected from patients and controls. The secondary outcome measure was the selection rate of anti-Pseudomonas and anti-methicillin-resistant Staphylococcus aureus (MRSA) drugs for patients and controls.ResultsAmong the 1,730 patients admitted to the ICU during the study period, BCs were obtained from 186 patients, and 173 samples were finally included in the analysis (n = 129 cases; n = 44 controls). No MDR bacteria or Pseudomonas aeruginosa were detected in the controls (14 (11%) vs. 0 (0%)) (P = 0.014) However, there was no difference in empiric antimicrobials, including anti-MRSA (30 (23%) vs. 12 (27%)) (P = 0.592) and anti-Pseudomonas aeruginosa (61 (47%) vs. 16 (36%)) (P = 0.208) drugs, that were administered to the two groups.ConclusionsEven in critically ill patients in the ICU, MDR bacteria are unlikely to be detected in patients without the risk of MDR bacterial infections. Therefore, for such patients, a strategy of starting empiric narrow-spectrum antimicrobial therapy rather than empiric broad-spectrum therapy should be considered. This strategy, in conjunction with daily updates of clinical and epidemiological data at each facility, will promote the appropriate use of antimicrobials and reduce the emergence of MDR bacteria in the ICU.Trial registration: None.

Chain entanglement-driven tough, fatigue-resistant PEG-based injectable hydrogel adhesive for joint skin wound healing

The development of effective wound dressings that can withstand the frequent movement and stretching of joint skin wounds remains a significant challenge. Traditional wound dressings are prone to damage or shedding, which increases the risk of bacterial infection and delays wound healing. To address this issue, a new type of injectable, stretchable, low hysteresis, and fatigue-resistant hydrogel (LZM/PEG) adhesive has been designed for wound healing in movable parts. The hydrogel is formed through the flexible chain entanglement of high molecular weight polyethylene glycol functionalized by Succinimide Carbonate (SC-PEG-SC) and Amidation crosslinking between LZM-NH2 and SC-PEG-SC. The long-chain of SC-PEG-SC enables the hydrogel to penetrate the surface of the target tissue, generating physical entanglements and covalent bonds with functional groups in the matrix, enabling close fitting of joint skin and wound healing without the need of secondary fixation. In a neck trauma model of full-thickness skin defect in vivo, the hydrogel dressing significantly promoted wound healing with milder inflammation, higher granulation tissue thickness and collagen disposition, demonstrating its potential for joint skin wound treatment in clinics. Overall, the LZM/PEG hydrogel is capable of adapting to the frequent movement of joint, promoting healing of joint skin wounds, which makes it a promising approach for joint skin wound treatment.

Preparation and investigation of a novel antibacterial collagen-based material loaded with gentamicin following surface modification with citric acid for corneal tissue engineering

Corneal disease is an important clinical problem that affects millions of blind people and keratoplasty is currently the most successful treatment for corneal blindness. Unfortunately, there is a very high risk of bacterial infection during corneal transplantation. In this study, we proposed a novel synthetic collagen-based film for corneal therapy, and we effectively incorporated aminoglycoside gentamicin molecules onto the surface of the collagen film. We anticipate that this collagen-based substance will be antimicrobial and repair corneal tissue damage. Three steps were used to create this gentamicin-modified carboxylated collagen film, including: (i) Cross-link the collagen molecules with 1-ethyl-3- (3-dimethylaminopropyl) carbodiimide and n-hydroxysuccinimide to create a collagen (Col) film. (ii) Citric acid was used to modify the Col film's surface in order to increase the number of carboxyl groups there (ColCA). (iii) Gentamicin molecules were grafted onto the surface of ColCA film by forming amide bonds (ColCA-GM). We discovered that this ColCA-GM film has good physicochemical properties and excellent biocompatibility. Furthermore, it was demonstrated that treating collagen films with citric acid significantly improved the antibacterial properties of ColCA-GM film. The outcomes point to a variety of potential applications for this novel film in corneal tissue engineering.

A Case Study of the Treatment Strategies Employed to Cure a COVID-19 Patient with Multiple Infections Successfully

The COVID-19 pandemic has given rise to new clinical challenges in healthcare settings. One of these challenges includes a heightened risk of secondary invasive bacterial and fungal infections, which have been associated with a notable mortality rate. We report a fatal case of a COVID-19 patient with two bacterial and one fungal infection successfully cured. A woman went to the hospital with fatigue, cough, chest and abdominal pain, nausea, and vomiting symptoms. She tested positive for COVID-19 and had underlying health conditions. She had a bacterial infection called Klebsiella Pneumoniae. The bacteria were resistant to many antibiotics, but colistin was effective. After 20 days in the ICU, she developed a fungal and Enterococcus faecalis(which was a Vancomycin-Resistant Enterococcus (VRE)) infection. The second bacteria were treated with linezolid. After 35 days in the hospital, she was discharged with no signs of infection. It is crucial to include proper bacterial screening and treatment when addressing COVID-19. Doi: 10.28991/SciMedJ-2023-05-03-02 Full Text: PDF

MANAGEMENT OF IRREGULAR ASTIGMATISM AFTER CORNEAL ULCER WITH RGP CONTACT LENS IN PATIENTS WITH HIGH MYOPIA

Introduction: RGP contact lenses are indicated for correcting refractive errors in cases of high myopia and irregular astigmatism due to changes in the corneal curvature. Case Report: A 30-year-old female came with complaints of redness, pain, glare, blurred vision, and yellow discharge and tearing on the left eye for 2 days, history of using Soft Contact Lens (SCL) since 10 years old due to myopia. Visual Acuity of the right eye (VOD) with glasses was 6/12 and VA of the left eye (VOS) was 1/300. The patient was diagnosed with left eye corneal ulcer and was given levofloxacin eye drops, hydroxypropyl methylcellulose eye drops, and vitamin C 1000 mg. The left eye's corneal ulcer healed after three days, but the scarring left the cornea's surface uneven.. Patients were advised to replace the contact lenses with RGP contact lenses. After the RGP fitting, the appropriate size was obtained in both eyes and the patient adapted well with VOD RGP 1.0 and VOS RGP 1.0 False. The patient felt helped by the RGP contact lens. Discussion: RGP was given because it helped reduce the bacterial infection risk. RGP has a higher oxygen transmissibility and maintains the cornea's curvature to become more regular. It can be utilized as an optical device to repair excessive myopia in addition to irregular astigmatism. Conclusion: RGP contact lens can be an option for irregular astigmatism after corneal ulcers due to the SCL use in patients with high myopia to provide good outcomes.

Antibacterial, conductive nanocomposite hydrogel based on dextran, carboxymethyl chitosan and chitosan oligosaccharide for diabetic wound therapy and health monitoring

Diabetic severe wound healing is challenging and also carries a high risk of bacterial infection and may be accompanied by serious complications. Electrical stimulation (ES) can effectively promote wound healing, but its effectiveness is often limited by incomplete contact between the electrodes and the wound site. In order to improve the efficiency of electrical stimulation utilization and to avoid wound infection, a multi-dynamically crosslinked nanocomposite hydrogel was prepared from dextran modified with aldehyde groups and phenylboronic acid esters (Dex-FA-BA), carboxymethyl chitosan (CMCS), polyaniline grafted chitosan oligosaccharide (CP), and Epigallocatechin Gallate/Ca2+ modified melanin-like nanoparticles (CEMNPs), based on dynamic Schiff base bonds, phenylboronic acid/diol interactions, and hydrogen bonding. The CEMNPs have good photothermal conversion properties and antioxidant activity and can also enhance the mechanical properties of the hydrogel system. The CP endows the hydrogel with good electrical conductivity and sensing properties and can record the respiratory and heart rate of rats in real time. Based on the convolutional neural networks (CNN) algorithm constructed by ResNet9, the respiratory and heart rate signals can be distinguished with 93.9 % accuracy. This multifunctional nanocomposite hydrogel can provide a new strategy to promote chronic wound healing and achieve health monitoring effectively.

Risk factors for bacterial infection following replantation of zone 1 amputation

Purpose: Bacterial infection is a critical complication influencing the survival of a replanted digit. This study aimed to identify risk factors for bacterial infection following zone 1 replantation. Methods: A retrospective chart review was conducted on patients who underwent zone 1 replantation from January 2016 to November 2022. The factors included in the comparative analysis were patient demographics (age, sex), past medical history (hypertension, diabetes mellitus), smoking, types of injury, degree of contamination, source of trauma, fractures, number of vascular anastomoses, use of salvage therapies, and the use of vein grafts. A bacterial infection was diagnosed based on observation of visible inflammatory signs with the results of culture studies. Results: In total, 313 patients were selected. Thirty-eight cases of bacterial infection were identified, which accounted for 12.1% of total patients. Methicillin-resistant &lt;i&gt;Staphylococcus epidermidis&lt;/i&gt; (MRSE) was the most prevalent bacterium (63.2%, 24 of 38 cases). The patient and injury-related factors showed no significant differences, but the number of vein anastomoses and use of salvage therapy were significantly correlated with the occurrence of bacterial infection. Conclusion: Performing fewer vein anastomoses appears to increase the likelihood of a salvage procedure, and subsequently increases the risk of bacterial infection by an increased need for direct wound manipulation after zone 1 replantation. Infections caused by MRSE were more commonly identified than those by &lt;i&gt;Aeromonas hydrophilia&lt;/i&gt;, which is a commonly known pathogen in medicinal leeches.

FeBRILe3: Safety Evaluation of Febrile Infant Guidelines Through Prospective Bayesian Monitoring.

Despite evidence supporting earlier discharge of well-appearing febrile infants at low risk of serious bacterial infection (SBI), admissions for ≥48 hours remain common. Prospective safety monitoring may support broader guideline implementation. A sequential Bayesian safety monitoring framework was used to evaluate a new hospital guideline recommending early discharge of low-risk infants. Hospital readmissions within 7 days of discharge were regularly assessed against safety thresholds, derived from historic rates and expert opinion, and specified a priori (8 per 100 infants). Infants aged under 3 months admitted to 2 Western Australian metropolitan hospitals for management of fever without source were enrolled (August 2019-December 2021), to a prespecified maximum 500 enrolments. Readmission rates remained below the prespecified threshold at all scheduled analyses. Median corrected age was 34 days, and 14% met low-risk criteria (n = 71). SBI was diagnosed in 159 infants (32%), including urinary tract infection (n = 140) and bacteraemia (n = 18). Discharge occurred before 48 hours for 192 infants (38%), including 52% deemed low-risk. At study completion, 1 of 37 low-risk infants discharged before 48 hours had been readmitted (3%), for issues unrelated to SBI diagnosis. In total, 20 readmissions were identified (4 per 100 infants; 95% credible interval 3, 6), with >0.99 posterior probability of being below the prespecified noninferiority threshold, indicating acceptable safety. A Bayesian monitoring approach supported safe early discharge for many infants, without increased risk of readmission. This framework may be used to embed safety evaluations within future guideline implementation programs to further reduce low-value care.

Characterization of aminoglycoside resistance genes in multidrug-resistant Klebsiella pneumoniae collected from tertiary hospitals during the COVID-19 pandemic.

Since the peak of the coronavirus disease 2019 (COVID-19) pandemic, concerns around multidrug-resistant (MDR) bacterial pathogens have increased. This study aimed to characterize aminoglycoside resistance genes in MDR Klebsiella pneumoniae (K. pneumoniae) collected during the COVID-19 pandemic. A total of 220 clinical isolates of gram-negative bacteria were collected from tertiary hospitals in Makkah, Saudi Arabia, between April 2020 and January 2021. The prevalence of K. pneumoniae was 40.5%; of the 89 K. pneumoniae isolates, MDR patterns were found among 51 (57.3%) strains. The MDR isolates showed elevated resistance rates to aminoglycoside agents, including amikacin (100%), gentamicin (98%), and tobramycin (98%). PCR assays detected one or more aminoglycoside genes in 42 (82.3%) MDR K. pneumoniae strains. The rmtD gene was the most predominant gene (66.7%; 34/51), followed by aac(6')-Ib and aph(3')-Ia (45.1%; 23/51). The aac(3)-II gene was the least frequent gene (7.8%; 4/51) produced by our isolates. The rmtC gene was not detected in the studied isolates. Our findings indicated a high risk of MDR bacterial infections through the COVID-19 outbreak. Therefore, there is a need for continuous implementation of effective infection prevention control (IPC) measures to monitor the occurrence of MDR pathogens and the emergence of MDR bacterial infections through the COVID-19 outbreak.

Antibiotics Prescriptions Pattern among Patients Visiting Primary Health Care Centers (PHCC) before and during COVID-19 Pandemic: A Cross-Sectional Population-Based Study from Qatar.

The COVID-19 pandemic, caused by the novel coronavirus 2 (SARS-CoV-2), has been associated with an increased risk of secondary bacterial infections. Numerous studies have reported a surge in antibiotic usage during the COVID-19 pandemic. This study aims to examine the impact of the COVID-19 pandemic on the frequency and patterns of antibiotic prescriptions at Primary Health Care Centers (PHCC) in Qatar, comparing the period before and during the pandemic. This population-based, cross-sectional study analyzed all antibiotic prescriptions issued in two-month intervals before COVID-19 (November and December 2019) and during the initial wave (June and July 2020) of COVID-19. The study included 27 PHCCs in Qatar. Prior to the COVID-19 outbreak, the PHCCs dispensed a total of 74,909 antibiotic prescriptions in November and December. During the first wave of COVID-19, the number decreased to 29,273 prescriptions in June and July 2020. Antibiotics were most commonly prescribed for adults and least commonly for the elderly, both before and during the COVID-19 period. In the pre-COVID-19 period, Betalactams and macrolides accounted for the majority (73%) of all antibiotic prescriptions across all age groups. However, during the COVID-19 period, Betalactams and other antibiotics such as Nitrofurantoin and Metronidazole (73%) were the most frequently prescribed. The rate of antibiotic prescriptions during the first wave of COVID-19 was lower compared to the two months preceding the pandemic at the PHCC in Qatar.

Choice of Polymer, but Not Mesh Structure Variation, Reduces the Risk of Bacterial Infection with Staphylococcus aureus In Vivo.

Synthetic mesh material is of great importance for surgical incisional hernia repair. The physical and biochemical characteristics of the mesh influence mechanical stability and the foreign body tissue reaction. The influence on bacterial infections, however, remains ill-defined. The aim of the present study was to evaluate the influence of a modified mesh structure with variation in filament linking on the occurrence of bacterial infection that is indicated by the occurrence of CD68+, CD4+, and CD8+ cells in two different materials. A total of 56 male Sprague Dawley rats received a surgical mesh implant in a subcutaneous abdominal position. The mesh of two different polymers (polypropylene (PP) and polyvinylidenfluoride (PVDF)) and two different structures (standard structure and bold structure with higher filament linking) were compared. During the implantation, the meshes were infected with Staphylococcus (S.) aureus. After 7 and 21 days, meshes were explanted, and the early and late tissue responses to infection were histologically evaluated. Overall, the inflammatory tissue response was higher at 7 days when compared to 21 days. At 7 days, PP meshes of the standard structure (PP-S) showed the strongest inflammatory tissue response in comparison to all the other groups. At 21 days, no statistically significant difference between different meshes was detected. CD8+ cytotoxic T cells showed a significant difference at 21 days but not at 7 days. PP meshes of both structures showed a higher infiltration of CD8+ T cells than PVDF meshes. CD4+ T helper cells differed at 7 days but not at 21 days, and PVDF meshes in a bold structure showed the highest CD4+ T cell count. The number of CD68+ macrophages was also significantly higher in PP meshes in a standard structure when compared to PVDF meshes at 21 days. The inflammatory tissue response to S. aureus infection appears to be highest during the early period after mesh implantation. PP meshes showed a higher inflammatory response than PVDF meshes. The mesh material appears to be more important for the risk of infection than the variation in filament linking.

The Impact of Respiratory Symptoms on the Risk of Serious Bacterial Infection in Febrile Infants < 60 Days Old.

We aimed to evaluate the impact of respiratory symptoms and positive viral testing on the risk of serious bacterial infections (SBIs). A retrospective study was conducted that included infants (0-60 days) presenting with a fever between 2001 and 2022 at a tertiary hospital in northern Israel. Demographic, clinical, and laboratory parameters were collected, and risk factors for SBIs were analyzed. Data from a total of 3106 infants, including data from blood, urine, and CSF cultures, were obtained in 96.6%, 89%, and 29% of cases, respectively. A fever without respiratory symptoms (fever only) was present in 1312 infants, while 1794 had a fever and respiratory symptoms-427 were positive for a respiratory virus (virus+), 759 tested negative (virus-), and 608 were not tested. The SBI rate was 5.1% vs. 7.5% in the fever-and-respiratory group vs. the fever-only group (p = 0.004, OR = 0.65 (95% CI = 0.49-0.88)) and 2.8% vs. 7% in the virus+ vs. virus- group (p = 0.002, OR = 0.385, (95% CI = 0.203-0.728)). The male gender, an age < 1 month, leukocytosis > 15 × 109/L, or a CRP > 2 mg/dL increased the risk of SBIs. Respiratory symptoms or a confirmed viral infection reduced the risk of SBIs in the presence of the above risk factors. Respiratory symptoms and a positive viral test decreased the risk of SBIs. Combining rapid viral testing with clinical variables may identify low-risk infants. Despite the relatively low risk of SBIs in individuals with viral infections, conducting prospective studies remains essential for accurately predicting the occurrence of these potentially life-threatening infections.