Risk Of Infection Research Articles

Harm Reduction Strategies for People Who Use Drugs

This JAMA Insights explores harm reduction strategies for people who use drugs and the clinicians who treat them to help reduce the risk of unintentional drug overdose and infection.

Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients

Whether exposing the microbiome to antibiotics decreases or increases the risk of blood stream infection with Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter, and Candida among ICU patients, and how this altered risk might be mediated, are critical research questions. Addressing these questions through the direct study of specific constituents within the microbiome would be difficult. An alternative tool for addressing these research questions is structural equation modelling (SEM). SEM enables competing theoretical causation networks to be tested ‘en bloc’ by confrontation with data derived from the literature. These causation models have three conceptual steps: exposure to specific antimicrobials are the key drivers, clinically relevant infection end points are the measurable observables, and the activity of key microbiome constituents on microbial invasion serve as mediators. These mediators, whether serving to promote, to impede, or neither, are typically unobservable and appear as latent variables in each model. SEM methods enable comparisons through confronting the three competing models, each versus clinically derived data with the various exposures, such as topical or parenteral antibiotic prophylaxis, factorized in each model. Candida colonization, represented as a latent variable, and concurrency are consistent promoters of all types of blood stream infection, and emerge as harmful mediators.

A multilevel analysis of factors associated with wasting in children one to two years old in Hamadan city

AbstractThe study aimed to identify risk factors for childhood wasting in 1–2 year-olds in Hamadan city, focusing on this age group due to infection and malnutrition risks. Unlike previous cross-sectional studies on children under 5 years old, this longitudinal study tracked weight-to-height changes over time. Data were analyzed from 455 mother-child pairs, aged 1–2 years, collected from health centers and recorded in the Integrated Electronic Health System (SIB). The weight-for-height index, an ordinal response with three categories (wasting, normal, and overweight), was measured several times. A two-level longitudinal ordinal model was used to identify factors associated with wasting. The analysis of data from 230 girls and 225 boys identified several factors associated with wasting: lower birth weight (Adjusted Odds Ratio (AOR) = 0.77), age 12–15 months (AOR = 1.15), lack of health insurance (AOR = 3.09), mother-child residence (AOR = 3.80), maternal height (AOR = 0.92), and age at pregnancy < 24 years (AOR = 4.71). The results of this study showed that most of the factors contributing to childhood wasting can be controlled and prevented. Therefore, implementation of targeted policies and appropriate interventions for mothers before, during, and after pregnancy could reduce the burden of childhood wasting.

Risk Assessment and Recommended Approaches to Optimize Infection Control and Antibiotic Stewardship to Reduce External Ventricular Drain Infection: A Single-Center Study

Background: An external ventricular drain (EVD) is used to release elevated intracranial pressure by draining cerebrospinal fluid (CSF) from the brain’s ventricles. The establishment of an EVD is one of the most commonly performed neurosurgical procedures to treat intracranial pressure in patients. Nevertheless, infections are very frequent complications. Identifying the risk factors for EVD-related infections is a key to improving patient safety and outcomes. Methods: We conducted a retrospective, single-center study of patients who underwent EVD implantation between January 2022 and March 2024. Patients were classified into infected and non-infected groups based on their clinical symptoms, as well as laboratory and microbiological results. Patient characteristics and possible risk factors for infection were compared between the two groups. Results: In total, 123 patients treated with 156 EVDs were included in this study, with a mean age of 55.8 (range: 25–84) years. EVD-associated infections were observed in 37 patients (30%). We found no significant association between infection risk and patient characteristics, including gender, primary diagnosis, craniotomy, or immunosuppression. There was no significant difference in terms of EVD insertion, i.e., whether the insertion took place in the operating room (OR) with antibiotic prophylaxis or outside the OR with no periprocedural antibiotic treatment. However, within the intensive care unit (ICU), EVD infection was much lower (13%) if EVD insertion took place in a single-bed room compared to multiple-bed room insertions (34%). Furthermore, there were significant differences in terms of the duration of first EVD (both single and multiple catheterizations) (p < 0.0001) and the total catheterization time (p = 0.0001). Additionally, there was a significant association with patient days in the ICU and EVD catheterization. Conclusions: Revisiting infection control measures is necessary, with special attention to the replacement of EVDs in single-bed ICU rooms, to introduce antibiotic prophylaxis in the ICU. Minimizing unnecessary EVD manipulation during catheterization is crucial in order to decrease the risk of EVD infection.

Validity of Mehrviru® and Sacace® in molecular detection of HPV: a latent class analysis.

Valid diagnostic tests for human papillomavirus (HPV) detection are crucial to identify individuals at high risk of cervical cancer. We assessed and compared the validity of Mehrviru HPV genotyping and Sacace (HPV Genotypes 14 Real-TM Quant) for molecular detection of 14 high-risk human papillomaviruses. We used three HPV test results to identify HPV-positive individuals (14 high-risk genotypes) in a specialist gynecology clinic. The HPV test results were collected using Mehrviru®, Sacace®, and a third kit from the clinical diagnostic laboratory. We used Latent class analysis to determine the actual status of HPV infection in study participants. The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, Youden, and area under the ROC curve indices of each diagnostic kit and their 95% confidence intervals were calculated. The agreement between the Mehrviru and Sacace kits was determined using the Kappa statistic. We examined 117 women at high risk of HPV infection. The mean age (SD) was 37.2 (9.1). According to LCA, 28.6% of participants had an HPV infection. The sensitivity and specificity (95% CI) of the Mehrviru were 90.8% (73.7-97.2%) and 90.9% (82.1-95.6%), and corresponding figures for Sacace were 92.0% (72.3-98.1%) and 97.4% (90.2-99.3%). The kappa index between the Mehrviru and Sacace kits was 69.7% (55.6-83.9%). The area under the ROC curve for Mehrviru and Sacace test were 91.4% (85.7-97.1%) and 94.4% (89.3-99.5%). There is an excellent agreement between Mehrviru and Sacace test results, and the diagnostic accuracy indices were similar.

Survival of a Patient Following Initial LVAD Implantation and Two Successive LVAD Exchanges: case report

Abstract Background Initially conceptualized as a bridge to heart transplantation, the Left Ventricular Assist Device (LVAD) has become an important option for improving survival in patients with severe heart failure and poor prognosis. Case summary We report the case of a patient suffering from severe chronic heart failure, complicated by ST-elevation myocardial infarction (STEMI) due to left main coronary artery (LMCA) stenosis (NYHA IV, INTERMACS profile 1). Despite support with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), inotropes and catecholamine therapy, the patient´s cardiac function did not recover sufficiently. Consequently, the decision was made to proceed with LVAD implantation as destination therapy. The initial LVAD implantation was uneventful, and the patient received anticoagulant therapy according to standard operating procedure (SOP). However pump thrombosis occurred on the first postoperative day, necessitating an LVAD exchange. Following an extended stay in the cardiac surgery intensive care unit (ICU), the patient was eventually discharged. Approximately 15 months later, the patient developed a driveline infection, involving most of the intrapericardial components of the LVAD. A second LVAD exchange was required and the patient received a third LVAD. To mitigate the risk of recurrent infection, suppressive antibiotic therapy with ampicillin/sulbactam was initiated. Discussion This is the first reported case of a patient surviving three LVAD implantations and highlights an instance of off-label use of lifelong antibiotic therapy following a driveline infection.

Properties, Production, and Recycling of Regenerated Cellulose Fibers: Special Medical Applications

Regenerated cellulose fibers are a highly adaptable biomaterial with numerous medical applications owing to their inherent biocompatibility, biodegradability, and robust mechanical properties. In the domain of wound care, regenerated cellulose fibers facilitate a moist environment conducive to healing, minimize infection risk, and adapt to wound topographies, making it ideal for different types of dressings. In tissue engineering, cellulose scaffolds provide a matrix for cell attachment and proliferation, supporting the development of artificial skin, cartilage, and other tissues. Furthermore, regenerated cellulose fibers, used as absorbable sutures, degrade within the body, eliminating the need for removal and proving advantageous for internal suturing. The medical textile industry relies heavily on regenerated cellulose fibers because of their unique properties that make them suitable for various applications, including wound care, surgical garments, and diagnostic materials. Regenerated cellulose fibers are produced by dissolving cellulose from natural sources and reconstituting it into fiber form, which can be customized for specific medical uses. This paper will explore the various types, properties, and applications of regenerated cellulose fibers in medical contexts, alongside an examination of its manufacturing processes and technologies, as well as associated challenges.

Review: Advances in Self-Preservation Techniques in Cosmetics Using Hurdle Technology

Preservatives are essential in cosmetic products to prevent microbial growth, extending product shelf life and ensuring user safety by minimizing infection risks. While traditional chemical preservatives have long been effective in protecting against microbial contamination, growing consumer concerns over their safety and potential health impacts are prompting a shift toward preservative-free or self-preserving cosmetic formulations. This shift has increased interest in developing products that maintain antimicrobial effectiveness without synthetic preservatives, with hurdle technology emerging as a promising approach.Originally applied in the food industry in the 1970s, hurdle technology involves combining multiple preservation strategies to inhibit microbial growth without relying on traditional preservatives. In cosmetic applications, hurdle technology can reduce or eliminate the need for synthetic preservatives by implementing several protective measures. These “hurdles” may include high manufacturing standards, protective packaging, emulsions that limit microbial growth, controlled water activity, and pH adjustments to create an environment less conducive to microbial survival.This review explores the adaptation of hurdle technology principles in cosmetics, focusing on techniques for creating self-preserving formulations. It highlights the role of multifunctional ingredients with natural antimicrobial properties, such as plant-derived essential oils, which can serve as alternatives to chemical preservatives. These ingredients not only inhibit microbial growth but also provide additional benefits, aligning with consumers' growing preference for natural, safe, and effective skincare options.

Infection Risk Associated with High-Efficacy Disease-Modifying Agents in Multiple Sclerosis: A Retrospective Cohort Study.

In patients with multiple sclerosis (MS), infections represent a significant concern, particularly given the immunomodulatory effects of disease-modifying agents (DMAs). High-efficacy DMAs (heDMAs) play a pivotal role in delaying MS progression, yet their use also raises concerns regarding the risk of infection. This study aimed to compare the infection risk with the use of heDMA and moderate-efficacy disease-modifying agents (meDMAs) in MS patients. This retrospective cohort study involved adult (18-64 years) MS patients with incident DMA use based on the 2015-2019 MarketScan Commercial Claims and Encounters Database. Patients initiating heDMAs (natalizumab, alemtuzumab, and ocrelizumab) or meDMAs (interferon beta-1a, interferon beta-1b, fingolimod, teriflunomide, dimethyl fumarate, and glatiramer acetate) were included. The outcomes of interest were comparative risk of overall infection, serious infection, and frequently reported types of infection. Adjusted hazard ratios (aHR) were estimated in inverse probability treatment weighting (IPTW) based on Cox proportional hazard models. Among 10,003 eligible incident DMA users, 22.92% of patients initiated heDMAs. The IPTW-CPH model revealed that patients with heDMAs were associated with a higher risk of serious infection (aHR: 1.24, 95% confidence interval (CI): 1.06-1.44) and urinary tract infection (UTI; aHR: 1.21, 95% CI: 1.14-1.30). Sensitivity analyses with different follow-up periods yielded consistent findings with the main analyses. In MS, heDMAs were associated with a greater risk of serious infection and UTI compared with meDMAs. These findings suggest the need to carefully monitor and manage the infection risk to optimize the use of heDMAs in MS.

Modelling indoor airborne transmission combining architectural design and people movement using the VIRIS simulator and web app.

A Viral Infection Risk Indoor Simulator (VIRIS) has been developed to quickly assess and compare mitigations for airborne disease spread. This agent-based simulator combines people movement in an indoor space, viral transmission modelling and detailed architectural design, and it is powered by topologicpy, an open-source Python library. VIRIS generates very fast predictions of the viral concentration and the spatiotemporal infection risk for individuals as they move through a given space. The simulator is validated with data from a courtroom superspreader event. A sensitivity study for unknown parameter values is also performed. We compare several non-pharmaceutical interventions (NPIs) issued in UK government guidance, for two indoor settings: a care home and a supermarket. Additionally, we have developed the user-friendly VIRIS web app that allows quick exploration of diverse scenarios of interest and visualisation, allowing policymakers, architects and space managers to easily design or assess infection risk in an indoor space.

Toward a better understanding of barriers to wayfinding technology use for people with disabilities

ABSTRACT Wayfinding is the process of navigating from one’s present location to their desired location. While wayfinding technologies are increasingly used by people with disabilities, there is little understanding of the barriers specific to wayfinding technology. The objective of this study was to understand the wayfinding technology barriers experienced by Canadians with disabilities. A total of 213 participants with varying disabilities (i.e. mobility, visual, hearing, memory and learning disabilities) completed a survey of open-ended questions about their personal experiences with different types of technologies. Technologies were categorized into public (i.e. digital and tactile interfaces) and personalized (i.e. mobile/website applications, wearable devices, smart assistive devices), and qualitative content analysis was used. Main themes were identified and either common across both groups (i.e. compatibility, demands on personal resources, information provision, interactability) or specific to one technology type (i.e. stigma, specific to personalized technology). Detailed subthemes provided greater specificity on the types of barriers encountered. For example, infection risk was noted as a barrier to public technology and high costs was a barrier for personalized technology. Results support the inclusion of wayfinding technology within accessibility standards and provide insights to clinicians on how to best support people with disabilities and their use of technology.

SUPERLOTAÇÃO DOS SERVIÇOS DE EMERGÊNCIA: IMPLICAÇÕES PARA A SEGURANÇA DO PACIENTE E PARA O TRABALHO DA EQUIPE DE SAÚDE

Introduction: Overcrowding in emergency services is a reality that is likely to worsen, making it necessary to implement measures to ensure patient safety in the care provided. Objective: To describe the implications of overcrowding for patient safety and the work/daily routine of the healthcare team. Methodology: This is a bibliographic review article in which an exploratory, qualitative approach was used. The search for articles, theses, dissertations, book chapters was conducted in databases such as Lilacs BDNF, Medline, Scielo, and university repositories containing scientific journals. Publications were sought that addressed the topic in Portuguese, within the period of 2015 to 2024. The results yielded 34 articles related to the topic, of which 12 were selected for this study, in addition to the book by the Joint Commission International (JCI), “Managing Patient Flow: Strategies and Solutions for Overcoming Overcrowding.” Results and Discussion: It is well known that patient safety is a globally discussed topic and a recurring requirement for institutions undergoing accreditation processes. In this context are healthcare professionals, who, due to the nature of their work, are subject to committing/experiencing adverse events within their professional environment. Final Considerations: The consequences of overcrowding bring numerous implications for the work of healthcare professionals and for patient safety, such as reduced quality of care, exhaustion of healthcare professionals, increased risk of infections, inequality in access to care, impact on the efficiency of the healthcare system, and increased costs, making it a critical challenge for both public and private healthcare systems.

Disparities in Vaccination Amongst Socially Vulnerable Patients with Inflammatory Bowel Disease.

Social determinants of health (SDOH) have a known impact on disparities in vaccination. Despite an increased risk for infection in patients with inflammatory bowel disease (IBD), SDOH and vaccination in this population have not been studied. Using census tract-level data from the Centers for Disease Control's social vulnerability index (SVI), we aimed to understand the relationship between SDOH and adherence to guideline-recommended vaccinations in patients with IBD. A single-center retrospective cohort of patients with IBD was used to geocode patient addresses to their individual census tract and corresponding SVI and subthemes (Socioeconomic Status, Household Composition, Minority Status, and Housing/Transportation). We used separate multivariable logistic regressions to examine the relationship between SVI and vaccination against influenza, COVID-19, pneumococcal pneumonia, and herpes zoster. A total of 7,036 patients were included. Rates of vaccination varied across vaccine-types: influenza (57%), COVID-19 (65%), pneumococcal pneumonia (58%), and herpes zoster (11%). High social vulnerability was associated with lower odds of vaccination against influenza (OR 0.47, p < 0.001), COVID-19 (OR 0.54, p < 0.001), pneumonia (OR 0.73, p = 0.012), and herpes zoster (OR 0.39, p < 0.001). Within the SVI subthemes, Socioeconomic Status, Household Composition, and Minority Status were important factors associated with differences in vaccine uptake. Higher social vulnerability was associated with lower rates of vaccination across all vaccine types. Identifying these disparities in vaccination for socially vulnerable patients with IBD is the first step to reducing preventable infections and ensuring all patients receive high quality, equitable care.

Prophylactic closed-incisional negative pressure wound therapy following posterior instrumented spinal fusion: a single surgeon's experience and cost-benefit analysis.

Surgical site infections (SSIs) following spine surgery are associated with morbidity and resource utilization. Applying prophylactic closed-incisional negative pressure wound therapy (ciNPWT) during posterior instrumented fusion has mixed results in reducing rates of wound complications and SSI. We evaluated the clinical efficacy and potential cost-savings associated with ciNPWT in high-risk patients receiving posterior instrumented spinal fusion. We retrospectively reviewed patients receiving posterior instrumented spinal fusion for any surgical indication between July 1, 2017 and December 31, 2019, and compared rates of wound dehiscence, SSI, and reoperation for wound complications between standard surgical dressings and ciNPWT. Surgical dressing selection was based on the senior author's assessment of infection risk factors. A total of 229 patients (n = 85 standard surgical dressings, n = 144 ciNPWT) were included. The ciNPWT group had significantly more risk factors for wound-related complications, including older age (61.8 vs. 58.5 years, p = 0.042), diabetes mellitus (36.8% vs. 23.5%, p = 0.037), more instrumented levels (5.6 vs. 3.9, p < 0.0001), estimated blood loss (1298 vs. 998 mL, p = 0.036), and deformity was the predominant operative indication (29.9% vs. 17.7%, p = 0.040). Prophylactic ciNPWT was associated with significantly lower rates of wound dehiscence (21.5% vs. 34.1%, p = 0.036) and SSI (8.3% vs. 21.2%, p = 0.005). Number needed to treat with ciNPWT to prevent one SSI was 8 patients. The cost of preventing one SSI was $4,560. Cost-benefit analysis demonstrated a potential mean savings of $21,662 per operative SSI prevented and $270,775 per 100 patients undergoing posterior instrumented fusion with ciNPWT. Prophylactic ciNPWT use is a cost-effective means of reducing rates of wound dehiscence and SSI following posterior instrumented fusion.

Perceptions of distinctions between patient and healthcare zones among intensive care unit nurses at a Korean tertiary hospital: A cross-sectional study.

Intensive care unit (ICU) patients face higher infection risks from invasive procedures, highlighting the critical role of ICU nurses in infection prevention. Clear differentiation between the patient and healthcare zones is essential for effective hand hygiene and disinfection, yet research on this topic is limited. To assess ICU nurses' perception of the concept of patient and healthcare zones and evaluate their similarity and accuracy in identifying the zones. A descriptive survey was conducted at a 2,732-bed tertiary hospital in Korea from 28 July to 27 August 2022. Participants were recruited from various ICUs through flyers. 225 questionnaires-with illustrations 27 item locations for three ICU scenarios-were made available at nursing stations for voluntary completion. Participants were asked to classify items into the patient zone or the healthcare zone. Similarity scores reflected participant agreement, while accuracy scores measured the proportion of correct answers. Participants' free-text opinions regarding zone classification were analysed thematically. 104 nurses participated voluntarily. Average similarity and accuracy were 84.7% and 82.7%, respectively. The top 8 items, with over 97% similarity and accuracy, were all frequently in contact with ICU patients (e.g., pulse oximeter, Levin tube, central line, urine bag, and patient bed). The bottom 7 items, with less than 80%, included the glucometer, flashlight, trolley, and sink. Participants with higher education levels had significantly higher similarity (p = .044) and accuracy (p = .033), whereas those already familiar with the patient-zone concept had significantly higher accuracy (p = .009). From the free-text analysis, participants considered factors beyond proximity to the patient, such as patient contact, room type, and distance. To address zone classification challenges, clear criteria for patient and healthcare zones, space redesign, and educational programs are recommended. Further research is necessary to improve greater clarity and consensus regarding patient and healthcare zones to enhance infection control practices.

Effects of establishing infection control program with core components of World Health Organization on reducing the risk of residents' infections and improving staff infection control competency in a nursing home.

Nursing homes (NHs) are high-risk facilities with limited infection control resources and residents susceptible to infectious diseases. The evidence regarding World Health Organization (WHO) core components in NHs is lacking. This study evaluates the effectiveness of establishing an infection prevention and control (IPC) program with WHO's core components in an NH. The IPC program, encompassing evidence-based guidelines, education and training, surveillance, multimodal strategies, monitoring and feedback, workload and staffing considerations, and the built environment, was implemented in a 130-bed NH for one year. The effects were assessed based on the number of infections among residents, the level of knowledge, and the performance of infection control among staff. The risk of infection was analyzed across three phases: pre-implementation phase, implementation phase (6 and 12 months after intervention initiation), and sustainability phase (3, 6, and 12 months after intervention was finished). Staff data were analyzed before and after the intervention. Analysis of 18,124 resident-days revealed that during the sustainability phase, the risk of respiratory tract infection was significantly lower than before intervention implementation (odds ratio [OR] 0.51, 95% CI 0.30-0.86, p = 0.012). Moreover, a significant improvement was observed in staff knowledge (p = 0.002) and performance (p < 0.001) after the intervention compared to before. WHO's core components may have a potential effect on reducing healthcare-associated infections among residents and enhancing the infection control competency of staff in the NH with limited IPC resources.

Antibiotic consumption patterns in older adults: a comparative study of people 65 years and older in and outside nursing homes, Belgium, 2016 to 2022.

BackgroundInappropriate antimicrobial consumption (AMC) drives the emergence of antimicrobial resistance. Institutionalised, older populations are associated with antimicrobial treatments of longer duration and broader spectrum than recommended, higher rates of multidrug-resistant infections and poorer outcomes for resistant infections. Yet systematic, national monitoring of AMC in nursing home (NH) residents is lacking.AimTo perform a retrospective analysis of antibiotic consumption in Belgian NHs, we compared analogous populations inside and outside NHs. We aimed to provide a blueprint for establishing surveillance of NH AMC, based on national reimbursement data.MethodsThe National Institute for Health and Disability Insurance supplied reimbursement AMC data for outpatients from 2016 to 2022. Data were classified by the Anatomical Therapeutic Chemical system, expressed as defined daily doses (DDD) and aggregated by prescription month, patient age, sex and residency inside/outside a NH. The number of ensured beneficiaries, aggregated by the same demographic variables, was collected from the Intermutualistic Agency. We compared the DDDs per 1,000 beneficiaries per day, along with secondary metrics for national and international targets for analogous populations inside and outside NHs.ResultsTotal antibiotic consumption decreased in both populations but remained twofold higher in NH residents. Proxy prescription quality metrics were consistently less favourable within NHs and diverged further during the COVID-19 pandemic. Distinct consumption patterns and greater seasonal fluctuations were observed in NH residents.ConclusionGiven the different infection risks and higher antibiotic consumption of NH residents, AMC surveillance and antimicrobial stewardship efforts targeting this fragile population are needed.

HIV incidence and recreational drug use among men who have sex with men aged 18-24 years in Tianjin, China: a retrospective cohort study.

Recreational drug use has been identified as a significant risk factor for the transmission of human immunodeficiency virus (HIV). This behavior is particularly prevalent among young men who have sex with men (YMSM). However, limited research has been conducted to investigate the correlation between recreational drug use and HIV incidence within this population. To examine HIV incidence and explore the association between recreational drug use and HIV incidence among YMSM. A retrospective cohort study was conducted by a local non-governmental organization (NGO) among MSM aged 18-24 years from October 2017 to December 2023 in Tianjin, China. Participants were included if they had at least two HIV test records during this period. HIV incidence density and its 95% confidence interval (CI) were calculated using person-years (PYs) with a Poisson distribution. Risk factors for HIV incidence were identified using univariable and multivariable Cox proportional hazards regression models. A total of 56 HIV seroconversions were reported with 2901.9 PYs, resulting in an overall incidence density of 1.9/100 PYs (95% CI: 1.4-2.4). Among YMSM who do not use recreational drugs (YMSM-URD), the incidence density was 1.1/100 PYs (95% CI: 0.5-1.6), while it was 2.8/100 PYs (95% CI: 1.9-3.7) among those who do use recreational drugs (YMSM-RD). Adjusted for confounders, factors associated with HIV infection included recreational drug use (adjusted hazard ratio = 2.6, 95% CI = 1.4-4.7) and unprotected anal intercourse in the past six months (adjusted hazard ratio = 2.3, 95% CI = 1.2-4.4). Recreational drug use and unprotected anal intercourse significantly increase the risk of HIV infection. To effectively mitigate the spread of HIV, interventions should focus on these risk factors by employing HIV counseling and testing clinics, collaborating with NGOs focused on MSM, and establishing peer education programs aimed at YMSM.

Light-Activable Inhibitor Overcomes Antimicrobial Resistance and Regulates Antibacterial Activity.

Overuse of antibiotics and the widespread environmental accumulation of antibiotics drive the evolution and spread of antimicrobial resistance, posing a significant global health threat by reducing the effectiveness of available treatments and increasing the risk of untreatable infections. We designed and synthesized PhoPS, a novel photocaged β-lactamase inhibitor, which incorporates the pharmacophore of sulbactam caged with a photoresponsive moiety of o-nitrobiphenyl derivative. Experimental results demonstrate its rapid photoactivation, good stability in solution, and light-activated β-lactamase inhibition in vitro. PhoPS displays synergy with a cephalosporin antibiotic cefoperazone against both susceptible and resistant strains of Escherichia coli and biofilm formation. Additionally, PhoPS treatment demonstrates the potential to suppress the development of resistance in E. coli. These findings suggest that PhoPS offers a promising approach for restoring the efficacy of existing antibiotics and mitigating the emergence of AMR.

Effects of Routine Catheterization on Urinary Tract Infection Rates After Minor Gynecologic Surgeries

This pilot study describes urinary tract infection (UTI) rates after routine single catheterization during minor gynecologic surgeries at a tertiary care community hospital. Records from 762 patients from 2021 were reviewed, including procedures such as hysteroscopy, loop electrosurgical excision procedure, and dilation and curettage. Findings revealed a 42.4% catheterization rate, with a significantly higher proportion of catheterized patients having UTIs (5.6%) compared with noncatheterized patients (2.5%). This study suggests that catheterization, unless medically necessary, should be avoided to reduce nosocomial infection risk. These results advocate for reconsidering current practices to enhance patient care and minimize preventable UTIs.