Significant Difference In Infection Rate Research Articles

No significant association between non-Helicobacter pylori Helicobacter infection with gastritis-related indices and gastric cancer

BackgroundNon-Helicobacter pylori Helicobacter (NHPH) has recently been linked to various gastric diseases. However, the relationship between NHPH infection and gastric cancer remains controversial. This study aimed to identify the effect of NHPH infection on gastritis and gastric cancer development. Materials and methodsFormalin-fixed paraffin-embedded tissues were obtained from 73 patients with gastric cancer, of whom 21 cases were Helicobacter pylori (Hp) current infection, 37 cases were Hp previous infection, and 15 cases were Hp naïve infection, and were screened for NPHPs using polymerase chain reaction. The results were compared with NHPH infection rates in the patients with gastritis-related diseases reported in the previous study. We evaluated the association of NHPH infection with gastritis and clinicopathological features of gastric cancer. ResultsNHPH infection rates were 4/21 (19%) in “Hp current” patients, 4/37 (11%) in “Hp previous” infection patients, and 1/15 (7%) in “Hp naïve” patients, showing no significant difference in infection rates based on Hp infection status. NHPH infection rates in gastric cancer patients were similar to those in the patients with gastritis-related diseases reported in the previous study. A comparison of NHPH-positive and negative patients showed no significant differences in atrophic gastritis status, serum gastritis markers, or clinicopathological characteristics of gastric cancer, such as localization, size, gross type, differentiation, or depth. ConclusionsThe association between gastric cancer and NHPH infection would have important implications for gastric cancer prevention, diagnostics, and treatment, however, no significant association was found in this particular population.

The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review.

Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.

MRNA versus inactivated virus COVID-19 vaccines in multiple sclerosis: Humoral responses and protectivity-Does it matter?

COVID-19 vaccines are recommended for people with multiple sclerosis (pwMS). Adequate humoral responses are obtained in pwMS receiving disease-modifying therapies (DMTs) after vaccination, with the exception of those receiving B-cell-depleting therapies and non-selective S1P modulators. However, most of the reported studies on the immunity of COVID-19 vaccinations have included mRNA vaccines, and information on inactivated virus vaccine responses, long-term protectivity, and comparative studies with mRNA vaccines are very limited. Here, we aimed to investigate the association between humoral vaccine responses and COVID-19 infection outcomes following mRNA and inactivated virus vaccines in a large national cohort of pwMS receiving DMTs. This is a cross-sectional and prospective multicenter study on COVID-19-vaccinated pwMS. Blood samples of pwMS with or without DMTs and healthy controls were collected after two doses of inactivated virus (Sinovac) or mRNA (Pfizer-BioNTech) vaccines. PwMS were sub-grouped according to the mode of action of the DMTs that they were receiving. SARS-CoV-2 IgG titers were evaluated by chemiluminescent microparticle immunoassay. A representative sample of this study cohort was followed up for a year. COVID-19 infection status and clinical outcomes were compared between the mRNA and inactivated virus groups as well as among pwMS subgroups. A total of 1484 pwMS (1387 treated, 97 untreated) and 185 healthy controls were included in the analyses (male/female: 544/1125). Of those, 852 (51.05%) received BioNTech, and 817 (48.95%) received Sinovac. mRNA and inactivated virus vaccines result in similar seropositivity; however, the BioNTech vaccination group had significantly higher antibody titers (7.175±10.074) compared with the Sinovac vaccination group (823±1.774) (p<0.001). PwMS under ocrelizumab, fingolimod, and cladribine treatments had lower humoral responses compared with the healthy controls in both vaccine types. After a mean of 327±16 days, 246/704 (34.9%) of pwMS who were contacted had COVID-19 infection, among whom 83% had asymptomatic or mild disease. There was no significant difference in infection rates of COVID-19 between participants vaccinated with BioNTech or Sinovac vaccines. Furthermore, regression analyses show that no association was found regarding age, sex, Expanded Disability Status Scale score (EDSS), the number of vaccination, DMT type, or humoral antibody responses with COVID-19 infection rate and disease severity, except BMI Body mass index (BMI). mRNA and inactivated virus vaccines had similar seropositivity; however, mRNA vaccines appeared to be more effective in producing SARS-CoV-2 IgG antibodies. B-cell-depleting therapies fingolimod and cladribine were associated with attenuated antibody titer. mRNA and inactive virus vaccines had equal long-term protectivity against COVID-19 infection regardless of the antibody status.

Prevalence and Genotype Distribution of Human Papillomavirus in 92,932 Cases in Shanghai, China

Aim: Human papillomavirus (HPV) is the most common cause of high-grade lesions and carcinogenesis such as cervical intraepithelial neoplasia (CIN) and cervical cancer (CC). The prevalence and genotype distribution of HPV infection varies greatly in different geographical areas. Patients &amp; methods: This study enrolled 92,932 patients from January 2017 to December 2021 and analyzed the prevalence and distribution of HPV genotypes. Results: 18038 (19.41%) specimens were HPV-positive. No significant difference in infection rates between men and women (19.05 vs 19.41%). The most prevalent HPV subtypes are HPV52, HPV58, HPV16, HPV53, HPV51 and HPV81. Single infection of HPV has dominated in HPV-positive patients. Conclusion: Our results show that the prevalence and distribution of HPV subtypes have obvious region-specific and age-specific characteristics.

High-rise buildings: A risk factor in the COVID-19 Omicron epidemic period

ObjectivesThis study aimed to investigate possible viral transmission scenarios inside a high-rise building during the Omicron phase of the COVID-19 pandemic. Study designCross-sectional study design. MethodsIn order to determine the pathogenicity of the Omicron variant of SARS-CoV-2, demographic, vaccination and clinical data were collected from COVID-19 positive cases during an outbreak in a high-rise residential building in Shenzhen, China, in early 2022. The pattern of viral transmission inside the building was determined through field investigation and engineering analysis. The results highlight the risk of Omicron infection in high-rise residential buildings. ResultsSymptoms of infection with the Omicron variant are predominantly mild. Younger age has a greater impact on the severity of disease than vaccination status. Each floor of the high-rise building investigated contained 7 apartments, numbered 01 to 07, positioned in the same layout on each floor. The drainage system included vertical pipes from the ground to the roof of the building. There were statistically significant differences in infection rates at different time points and incidence ratios between apartment numbers ending in 07 (type 07) and other apartments (P < 0.001). Households with early disease onset were concentrated in apartment type 07 and the severity of their disease was more severe. The incubation period of the outbreak was 5.21–5.31 days and the time-dependent reproduction number (Rt) was 12.08 (95% confidence interval [CI] 7.66, 18.29). Results suggest both non-contact and contact viral transmission may have contributed to the outbreak. The drainage system in the building allows aerosol regurgitation, thus indicating that the structure of the building may have led to spread of the virus from the sewage pipes. Infections in other apartments may have been as result of viral transmission in the elevators and intimate family contact. ConclusionsResults from this study suggest that Omicron transmission was likely to be via the sewage system, supplemented by contact transmission in the stairs and elevators. The environmental spread of Omicron needs to be highlighted and prevented.

P057 Immunosuppression doubles the risk of COVID-19 infection in a large vaccinated cohort of 898 patients with rheumatic diseases: implications for future practice

Abstract Background/Aims It is recognised that immunosuppressive medications, often relied upon in the management of autoimmune rheumatic disease, inhibit vaccine-induced immunity against the SARS-CoV-2 virus. A key challenge for rheumatologists is maximising immunity provided by the vaccine in their patients. Recent data has implicated methotrexate (MXT), a commonly used disease modifying anti-rheumatic drug (DMARD), in reducing patients’ vaccine-induced immunity against the virus and studies have demonstrated the effectiveness of pausing MXT medication for 2-weeks after receiving the vaccine in boosting patients’ immunity. There is a lack of data exploring the impact of concurrent biologic-DMARD (b-DMARD) use with MXT on COVID-19 infection rates in vaccinated individuals. This analysis forms part of a larger programme of research (clinicaltrials.gov NCT04542031) exploring COVID-19 in patients with rheumatic disease. Here we provide a comparative analysis of COVID-19 infection rates between patients taking MXT either with or without b-DMARD therapy and those on no immunosuppression. Methods We distributed two web-based questionnaires via SMS-messaging in April 2020 and December 2021 and two interim monitoring questionnaires in December 2020 and June 2021. All rheumatology patients with a valid mobile telephone number under follow up at the Royal Wolverhampton Trust were invited to participate in the study; those that consented received follow up questionnaires. We collected information on demographics, rheumatology diagnosis and treatment, vaccination status, and COVID-19 infection rates. Data were collected 7-days following questionnaire distribution. Results Initial questionnaires were sent to 7911 active follow up patients, 1636/7911 (21%) responded and consented to further follow up; 906/1636 (55.4%) provided a complete response to the final survey which was subsequently linked to survey one enabling analysis. Responders were female (622/906, 68.7%), white (865, 95.5%), 60 years or above (519, 57.3%), and vaccinated (898/906; 99.1%). Of those vaccinated significantly more patients that were on any immunosuppressive therapy compared to those on no immunosuppression (92/530 (17.4%) vs. 26/368 (7.1%); p &amp;lt; 0.001), and more in the MXT monotherapy group compared to no immunosuppression (33/222 (14.9%) vs. 26/368 (7.1%); p = 0.001) contracted COVID-19. Similar numbers in the MTX and b-DMARD and b-DMARD without MXT groups (23/140 (16.4%) vs. 36/168 (21.4%); p = 0.23) contracted COVID-19. Conclusion Recent trial data from the VROOM study has demonstrated that omitting a patients MXT therapy for a 2-week period following administration of the COVID-19 vaccine doubles their antibody response. This data highlights that the risk of COVID-19 infection in vaccinated rheumatology patients is doubled in patients on any immunosuppressive medication compared to those on no immunosuppression, while there is no significant difference in infection rates between patients on MXT and a b-DMARD and b-DMARD therapy without MXT. Further work exploring the impact of different types of immunosuppression on COVID-19 vaccine-induced immunity and simple interventions to maximise this immunity in immunosuppressed individuals is required. Disclosure N. Cox: None. J. Bateman: None.

MP15-16 SINGLE DOSE ANTIBIOTICS AT THE TIME OF TRANSPERINEAL PROSTATE BIOPSY ARE EQUIVALENT TO OUTPATIENT ANTIBIOTIC PROPHYLAXIS IN PREVENTING INFECTION

You have accessJournal of UrologyCME1 Apr 2023MP15-16 SINGLE DOSE ANTIBIOTICS AT THE TIME OF TRANSPERINEAL PROSTATE BIOPSY ARE EQUIVALENT TO OUTPATIENT ANTIBIOTIC PROPHYLAXIS IN PREVENTING INFECTION Maxwell Sandberg, Wyatt Whitman, Janmejay Hingu, Parth Thakker, Caleb Bercu, Anita Rong, Jacob Greenberg, Ronald Davis, Ashok Hemal, and Matvey Tsivian Maxwell SandbergMaxwell Sandberg More articles by this author , Wyatt WhitmanWyatt Whitman More articles by this author , Janmejay HinguJanmejay Hingu More articles by this author , Parth ThakkerParth Thakker More articles by this author , Caleb BercuCaleb Bercu More articles by this author , Anita RongAnita Rong More articles by this author , Jacob GreenbergJacob Greenberg More articles by this author , Ronald DavisRonald Davis More articles by this author , Ashok HemalAshok Hemal More articles by this author , and Matvey TsivianMatvey Tsivian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003235.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There has been a trend towards transperineal (TP) prostate biopsy over transrectal (TR) due to a reduced rate of infection. In response, there is now an ongoing debate as to the need for prophylactic antibiotics during TP biopsy. The objective of this study was to argue for the non-inferiority of single-dose antibiotics at the time of biopsy to outpatient antibiotics in preventing infection, regardless of antibiotic class chosen. METHODS: Biopsies were performed using TP technique under TR ultrasound guidance with anesthesia. All patients from 2012-present who underwent TP biopsy were identified and retrospectively chart reviewed. Infection was defined as at least one of the following: fever (≥38.3 °C) or positive urine culture (>10^5 CFU) within 72 hours post-biopsy. Patients were divided into 2 groups, those who received antibiotics at the time of biopsy along with outpatient antibiotics either before/after biopsy (group 1) and those who only received intraoperative antibiotics at the time of biopsy (group 2). Antibiotic choice and duration were at the discretion of the treating physician. Pearson’s Chi Squared was run to evaluate the difference in infection rate between the 2 groups. Fisher’s exact test evaluated the relationship between type of antibiotic and infection rate. RESULTS: A total of 767 biopsies were included in the study. Group 1 had 327 patients and group 2 had 440 patients. Infection rate post-TP biopsy was 1.97% (N=15). The infection rate for group 1 was 1.83% (N=6) and 2.05% (N=9) in group 2. No significant difference in infection rate existed between group 1 and group 2 (p=0.835). Secondary analysis was performed to evaluate infection rates based on antibiotic agent. TP biopsies with multiple antibiotics used at the same time were excluded from analysis. The type of antibiotic administered did not change infection rates within group 1 (p>0.99), group 2 (p=0.673), or between groups 1 and 2 (p>0.99). CONCLUSIONS: Based on our data, it appears that single dose antibiotics at the time of TP prostate biopsy are equivalent to outpatient antibiotic prophylaxis in preventing infection. Further, the class of antibiotic does not seem to affect infection rates. Given the overall low rate of infection, antibiotic regimens should be further evaluated for their utility. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e198 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxwell Sandberg More articles by this author Wyatt Whitman More articles by this author Janmejay Hingu More articles by this author Parth Thakker More articles by this author Caleb Bercu More articles by this author Anita Rong More articles by this author Jacob Greenberg More articles by this author Ronald Davis More articles by this author Ashok Hemal More articles by this author Matvey Tsivian More articles by this author Expand All Advertisement PDF downloadLoading ...

A Prospective Study Comparing the Infection Rate Between Buried vs Exposed Kirschner Wires in Hand and Wrist Fixations.

Kirschner wires (K-wires) are used in fracture fixations but are often associated with pin tract infections. This prospective study compared the infection rate between buried and exposed K-wires in closed injuries of the wrist and hands in individuals with no comorbidities. Fifteen patients were recruited with a total of 41 K-wires (21 buried K-wires; 20 exposed K-wires). Clinical and radiographic evidence of infection was assessed at three months based on the Modified Oppenheim classification. Two out of 21 wires in the buried group developed grade 4 infection, while 20 wires in the exposed group did not have any significant infection. No significant difference in infection rate based on K-wire size or number in both groups. There is no significant difference ininfection rate between buried and exposed K-wires in healthy individuals with closed injuries of the wrist and hand.

Correction of Breast Ptosis in Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy

Objective: Nipple-sparing mastectomy (NSM) is psychologically advantageous and can result in superior cosmetic outcomes. Pre-existing ptosis can result in suboptimal shape of reconstructed breast with lateral nipple displacement. To prevent this deformity, skin tightening with nipple lift are indicated. However, concurrent mastopexy with NSM may lead to ischemic complications. This study reviewed outcomes of breast ptosis correction in immediate prosthetic breast reconstruction after NSM. Methods: All patients who underwent immediate breast reconstruction with tissue expander (TE) or direct-to-implant (DTI) after NSM by the senior author between April 2010 and January 2021, were included in this study. Procedures were stratified into Lift or No-Lift cohorts. Irrespective of Lift or No-Lift, prepectoral and subpectoral implant placement was also analyzed, as was ADM use versus No-ADM. Complications within 30 days were analyzed. Minor complications included erythema, seroma, flap necrosis, nipple necrosis, and prescription of extra antibiotics. Major complications included hematoma, dehiscence, infection, hospitalization, necrosis requiring surgery, any surgical intervention, capsular contracture, and implant loss. Ecchymosis was individually measured. Results: A total of 143 patients underwent immediate reconstruction of 228 breasts after NSM. In 23 patients and 34 breasts, correction of breast ptosis was performed. The remaining 120 patients and 194 breasts did not undergo NAC elevation. Implants were placed in prepectoral position in 119 procedures and submuscular plane in 109. Mean patient age was 49 ± 10 years and BMI 25.9 ± 4.8. Average ptosis grade was 1 ± 1, and mastopexy lift was 3.73 ± 2.12 cm. There was no significant difference in infection rates (8.8% vs 10.3%, p = NS), nor other major (57.7% vs 47.1%, p = NS) and minor complications (76.5% vs 74.7%, p = NS) between Lift and No-Lift groups. Ecchymoses were increased with No-Lift (43.3% vs 11.8%, p < 0.001). All reconstructions were also analyzed based on anatomic plane of implant placement, which demonstrated no difference in major complications. However, loss of implant (27.7% vs 16.5%, p = 0.042) and seroma formation requiring in-office aspiration (28.6% vs 10.1%, p < 0.001) as individual outcomes did occur more with prepectoral than subpectoral planes, as did ecchymoses (56.3% vs 19.3%, p < 0.001). As another distinct analysis, ADM use was associated with more nipple necrosis (26% vs 14.5%, p = 0.049), but this was partial thickness necrosis which did not require operative intervention. Conclusion: Mastopexy at the time of immediate prosthetic breast reconstruction after NSM is safe, with complications similar to a no-nipple-lift technique irrespective of plane of implant placement or ADM use. Corresponding Author: Elizabeth Bushong, 15 Michigan St NE, Grand Rapids, MI 49503, [email protected], (760) 285-4085

Prevalence of Liver Flukes in Some Areas of Salahalddin Province

The present study aimed to diagnosis liver flukes in sheep in Tikrit and Balad districts and compare between prevalence of liver flukes that infect sheep through prevalence of infection and severity of infection. The present study included examination of 951 sheep of both sexes, and aged ranges between less than 1 year and more than 2 years through December 2017 to the end of June 2018. Flukes were isolated directly from liver of sheep. Infected sheep in Tikrit was 97 sheep with prevalence of infection 17.54% and in Balad there was 35 infected sheep with prevalence of infection 8.79%. The highest prevalence of infection in Tikrit recorded in January30.58% and the lowest prevalence of infection recorded in June10% while highest severity of infection was in December it was 2.3 and the lowest severity of infection was in January 1.07 . In Balad discrete highest prevalence of infection recorded in December 13.33% and the lowest prevalence of infection recorded in June 3.84% while highest severity of infection was in December 2.75 and the lowest severity of infection was in January 1.75. The statistical analysis shows that there is no significant difference in infection rate between Tikrit and Balad. &#x0D; &#x0D;

Management of Dog Bite Injuries: Procedural Sedation, Infection, and Operative Indications at a Single-Institution Level I Pediatric Trauma Hospital.

Dog bite injuries are common within the pediatric population. Currently, there are inconclusive data on best sedation practice, antibiotic regimen, and need for plastic surgery referrals for treatment of dog bite injuries in the emergency department (ED) versus operating room (OR). This study set out to determine sedation practice, infection management, and necessity for plastic surgery referral at a level I pediatric trauma center. A retrospective review of all pediatric (0-18 years old) dog bites documented in electronic medical records from January 1, 2010, to December 31, 2019, was performed. Bitten by dog encounters were identified by International Classification of Diseases, Ninth Revision and Tenth Revision codes E906.0 and W54.0, W54.0XXA, and W54, respectively. Data gathered included age, gender, month of injury, circumstance of injury, injury characteristics, location of repair, person performing repair, sedation (if used, then length of sedation), inpatient admission, antibiotics prescribed, dog characteristics (breed, size, sex, age, relationship to patient), and complications. Summary statistics were calculated as mean ± SD. Comparisons for nominal variables were performed using the χ2 test. All analyses were performed using Stata v.16. 1. A total of 1438 pediatric patients were included in this study over a 10-year period. Of injuries requiring repair (n = 846), most repairs were performed in the ED (97.1% [822/846]), whereas 24 (2.8%) required repair in the OR. Of the bites that required repair (n = 846), 81.1% (686/846) were performed by an emergency medicine physician and 147 (17.4%) by plastic surgeons. Procedural sedation in the ED was performed in 146 repairs (17.3%). Documented sedation time ranged from 10 to 96 minutes. Most patients received a prescription for antibiotics (80.5%), usually amoxicillin/clavulanate (90.8%). Infection was the most common sequela (9.5%). There was no significant difference in infection rates between repairs performed in the ED versus those in the OR. Our study indicates that pediatric patient dog bite injuries can be successfully managed in an ED. Procedural sedation has demonstrated no increased safety risks compared with the OR. Rates of infection are also not demonstrated to be significantly higher in repairs done in the ED versus those taken to operating theater.

Role of Surgical Drains in Orthopedics

Abstract Introduction: The use of drains in orthopedic practice has been affected by the concept of evidence-based medicine, which is accepted as the standard of care for all surgical or medical practices. This concept questions all care processes that cannot be backed by evidence to be beneficial to the patient. There have been a large number of multi-center meta-analytical studies that have found drains to be of little or no benefit in trauma and orthopedic surgeries. As a result of these studies, there are few situations where drains are routinely used, such as calcaneal fractures in developed countries. Even major procedures such as total knee and arthroplasties are being performed without drains. We aim to investigate whether similar evidence can be found in our practice. Materials and Methods: This sounds like the description of a prospective randomized controlled trial studying the use of drains in certain types of surgical procedures. The study population consisted of 86 patients matched for sex and type of injury, and they were assigned to either a group that used drains or a group that did not use drains during their operations. The study aimed to observe and compare the rates of complications, such as hematoma, drain migration, infection, and inadvertent drain stitching, between the two groups. Results: Eighty-six major orthopedic operations were studied. There was no evidence of the occurrence of complication arising from nonuse of drains in the undrained group. Those patients whose wounds were drained had no need for drain change, thus making the wound care less eventful. Conclusion: Wound drains can help reduce tissue swelling in the postoperative period, but there is no significant difference in infection rates, hematoma, or seroma formation between drained and undrained wounds.

Cross-Sectional Study to Evaluate Infection in Operation Theater and Difference in Infection Pattern Between Laminar Air Flow and Non-Laminar Air Flow Operation Theaters

This was a cross-sectional study to compare the infection rate between laminar air flow and non-laminar air flow operation theater (OT). This was bi-center study and study places were the OT complexes of Sylhet Women’s Medical College Hospital (SWMCH) and Al Haramain Hospital Pvt. Ltd. of Sylhet. A Total 24 samples were collected from 12 OTs. Air and wall swab both types of samples were collected from each OT. Out of these 12 OTs 4 had laminar air flow system. Half of the air samples (50%) and 8.3% of wall samples were infected, whereas overall organism isolation rate was 29.17%. Among all the infected samples 25% were from laminar air flow OTs and the rest 75% were from non-laminar air flow OTs. Commonest isolated bacteria was staphylococcus epidermidis (62.5%) followed by bacillusspp (25%) and staphylococcus aureus (12.5%). staphylococcus epidermidis was predominantly found in General Surgery, Obstetrics and septic OTs. Distance from entry or toilet did not show any significant difference in infection rate in operation theaters.

Epidemiological Profile and Spatial Patterns of Enterobiasis in Children Aged 3-9 Years in China from 2016 to 2020.

(1) Background: Enterobius vermicularis infection causes a significant health burden in children. The infection occurs throughout the country and remains a serious public concern in China. Therefore, it is necessary to know the situation of E. vermicularis infection, to provide a scientific basis for the disease control and the optimum conditions for children's growth. (2) Methods: Descriptive epidemiological analysis was implemented to demonstrate the status and changing trend of E. vermicularis infection from 2016 to 2020, while the spatial distribution characteristics and spatial-temporal clustering were illuminated by spatial autocorrelation analysis and spatio-temporal scanning analysis. (3) Results: The infection of E. vermicularis showed a fluctuating downward trend with a decline of 32.00% in 2020 compared to that in 2016 and was concentrated in central and southern China. There was no significant difference in infection rate between boys and girls, while the high infection rate was presented in 4-, 5- and 6- year-old children. The hotspots and spatial clustering areas were mainly concentrated in southern China. (4) Conclusions: From 2016 to 2020, the infection rate of E. vermicularis in children aged 3 to 9 years in China demonstrated a declining trend, and its distribution showed spatial clustering, mainly in southern China. Therefore, it is necessary to strengthen surveillance and implement control measures in combination with health education and environmental improvement.

Predicting Risk of Infection Based on Immunoglobulin Nadirs after CD38 Monoclonal Antibody Treatment in Multiple Myeloma

Background: Anti-CD38 monoclonal antibodies are used to treat newly diagnosed and relapsed or refractory multiple myeloma. Previous studies have shown an increased risk of infection while on daratumumab due to the immunosuppressive effect on malignant and normal plasma cells. We sought to retrospectively analyze and further understand the correlation of immunoglobin levels and risk of infection during treatment with anti-CD38 monoclonal antibodies in Multiple Myeloma. Methods: Analysis was performed on data from 261 patients who had received anti-CD38 monoclonal antibody therapy as part of treatment for multiple myeloma between November 11, 2016, and May 11, 2022. 51.7% were male and 48.3% were female. 47.1% of the patients identified as Black, 46% as White, and 6.9% as other races. 14.9% of the patients had Stage I, 41.8% had Stage II and 17.2% had Stage III disease, based on the Revised International Staging System (RISS). Baseline renal disease was present in 35.6% of patients. Median number of anti-CD38 Monoclonal antibody infusions was 16. We examined rates of specific infections (determined by ICD-10 codes), including pneumonia, urinary tract infection, bacteremia, and sepsis, as well as emergency room visits, hospitalizations including ICU stays for up to a year after completing treatment. These rates were correlated with immunoglobulin levels, absolute lymphocyte count, and the presence of concomitant treatment with a proteasome inhibitor or immunomodulator. Results: The overall infection rate among patients receiving anti-CD 38 monoclonal antibody treatment was 32.6%. Bacterial infection developed in 22.2%, viral infections in 17.6%, and fungal infections in 3.4% of patients. SARS-CoV-2 infection rate was 13.4%. The median number of infusions was 15 in those without an infection and 20 in those who developed an infection (p<0.001).19.2% of patients who began anti-CD38 monoclonal antibody treatment during the study period have expired, of whom 56.0 % had an infection. Higher rates of infection were noted with lower IgA levels (p=0.007). There was no significant difference in infection rate with lower IgG and IgA levels or lower absolute lymphocyte levels (p=0.054). However, in patients with an infection there was a longer duration of sub-normal IgG days (114 vs 287 days, p=<0.001), IgA (119.5 vs 215, p=0.006), and IgM (161 vs 274.5, p=0.011). 44.4% of patients had an emergency room visit of whom 40.0% were due to infections (p=0.113). 66.9% of patents required hospital admissions of whom 43.2% had an infection) p<0.001). 18.5% of treated patients required ICU stays of whom 63.9% had an infection) p<0.001). Discussion:Conclusions: A longer duration of subnormal Immunoglobulin levels correlated with higher risk of infection in Multiple Myeloma patients treated with anti-CD 38 monoclonal antibodies. Lowest Ig A levels during treatment correlated with a higher rate of infection while lowest IgG levels did not. Patients who developed infectious complications while on treatment with anti-CD 38 monoclonal antibodies had a significantly higher risk of hospitalization, ICU stays, and death. Prophylactic intravenous immunoglobulin can be studied to evaluate mitigation of infection in the highest risk subpopulation identified in this analysis such as those with prolonged subnormal Immunoglobulin levels. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

First Experience With Postoperative Transcranial Ultrasound Through Sonolucent Burr Hole Covers in Adult Hydrocephalus Patients.

Managing patients with hydrocephalus and cerebrospinal fluid (CSF) disorders requires repeated head imaging. In adults, it is typically computed tomography (CT) or less commonly magnetic resonance imaging (MRI). However, CT poses cumulative radiation risks and MRI is costly. Ultrasound is a radiation-free, relatively inexpensive, and optionally point-of-care alternative, but is prohibited by very limited windows through an intact skull. To describe our initial experience with transcutaneous transcranial ultrasound through sonolucent burr hole covers in postoperative hydrocephalus and CSF disorder patients. Using cohort study design, infection and revision rates were compared between patients who underwent sonolucent burr hole cover placement during new ventriculoperitoneal shunt placement and endoscopic third ventriculostomy over the 1-year study time period and controls from the period 1 year before. Postoperatively, trans-burr hole ultrasound was performed in the clinic, at bedside inpatient, and in the radiology suite to assess ventricular anatomy. Thirty-seven patients with sonolucent burr hole cover were compared with 57 historical control patients. There was no statistically significant difference in infection rates between the sonolucent burr hole cover group (1/37, 2.7%) and the control group (0/57, P = .394). Revision rates were 13.5% vs 15.8% (P = 1.000), but no revisions were related to the burr hole or cranial hardware. Trans-burr hole ultrasound is feasible for gross evaluation of ventricular caliber postoperatively in patients with sonolucent burr hole covers. There was no increase in infection rate or revision rate. This imaging technique may serve as an alternative to CT and MRI in the management of select patients with hydrocephalus and CSF disorders.

Prevalence of Toxoplasmosis in Sheep and Goats in Pakistan: A Systematic Review and Meta-Analysis.

Toxoplasmosis, a parasitic disease caused by Toxoplasma gondii, results in congenital disorders and miscarriages among livestock and humans worldwide. This systematic review and meta-analysis were conducted to determine the prevalence of T. gondii infection in sheep and goats in Pakistan from 2000 to 2020. We searched the PubMed, Scopus, EMBASE, and Google Scholar databases and selected 17 publications that fulfilled our inclusion criteria. Eight studies were conducted in Southern Punjab, six in Khyber Pakhtunkhwa, two in Northern Punjab, and one in Central Punjab. The diagnostic tests used in the included articles to confirm toxoplasmosis were the latex agglutination test in 56% of the studies, the enzyme-linked immunosorbent assay in 38%, and the indirect hemagglutination assay in 6%. The infection rates were substantially higher among sheep &gt; 1 year of age (37%) than among sheep ≤ 1 year old (19%). Statistically significant differences in infection rates were found between male and female sheep and goats. The overall infection rate by age was also significant among sheep and goats. Sex and age variability between sheep investigations were significant, and sex heterogeneity and age homogeneity were significant among goats. Hence, robust infection control protocols should be implemented to prevent infection in animals and humans.

Preoperative epidural steroid injections do not increase the risk of postoperative infection in patients undergoing lumbar decompression or fusion: a systematic review and meta-analysis.

Epidural corticosteroid injections (ESI) are a mainstay of nonoperative treatment for patients with lumbar spine pathology. Recent literature evaluating infection risk following ESI after elective orthopedic surgery has produced conflicting evidence. Our primary objective was to review the literature and provide a larger meta-analysis analyzing the temporal effects of steroid injections on the risk of infection following lumbar spine surgery. We conducted a query of the PubMed, Embase, and Scopus databases from inception until April 1, 2022 for studies evaluating the risk of infection in the setting of prior spinal steroid injections in patients undergoing lumbar spine decompression or fusion. Three meta-analyses were conducted, (1) comparing ESI within 30-days of surgery to control, (2) comparing ESI within 30-days to ESI between 1 and 3months preoperatively, and (3) comparing any history of ESI prior to surgery to control. Tests of proportions were utilized for all comparisons between groups. Study heterogeneity was assessed via forest plots, and publication bias was assessedquantiatively via funnel plots and qualitatively with the Newcastle-Ottawa Scale. Nine total studies were included, five of which demonstrated an association between ESI and postoperative infection, while four found no association. Comparison of weighted means demonstrated no significant difference in infection rates between the 30-days ESI group and control group (2.67% vs. 1.69%, p = 0.144), 30-days ESI group and the > 30-days ESI group (2.34% vs. 1.66%, p = 0.1655), or total ESI group and the control group (1.99% vs. 1.70%, p = 0.544). Heterogeneity was low for all comparisons following sensitivity analyses. Current evidence does not implicate preoperative ESI in postoperative infection rates following lumbar fusion or decompression. Operative treatment should not be delayed due to preoperative steroid injections based on current evidence. There remains a paucity of high-quality data in the literature evaluating the impact of preoperative ESI on postoperative infection rates. II.

Effect of malnutrition and nutritional support to reduce infections in elderly hospitalized patients with cancer: A multicenter survey in China

ObjectivesMalnutrition is common among elderly patients with cancer, and greatly affects patients’ quality of life. Malnutrition is a key factor in the development of systemic, chronic, low-grade inflammation that can exacerbate. MethodsA total of 633 elderly patients with cancer from 29 tertiary public hospitals in 14 cities in China were selected as the research subjects. Physical examination, questionnaire survey, medical history collection, and blood index detection were performed on the research subjects to analyze the relationship between malnutrition, nutritional support, and infection status. ResultsThere was no significant difference in infection rate among elderly hospitalized patients with cancer and different cancer types, cancer stages, or therapy methods (P > 0.05). The proportion of vomiting, loss of appetite, depression, and physical fatigue in patients with good nutritional status were lower than in patients with moderate or severe malnutrition (P < 0.05). Nutritional support is crucial for the nutritional status of elderly patients with cancer, and patients without special nutritional guidance are more likely to develop infection (P < 0.05). After adjusting for confounding variables, the results of the logistic regression analysis showed that oral nutritional supplements (odds ratio [OR]: 0.088; 95% confidence interval [CI], 0.015–0.514), parenteral nutrition (OR: 0.091; 95% CI, 0.011–0.758), and individualized nutritional guidance (OR: 0.026; 95% CI, 0.003–0.202) were all protective factors associated with cancer infection. ConclusionsMany elderly hospitalized patients with cancer have local or systemic infections, and good nutrition is associated with lower rates of infection. Receiving nutritional guidance or support is associated with lower infection rates in elderly patients with cancer.

Prevalence of Coccidiosis among local and exotic breeds of reared chickens in Azare Metropolis, Bauchi State Nigeria

Coccidiosis is a deadly disease that hampers chickens’ productivity and welfare. The disease is a major menace to the global poultry industry. Coccidiosis is caused by the apicomplexan parasite of the genus Eimeria. This study investigated the prevalence of Coccidiasis amongst the chickens reared in Azare metropolis. A total number of four hundred 400 feacal samples of live and slaughtered chickens were collected and examined using standard parasitological methods between March and June, 2022. The samples comprised of 246 female and 154 male; 300 exotic species and 100 local species. Chi-square test and simple percentage were used to analyze the generated data and p&lt;0.05 was adopted to determine the level of significance. An overall prevalence rate of 173 (43.3%) was recorded. The prevalence rate was higher in female 138 (56.1%) than male with 35 (22.7%). There was statistically significant difference in infection rate between the sexes of the Chickens. The lower age (1-4weeks) had the highest rate of prevalence rate of 64(59.8%) followed by age (5-16weeks) with 97(38.1%) and Adult (16weeks&gt;above) with lowest infection rate of 12(17.6%). Similarly, high infection rates were observed among local breed 64(64%) than exotic breed 109(36.3%). The difference between the age groups and the two breeds in prevalence rate was statistically significant (p&lt;0.05).Coccidiosis is endemic in both local and exotic chickens in the study area due to poor management system. It is therefore, recommended that good management system of rearing the chickens, regular vaccination against Coccidiosis, maintaining good hygienic practice as well as creating awareness among farmers on effect of this disease on their productivity and welfare should be ensured.