The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimic...The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimicrobials consumed by patients hospitalized to Infectious Diseases’ Clinic. This is a cross-sectional and analytical study, carried out from January 1 to December 31, 2017 in the Infectious Diseases Department of Point “G” Teaching Hospital in Mali. All biological specimens from patients during the study period were analyzed. In total, 322 patients benefited from microbiological test, with a mean age of 40.9 ± 12.2 years (range 15 and 74 years) with a sex ratio of 0.93. Only 5.6% of patients were HIV negative. In all participants, a total of 658 microbiological specimen were taken, 224 (34.0%) identified at least one pathogen including bacteria in more than a half of the cases (58.5%). On the report of bacteriological analysis, the most frequently identified organisms were <i>Mycobacterium tuberculosis</i> (42.2%) mainly in sputum;<i>Escherichia coli</i> (24.2%) and <i>Klebsiella pneumoniae</i> (7.8%) commonly in urine and <i>Gardnerella vaginalis</i> (7.0%) exclusively in vaginal secretions. <i>Candida albicans</i> (5/8) and <i>Cryptococcus neoformans</i> (3/8) were the most common fungi while <i>Plasmodium falciparum</i> (96.4%) represented the parasite frequently found in blood. From a therapeutic standpoint, 1143 antimicrobials were prescribed to 322 admitted patients, <i>i.e.</i> 3.55 anti-infectives per patient. Antibiotics (excluding tuberculosis drugs), antiparasitics and antifungals represented respectively 46.2%;18.8% and 15.1% of anti-infectives. Antibiotic therapy was effective in 274 (85.1%) patients and among them, only 76 (27.7%) cases were based on microbiological evidence. Antibiotics are the most widely used antimicrobials in an infectious disease department. Empiric treatments are common but must be minimized by the search for microbiological evidence.展开更多
Extreme air temperature and increased weather oscillations caused by climate change have been threatening global health.Meteorological conditions are external inducers that may trigger the onset of gastrointestinal di...Extreme air temperature and increased weather oscillations caused by climate change have been threatening global health.Meteorological conditions are external inducers that may trigger the onset of gastrointestinal diseases,in addition to bacterial infection or behavioral factors including smoking,alcohol consumption,and hot food consumption[1,2].展开更多
Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September...Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.展开更多
Background: Treating infectious diseases (ID) is the priority of health systems. Traditional Persian medicine (TPM) has diagnostic and preventive comments in most diseases. Readout TPM gives opportunity to know the vi...Background: Treating infectious diseases (ID) is the priority of health systems. Traditional Persian medicine (TPM) has diagnostic and preventive comments in most diseases. Readout TPM gives opportunity to know the viewpoints of ancient Iranian scholars for using these opinions in treating ID. In this regard returning to TPM options and modalities can be useful at least as complementary method in treating ID. For understanding the concepts of ID in TPM first of all it is needed to trace ID in TPM and translate them into western medicine language which is the goal of this report. Methodology: This research includes 80 ID mentioned in TIBBE-AKBARI (one of Persian Medicine textbook) for rewriting and comparing with conventional medicine findings. Findings: The majority of clinical signs, symptoms and physical examinations of ID are comparable with modern medicine except the viewpoint of TPM about aetiology which is based on Akhlat and Mezaj theory. By considering no option for antibiotic therapy in ancients time so there is a completely different opinion in treating ID with modern medicine. Conclusion: IDs have different names in TPM and conventional medicine. In contrast to modern medicine in which micro-organism are as etiologic agents, Akhlat and Mezaj theory of TPM has main role for description of ID, the subject which must to be decoded. Although they have completely different opinions in treatment, but with regard to the increasing of antibiotic resistance issue, TPM treatment comments may be useful in future in ID as complementary method beside antibiotics.展开更多
Objectives:This study explores the protective effects of glycyrrhizic acid(GA)on sepsis-induced cellular damage and inflammation in acute lung injury(ALI),specifically through the modulation of the sirtuin 1(SIRT1)and h...Objectives:This study explores the protective effects of glycyrrhizic acid(GA)on sepsis-induced cellular damage and inflammation in acute lung injury(ALI),specifically through the modulation of the sirtuin 1(SIRT1)and high mobility group box 1(HMGB1)pathway.Methods:The study employed two experimental models:lipopolysaccharide(LPS)-induced BEAS-2B human lung epithelial cells and cecal ligation and puncture(CLP)rats,to simulate sepsis conditions.The cell model involved treatments with LPS,GA,control siRNA(si-NC),and SIRT1-specific siRNA(si-SIRT1).Evaluations included cell viability,apoptosis,and cytokine production.In the rat model,treatments included GA and the SIRT1 inhibitor EX527,with assessments on lung tissue damage,inflammation,and protein expression using Western blot and co-immunoprecipitation(Co-IP)analysis.Results:LPS exposure significantly reduced SIRT1 mRNA levels and cell viability in BEAS-2B cells,which effects were reversed by cotreatment with GA and si-NC but negated by si-SIRT1.LPS also induced apoptosis and increased pro-inflammatory cytokines and HMGB1 expression,which were mitigated by GA and si-NC and exacerbated by si-SIRT1.In CLP rats,GA treatment decreased lung tissue damage,inflammatory cytokines,and HMGB1 expression,and enhanced SIRT1 levels.However,these protective effects were reversed when GA was combined with EX527.Conclusion:GA demonstrates significant protective effects against LPS-induced damage and inflammation in lung cells and tissue by modulating the SIRT1-HMGB1 pathway.This suggests that GA could be a potential therapeutic strategy for treating sepsis and related inflammatory conditions.展开更多
BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investiga...BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.展开更多
The b-1-6-linked poly-N-acetylglucosamine(PNAG)polymer is a conserved surface polysaccharide produced by many bacteria,fungi,and protozoan(and even filarial)parasites.This wide-ranging expression makes PNAG an attract...The b-1-6-linked poly-N-acetylglucosamine(PNAG)polymer is a conserved surface polysaccharide produced by many bacteria,fungi,and protozoan(and even filarial)parasites.This wide-ranging expression makes PNAG an attractive target for vaccine development,as it potentially encompasses a broad range of microorganisms.Significant progress has been made in discovering important properties of the biology of PNAG expression in recent years.The molecular characterization and regulation of operons for the production of PNAG biosynthetic proteins and enzymes have been studied in many bacteria.In addition,the physiological function of PNAG has been further elucidated.PNAG-based vaccines and PNAG-targeting antibodies have shown great efficacy in preclinical research.Furthermore,clinical tests for both vaccines and antibodies have been carried out in humans and economically important animals,and the results are promising.Although it is not destined to be a smooth road,we are optimistic about new vaccines and immunotherapeutics targeting PNAG becoming validated and eventually licensed for clinical use against multiple infectious agents.展开更多
Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult p...Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult patients with suspected scrub typhus who visited a tertiary care hospital in the Republic of Korea from September to December from 2019 to 2021.The included patients had an acute fever and at least one of the following ten secondary findings:myalgia,skin rash,eschar,headache,thrombocytopenia,increased liver enzyme levels,lymphadenopathy,hepatomegaly,splenomegaly,and pleural effusion.The diagnoses were grouped as scrub typhus or other diseases by two infectious disease physicians.Results:Among 136 patients who met the eligibility criteria,109 had scrub typhus and 27 had different diseases.Single and paired total antibodies using immunofluorescence assay(IFA),and total antibodies using immunochromatography-based rapid diagnostic testing(ICT)were measured in 98%,22%,and 75%of all patients,respectively.Confirmation using paired samples for scrub typhus was established at a median of 11[interquartile range(IQR)10-16]days following the first visit.Among the 82 admitted patients,the median admission time was 9(IQR 7-13)days.According to IFA,58(55%)patients with scrub typhus had total immunoglobulin titers≥1:320,while 23(85%)patients with other disease had titers<1:320.Positive ICT results were observed in 64(74%)patients with scrub typhus and 10(67%)patients with other diseases showed negative ICT results.Conclusions:Serological testing for scrub typhus is currently insufficient for decision-making in clinical practice.展开更多
BACKGROUND Musculoskeletal nontuberculous Mycobacterium(NTM)infections are rare,partic-ularly post-acupuncture therapy,and present diagnostic challenges due to their infrequency and potential severity.Prompt recogniti...BACKGROUND Musculoskeletal nontuberculous Mycobacterium(NTM)infections are rare,partic-ularly post-acupuncture therapy,and present diagnostic challenges due to their infrequency and potential severity.Prompt recognition and appropriate manage-ment are crucial for optimal outcomes.NTM-infected wounds involving the joints are difficult to treat,and only a few cases have been reported.CASE SUMMARY We present a case of a chronic intractable NTM-infected wound on the elbow joint that completely healed with conservative wound care and antibiotic treatment.An 81-year-old woman presented with a chronic,ulcerative wound on the right elbow joint where she had undergone repeated acupuncture therapy for chronic intolerable pain.Magnetic resonance imaging revealed synovial thickening,effusion,and subcutaneous cystic lesions.An orthopedic surgeon performed open synovectomy and serial debridement.However,1 month postoperatively,the wound had not healed and became chronic.A wound culture revealed NTM(Mycobacterium abscessus),and the patient was referred to the Department of Plastic and Reconstructive Surgery.Instead of surgical intervention,conservative wound care with intravenous antibiotics was provided,considering the wound status and the patient’s poor general condition.Complete wound healing was achieved in 12 months,with no impact on the range of motion of the elbow joint.CONCLUSION With clinical awareness,musculoskeletal NTM infection can be treated with conservative wound care and appropriate antimicrobial agents.展开更多
Reperfusion following cerebral ischemia causes both structural and functional damage to brain tissue and could aggravate a patient's condition;this phenomenon is known as cerebral ischemia-reperfusion injury.Curre...Reperfusion following cerebral ischemia causes both structural and functional damage to brain tissue and could aggravate a patient's condition;this phenomenon is known as cerebral ischemia-reperfusion injury.Current studies have elucidated the neuroprotective role of the sirtuin protein family(Sirtuins)in modulating cerebral ischemia-reperfusion injury.However,the potential of utilizing it as a novel intervention target to influence the prognosis of cerebral ischemia-reperfusion injury requires additional exploration.In this review,the origin and research progress of Sirtuins are summarized,suggesting the involvement of Sirtuins in diverse mechanisms that affect cerebral ischemia-reperfusion injury,including inflammation,oxidative stress,blood-brain barrier damage,apoptosis,pyroptosis,and autophagy.The therapeutic avenues related to Sirtuins that may improve the prognosis of cerebral ischemia-reperfusion injury were also investigated by modulating Sirtuins expression and affecting representative pathways,such as nuclear factor-kappa B signaling,oxidative stress mediated by adenosine monophosphate-activated protein kinase,and the forkhead box O.This review also summarizes the potential of endogenous substances,such as RNA and hormones,drugs,dietary supplements,and emerging therapies that regulate Sirtuins expression.This review also reveals that regulating Sirtuins mitigates cerebral ischemia-reperfusion injury when combined with other risk factors.While Sirtuins show promise as a potential target for the treatment of cerebral ischemiareperfusion injury,most recent studies are based on rodent models with circadian rhythms that are distinct from those of humans,potentially influencing the efficacy of Sirtuinstargeting drug therapies.Overall,this review provides new insights into the role of Sirtuins in the pathology and treatment of cerebral ischemia-reperfusion injury.展开更多
Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study desi...Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.展开更多
Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present stud...Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present study aims to determine the incidence rate of AAR cases and its complications. Methodology: This was a retrospective and analytical study over a period of 4 years (from January 2015 to December 2018) at the National Laboratory of Clinical Biology and Public Health (LNBCSP) in Bangui. It focused on samples concerning the diagnosis of AAR and patient files seen in consultation in the capital’s reference health establishments. Laboratory registers and patient consultation files were used to collect data. They were entered into Excel 2010 to be analyzed with Epi Info 7. A univariate analysis by logistic regression, Ficher’s exact test, and chi<sup>2</sup> at the 5% threshold (p Results: We analyzed 94 cases meeting Jones’s criteria. The ages of the patients ranged from 18 to 85 years (mean age 52 years and mode 45 years). The incidence rate of AAR for the female sex was higher than that of the male sex during the study period (p > 0.05). It went from 166.6 in 2015 to 200 in 2016 and 2018 cases of AAR per 1000 people per year. The average incidence rate was 296.18 cases of AAR per 1000 people per year. The average incidence rate was 223.5 cases of AAR per 1000 people per year for joint damage. Joint damage represented 80.85% (RR = 0.62;Chi<sup>2</sup> = 4.88;95% CI [0.39-0.97];p Conclusion: The study allowed data on the impact rate and complications of the AAR in Bangui. Special attention to data management will help produce a complete result on the problem. Joint complications predominated. Sustaining an effective surveillance system and preventing infection would help reduce the risk of AAR occurrence.展开更多
Autoimmune hepatitis is an inflammatory liver disease primarily mediated by T cell.It has not been fully elucidated about the pathogenesis,and it is presently thought to be related to genetic susceptibility,infection ...Autoimmune hepatitis is an inflammatory liver disease primarily mediated by T cell.It has not been fully elucidated about the pathogenesis,and it is presently thought to be related to genetic susceptibility,infection and environmental triggers,and abnormal autoimmune regulation.Recent studies have found that traditional Chinese medicine can improve the biochemical indicators and clinical symptoms of patients with autoimmune hepatitis.This article reviews the specific mechanism of traditional Chinese medicine on treating autoimmune hepatitis in order to propose new ideas for its clinical diagnosis and treatment.展开更多
Purpose of the study: Research of the clinical and diagnostic significance of determination of Lipocalin-2 associated with neutrophilic gelatinases (uNGAL) in the urine of children with urinary tract infection (UTI) a...Purpose of the study: Research of the clinical and diagnostic significance of determination of Lipocalin-2 associated with neutrophilic gelatinases (uNGAL) in the urine of children with urinary tract infection (UTI) and pyelonephritis. Materials and methods: We examined 30 children with acute pyelonephritis and UTI aged 1 to 16 years (average age 7.32 ± 4.52) including 26 girls and 4 boys. Verification of the diagnosis was conducted on the basis of clinical and laboratory data, medical history and instrumental examination of patients. All children were divided into 2 groups: 1st group—15 children with acute pyelonephritis, 2nd group—15 children with urinary tract infection. uNGAL was measured in the urine by enzyme-linked immunosorbent assay (EISA) (BioVendor Laboratoty Medicine). Results: It is found, that the urine level of NGAL depends on the damage degree of renal parenchyma. The correlation of medium strength was found between the excretion level of uNGAL during the acute period of pyelonephritis and the detection of renal scars according to the DMSA-nephroscintigraphy data. In the group of children with the acute pyelonephritis the direct correlation of medium strength was found between the excretion level of uNGAL/creatinine and leukocytosis value and also with the CRP blood level. Conclusion: The results allow us to recommend the determination of the excretion level of uNGAL/creatinine as an additional non-invasive marker for the early detection of renal parenchyma injury.展开更多
AIM: To investigate the incidence and clinical outcome of Clostridium difficile (C. difficile) associated diarrhea (CDAD) in patients with hematologic disease.
Tick-borne diseases(TBDs) are a major public health concern that has increased in the past three decades. Nevertheless, emerging or reemerging TBDs may be still misdiagnosed. Molecular biology techniques for the scree...Tick-borne diseases(TBDs) are a major public health concern that has increased in the past three decades. Nevertheless, emerging or reemerging TBDs may be still misdiagnosed. Molecular biology techniques for the screening of ticks, use of "Omics" approaches and the incorporation of analytical methods such as mass spectrometry or nuclear magnetic resonance, to the study of ticks and their associated pathogens or potential pathogens are promising tools for a more accurate differential diagnosis of TBDs. However, this huge amount of data needs to be carefully interpreted before being incorporated to the routine of clinical practice. In the meantime, a clinical approach and high level of suspicion keep being essential for the diagnosis and proper handling of TBDs.展开更多
Objective:To describe clinical and epidemiological characteristics,antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections(HCAIs)caused by Staphylococcus(S.)aureus in children...Objective:To describe clinical and epidemiological characteristics,antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections(HCAIs)caused by Staphylococcus(S.)aureus in children.Methods:We conducted a retrospective,single-centre study of pediatric HCAIs caused by S.aureus from a tertiary care hospital in Turkey between February 2014 and December 2019.The clinical and epidemiological characteristics and antimicrobial susceptibility of the methicillin-susceptible and methicillin-resistant S.aureus(MSSA and MRSA)isolates was evaluated.Results:A total of 310 pediatric patients were examined.Overall,225(72.6%)isolates were MSSA and 85(27.4%)were MRSA.All S.aureus isolates were susceptible to teicoplanin,vancomycin,linezolid,tigecycline,mupirocin,and daptomycin.Penicillin resistance rates were high(89.0%),while fosfomycin,gentamicin,and clindamycin resistance rates were low(1.3%,1.0%,and 2.3%,respectively).Except susceptibility to fosfomycin,which was significantly lower in 2014 compared to 2018 and 2019,no significant difference was found in the antimicrobial susceptibility of S.aureus isolates between the years.Baseline characteristics and mortality rate were similar comparing MRSA and MSSA causing HCAIs.The mortality rate of HCAIs caused by S.aureus was 6.5%(20 patients).Malignancy was an independent risk factor associated with mortality in the multivariate analysis(OR 5.446,95%CI 1.573-18.849).Conclusions:Our findings demonstrate that MSSA remained the most causative agent of HCAIs caused by S.aureus.The mortality rate was 6.5%,the antibiotic resistance rate was quite high for penicillin and diagnosis of malignancy was the main risk factor for increasing mortality in children.These findings could help improve the management of HCAIs caused by S.aureus in children.展开更多
In recent years,the relationship between intestinal flora and liver disease has become an important research direction of liver diseases.A growing body of evidence indicates that gut bacteria play a key role in the pa...In recent years,the relationship between intestinal flora and liver disease has become an important research direction of liver diseases.A growing body of evidence indicates that gut bacteria play a key role in the pathophysiology of liver disease,this article combed the at home and abroad in recent years,the changes of intestinal flora and autoimmune liver disease,alcoholic liver disease,fatty liver disease related to metabolism,hepatitis b viral hepatitis,cirrhosis and liver cancer occurrence and progress of relationship of related research,And the new progress of regulating intestinal microecology in the treatment of liver diseases.Dysregulation of intestinal flora plays an important role in the occurrence and development of liver diseases.Regulating intestinal flora to improve the prognosis of liver diseases will be an important development direction in the future.展开更多
Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functio...Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functional asplenia (associated with repeated thrombosis of splenic vessels), resulting in increased susceptibility to infection. However, several studies have reported differences in the spectrum of bacterial infections in malaria-endemic areas. Therefore, we proposed to conduct a study to determine the rate of positive blood cultures and the bacteriological spectrum in sickle cell patients. Materials and Method: This is a descriptive cross-sectional study of blood culture samples from patients who received a request for hemoglobin electrophoresis as part of their treatment at the Principal’s hospital in Dakar. The study took place from January 2008 to December 2021. For each patient, we collect demographic information, including age, gender, and the service from which the analysis request originated. Data were collected in the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: Our study included 1419 patients. The most common types of hemoglobin profiles were: normal profile (n = 1025), AS profile (n = 283), SS profile (n = 104), SC profile (n = 7). This corresponds to the proportions of 72%, 20%, 0.5% and 7.5% for the profiles Normal, AS, SC and SS. The male proportion was 61.1%, 61.5%, 57.1, respectively %, 55.8% for Normal, SA, SC, and SS profiles. A total of 19,090 individual blood culture bottles were collected from 1419 impatient patients as follows: Normal profile (n = 18,042 bottles), AS profile (n = 677 culture bottles), SS profile (n = 362 bottles). The majority of blood culture orders come from pediatric services, accounting for 70% of the total number of orders. Of 19,090 vials examined in this current study, 19.6% developed a positive blood culture. Overall, the most commonly isolated bacteria were Staphylococci (41.1%), Enterobacteriaceae (36.7%), Bacillaceae (10.2%), unfermented (6.30%), Streptococci (5.01%), and a small proportion of yeast (0.75%). There is no significant difference in bacterial spectrum between the SS profile and the normal profile of individuals (p = 0.104). Coagulase-negative staphylococci accounted for 32%, 24%, and 40% of the species isolated in the normal AS and SS profiles. respectively. Coagulase-negative staphylococci were the most commonly isolated organisms in SS. Group E and sptagged streptococci each account for less than 2% of the organisms isolated in SS. Pneumococci were not found. Bacillus accounts for 25% of isolates in SS subjects compared to 9% in normal and AS subjects, respectively. Pseudomonas aeruginosa and Burkholderia cepacia then make up 10% of the isolates in the subjects of the SS profile as non-fermenters. Conclusion: Our study shows that enterobacteria and staph are prevalent in people with sickle cell disease. There is no significant difference in bacterial spectrum between SS subjects compared to subjects with a normal profile. The rarity of Streptococcus pneumoniae in bacteremia isolates underlines the need for further studies with larger patient numbers to better understand the spectrum of bacterial infections in patients with sickle cell disease in West Africa.展开更多
Co-infections of the central nervous system (CNS) caused by bacterial and viral pathogens are considered to be rare. Herpes simplex virus type-1 (HSV-1) reactivation following Streptococcus pneumoniae infection is wel...Co-infections of the central nervous system (CNS) caused by bacterial and viral pathogens are considered to be rare. Herpes simplex virus type-1 (HSV-1) reactivation following Streptococcus pneumoniae infection is well described but most cases are related to oral or cutaneous lesions or in respiratory samples. HSV-1 CNS reactivation after Streptococcus pneumoniae meningitis is a very rare event and may have significant morbidity and mortality. In this case report, we describe a 71-year-old female patient that presented with a history of abdominal pain and confusion/disorientation that had tonic-clonic seizures while in the Emergency Department. The diagnostic work-up confirmed CNS co-infection caused by Streptococcus pneumoniae and HSV-1. Of note, beyond age, the patient had no known risk factors for both entities and recovered fully after antibiotic and antiviral therapy. This case underlines that clinicians must be aware of CNS co-infection despite being a rare diagnosis. This should be suspected particularly in patients who present an unusual clinical course of CNS infection.展开更多
文摘The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimicrobials consumed by patients hospitalized to Infectious Diseases’ Clinic. This is a cross-sectional and analytical study, carried out from January 1 to December 31, 2017 in the Infectious Diseases Department of Point “G” Teaching Hospital in Mali. All biological specimens from patients during the study period were analyzed. In total, 322 patients benefited from microbiological test, with a mean age of 40.9 ± 12.2 years (range 15 and 74 years) with a sex ratio of 0.93. Only 5.6% of patients were HIV negative. In all participants, a total of 658 microbiological specimen were taken, 224 (34.0%) identified at least one pathogen including bacteria in more than a half of the cases (58.5%). On the report of bacteriological analysis, the most frequently identified organisms were <i>Mycobacterium tuberculosis</i> (42.2%) mainly in sputum;<i>Escherichia coli</i> (24.2%) and <i>Klebsiella pneumoniae</i> (7.8%) commonly in urine and <i>Gardnerella vaginalis</i> (7.0%) exclusively in vaginal secretions. <i>Candida albicans</i> (5/8) and <i>Cryptococcus neoformans</i> (3/8) were the most common fungi while <i>Plasmodium falciparum</i> (96.4%) represented the parasite frequently found in blood. From a therapeutic standpoint, 1143 antimicrobials were prescribed to 322 admitted patients, <i>i.e.</i> 3.55 anti-infectives per patient. Antibiotics (excluding tuberculosis drugs), antiparasitics and antifungals represented respectively 46.2%;18.8% and 15.1% of anti-infectives. Antibiotic therapy was effective in 274 (85.1%) patients and among them, only 76 (27.7%) cases were based on microbiological evidence. Antibiotics are the most widely used antimicrobials in an infectious disease department. Empiric treatments are common but must be minimized by the search for microbiological evidence.
基金supported by the National Natural Science Foundation of China[42205185]the Natural Science Foundation of Sichuan Province[2024NSFSC0773]+1 种基金the Key Research and Development Plan of Gansu Province[21YF5FA169]China Meteorological Administration“Research on value realization of climate ecological products”Youth Innovation Team Project[CMA2024QN15].
文摘Extreme air temperature and increased weather oscillations caused by climate change have been threatening global health.Meteorological conditions are external inducers that may trigger the onset of gastrointestinal diseases,in addition to bacterial infection or behavioral factors including smoking,alcohol consumption,and hot food consumption[1,2].
文摘Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.
文摘Background: Treating infectious diseases (ID) is the priority of health systems. Traditional Persian medicine (TPM) has diagnostic and preventive comments in most diseases. Readout TPM gives opportunity to know the viewpoints of ancient Iranian scholars for using these opinions in treating ID. In this regard returning to TPM options and modalities can be useful at least as complementary method in treating ID. For understanding the concepts of ID in TPM first of all it is needed to trace ID in TPM and translate them into western medicine language which is the goal of this report. Methodology: This research includes 80 ID mentioned in TIBBE-AKBARI (one of Persian Medicine textbook) for rewriting and comparing with conventional medicine findings. Findings: The majority of clinical signs, symptoms and physical examinations of ID are comparable with modern medicine except the viewpoint of TPM about aetiology which is based on Akhlat and Mezaj theory. By considering no option for antibiotic therapy in ancients time so there is a completely different opinion in treating ID with modern medicine. Conclusion: IDs have different names in TPM and conventional medicine. In contrast to modern medicine in which micro-organism are as etiologic agents, Akhlat and Mezaj theory of TPM has main role for description of ID, the subject which must to be decoded. Although they have completely different opinions in treatment, but with regard to the increasing of antibiotic resistance issue, TPM treatment comments may be useful in future in ID as complementary method beside antibiotics.
基金supported by the Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project under Grant(No.2023ZL140).
文摘Objectives:This study explores the protective effects of glycyrrhizic acid(GA)on sepsis-induced cellular damage and inflammation in acute lung injury(ALI),specifically through the modulation of the sirtuin 1(SIRT1)and high mobility group box 1(HMGB1)pathway.Methods:The study employed two experimental models:lipopolysaccharide(LPS)-induced BEAS-2B human lung epithelial cells and cecal ligation and puncture(CLP)rats,to simulate sepsis conditions.The cell model involved treatments with LPS,GA,control siRNA(si-NC),and SIRT1-specific siRNA(si-SIRT1).Evaluations included cell viability,apoptosis,and cytokine production.In the rat model,treatments included GA and the SIRT1 inhibitor EX527,with assessments on lung tissue damage,inflammation,and protein expression using Western blot and co-immunoprecipitation(Co-IP)analysis.Results:LPS exposure significantly reduced SIRT1 mRNA levels and cell viability in BEAS-2B cells,which effects were reversed by cotreatment with GA and si-NC but negated by si-SIRT1.LPS also induced apoptosis and increased pro-inflammatory cytokines and HMGB1 expression,which were mitigated by GA and si-NC and exacerbated by si-SIRT1.In CLP rats,GA treatment decreased lung tissue damage,inflammatory cytokines,and HMGB1 expression,and enhanced SIRT1 levels.However,these protective effects were reversed when GA was combined with EX527.Conclusion:GA demonstrates significant protective effects against LPS-induced damage and inflammation in lung cells and tissue by modulating the SIRT1-HMGB1 pathway.This suggests that GA could be a potential therapeutic strategy for treating sepsis and related inflammatory conditions.
文摘BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.
基金supported by the National Natural Science Foundation of China(32141003 and 81703399)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(CIFMS,2021-I2M-1-026).
文摘The b-1-6-linked poly-N-acetylglucosamine(PNAG)polymer is a conserved surface polysaccharide produced by many bacteria,fungi,and protozoan(and even filarial)parasites.This wide-ranging expression makes PNAG an attractive target for vaccine development,as it potentially encompasses a broad range of microorganisms.Significant progress has been made in discovering important properties of the biology of PNAG expression in recent years.The molecular characterization and regulation of operons for the production of PNAG biosynthetic proteins and enzymes have been studied in many bacteria.In addition,the physiological function of PNAG has been further elucidated.PNAG-based vaccines and PNAG-targeting antibodies have shown great efficacy in preclinical research.Furthermore,clinical tests for both vaccines and antibodies have been carried out in humans and economically important animals,and the results are promising.Although it is not destined to be a smooth road,we are optimistic about new vaccines and immunotherapeutics targeting PNAG becoming validated and eventually licensed for clinical use against multiple infectious agents.
基金the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(grant no.HI22C0306).
文摘Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult patients with suspected scrub typhus who visited a tertiary care hospital in the Republic of Korea from September to December from 2019 to 2021.The included patients had an acute fever and at least one of the following ten secondary findings:myalgia,skin rash,eschar,headache,thrombocytopenia,increased liver enzyme levels,lymphadenopathy,hepatomegaly,splenomegaly,and pleural effusion.The diagnoses were grouped as scrub typhus or other diseases by two infectious disease physicians.Results:Among 136 patients who met the eligibility criteria,109 had scrub typhus and 27 had different diseases.Single and paired total antibodies using immunofluorescence assay(IFA),and total antibodies using immunochromatography-based rapid diagnostic testing(ICT)were measured in 98%,22%,and 75%of all patients,respectively.Confirmation using paired samples for scrub typhus was established at a median of 11[interquartile range(IQR)10-16]days following the first visit.Among the 82 admitted patients,the median admission time was 9(IQR 7-13)days.According to IFA,58(55%)patients with scrub typhus had total immunoglobulin titers≥1:320,while 23(85%)patients with other disease had titers<1:320.Positive ICT results were observed in 64(74%)patients with scrub typhus and 10(67%)patients with other diseases showed negative ICT results.Conclusions:Serological testing for scrub typhus is currently insufficient for decision-making in clinical practice.
文摘BACKGROUND Musculoskeletal nontuberculous Mycobacterium(NTM)infections are rare,partic-ularly post-acupuncture therapy,and present diagnostic challenges due to their infrequency and potential severity.Prompt recognition and appropriate manage-ment are crucial for optimal outcomes.NTM-infected wounds involving the joints are difficult to treat,and only a few cases have been reported.CASE SUMMARY We present a case of a chronic intractable NTM-infected wound on the elbow joint that completely healed with conservative wound care and antibiotic treatment.An 81-year-old woman presented with a chronic,ulcerative wound on the right elbow joint where she had undergone repeated acupuncture therapy for chronic intolerable pain.Magnetic resonance imaging revealed synovial thickening,effusion,and subcutaneous cystic lesions.An orthopedic surgeon performed open synovectomy and serial debridement.However,1 month postoperatively,the wound had not healed and became chronic.A wound culture revealed NTM(Mycobacterium abscessus),and the patient was referred to the Department of Plastic and Reconstructive Surgery.Instead of surgical intervention,conservative wound care with intravenous antibiotics was provided,considering the wound status and the patient’s poor general condition.Complete wound healing was achieved in 12 months,with no impact on the range of motion of the elbow joint.CONCLUSION With clinical awareness,musculoskeletal NTM infection can be treated with conservative wound care and appropriate antimicrobial agents.
文摘Reperfusion following cerebral ischemia causes both structural and functional damage to brain tissue and could aggravate a patient's condition;this phenomenon is known as cerebral ischemia-reperfusion injury.Current studies have elucidated the neuroprotective role of the sirtuin protein family(Sirtuins)in modulating cerebral ischemia-reperfusion injury.However,the potential of utilizing it as a novel intervention target to influence the prognosis of cerebral ischemia-reperfusion injury requires additional exploration.In this review,the origin and research progress of Sirtuins are summarized,suggesting the involvement of Sirtuins in diverse mechanisms that affect cerebral ischemia-reperfusion injury,including inflammation,oxidative stress,blood-brain barrier damage,apoptosis,pyroptosis,and autophagy.The therapeutic avenues related to Sirtuins that may improve the prognosis of cerebral ischemia-reperfusion injury were also investigated by modulating Sirtuins expression and affecting representative pathways,such as nuclear factor-kappa B signaling,oxidative stress mediated by adenosine monophosphate-activated protein kinase,and the forkhead box O.This review also summarizes the potential of endogenous substances,such as RNA and hormones,drugs,dietary supplements,and emerging therapies that regulate Sirtuins expression.This review also reveals that regulating Sirtuins mitigates cerebral ischemia-reperfusion injury when combined with other risk factors.While Sirtuins show promise as a potential target for the treatment of cerebral ischemiareperfusion injury,most recent studies are based on rodent models with circadian rhythms that are distinct from those of humans,potentially influencing the efficacy of Sirtuinstargeting drug therapies.Overall,this review provides new insights into the role of Sirtuins in the pathology and treatment of cerebral ischemia-reperfusion injury.
文摘Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.
文摘Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present study aims to determine the incidence rate of AAR cases and its complications. Methodology: This was a retrospective and analytical study over a period of 4 years (from January 2015 to December 2018) at the National Laboratory of Clinical Biology and Public Health (LNBCSP) in Bangui. It focused on samples concerning the diagnosis of AAR and patient files seen in consultation in the capital’s reference health establishments. Laboratory registers and patient consultation files were used to collect data. They were entered into Excel 2010 to be analyzed with Epi Info 7. A univariate analysis by logistic regression, Ficher’s exact test, and chi<sup>2</sup> at the 5% threshold (p Results: We analyzed 94 cases meeting Jones’s criteria. The ages of the patients ranged from 18 to 85 years (mean age 52 years and mode 45 years). The incidence rate of AAR for the female sex was higher than that of the male sex during the study period (p > 0.05). It went from 166.6 in 2015 to 200 in 2016 and 2018 cases of AAR per 1000 people per year. The average incidence rate was 296.18 cases of AAR per 1000 people per year. The average incidence rate was 223.5 cases of AAR per 1000 people per year for joint damage. Joint damage represented 80.85% (RR = 0.62;Chi<sup>2</sup> = 4.88;95% CI [0.39-0.97];p Conclusion: The study allowed data on the impact rate and complications of the AAR in Bangui. Special attention to data management will help produce a complete result on the problem. Joint complications predominated. Sustaining an effective surveillance system and preventing infection would help reduce the risk of AAR occurrence.
文摘Autoimmune hepatitis is an inflammatory liver disease primarily mediated by T cell.It has not been fully elucidated about the pathogenesis,and it is presently thought to be related to genetic susceptibility,infection and environmental triggers,and abnormal autoimmune regulation.Recent studies have found that traditional Chinese medicine can improve the biochemical indicators and clinical symptoms of patients with autoimmune hepatitis.This article reviews the specific mechanism of traditional Chinese medicine on treating autoimmune hepatitis in order to propose new ideas for its clinical diagnosis and treatment.
文摘Purpose of the study: Research of the clinical and diagnostic significance of determination of Lipocalin-2 associated with neutrophilic gelatinases (uNGAL) in the urine of children with urinary tract infection (UTI) and pyelonephritis. Materials and methods: We examined 30 children with acute pyelonephritis and UTI aged 1 to 16 years (average age 7.32 ± 4.52) including 26 girls and 4 boys. Verification of the diagnosis was conducted on the basis of clinical and laboratory data, medical history and instrumental examination of patients. All children were divided into 2 groups: 1st group—15 children with acute pyelonephritis, 2nd group—15 children with urinary tract infection. uNGAL was measured in the urine by enzyme-linked immunosorbent assay (EISA) (BioVendor Laboratoty Medicine). Results: It is found, that the urine level of NGAL depends on the damage degree of renal parenchyma. The correlation of medium strength was found between the excretion level of uNGAL during the acute period of pyelonephritis and the detection of renal scars according to the DMSA-nephroscintigraphy data. In the group of children with the acute pyelonephritis the direct correlation of medium strength was found between the excretion level of uNGAL/creatinine and leukocytosis value and also with the CRP blood level. Conclusion: The results allow us to recommend the determination of the excretion level of uNGAL/creatinine as an additional non-invasive marker for the early detection of renal parenchyma injury.
基金Supported by Business of Globalization for Science and Tech-nology funded by the Ministry of Education,Science and Tech-nology,Seoul,South Korea,No.NRF-2011-0031644
文摘AIM: To investigate the incidence and clinical outcome of Clostridium difficile (C. difficile) associated diarrhea (CDAD) in patients with hematologic disease.
文摘Tick-borne diseases(TBDs) are a major public health concern that has increased in the past three decades. Nevertheless, emerging or reemerging TBDs may be still misdiagnosed. Molecular biology techniques for the screening of ticks, use of "Omics" approaches and the incorporation of analytical methods such as mass spectrometry or nuclear magnetic resonance, to the study of ticks and their associated pathogens or potential pathogens are promising tools for a more accurate differential diagnosis of TBDs. However, this huge amount of data needs to be carefully interpreted before being incorporated to the routine of clinical practice. In the meantime, a clinical approach and high level of suspicion keep being essential for the diagnosis and proper handling of TBDs.
文摘Objective:To describe clinical and epidemiological characteristics,antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections(HCAIs)caused by Staphylococcus(S.)aureus in children.Methods:We conducted a retrospective,single-centre study of pediatric HCAIs caused by S.aureus from a tertiary care hospital in Turkey between February 2014 and December 2019.The clinical and epidemiological characteristics and antimicrobial susceptibility of the methicillin-susceptible and methicillin-resistant S.aureus(MSSA and MRSA)isolates was evaluated.Results:A total of 310 pediatric patients were examined.Overall,225(72.6%)isolates were MSSA and 85(27.4%)were MRSA.All S.aureus isolates were susceptible to teicoplanin,vancomycin,linezolid,tigecycline,mupirocin,and daptomycin.Penicillin resistance rates were high(89.0%),while fosfomycin,gentamicin,and clindamycin resistance rates were low(1.3%,1.0%,and 2.3%,respectively).Except susceptibility to fosfomycin,which was significantly lower in 2014 compared to 2018 and 2019,no significant difference was found in the antimicrobial susceptibility of S.aureus isolates between the years.Baseline characteristics and mortality rate were similar comparing MRSA and MSSA causing HCAIs.The mortality rate of HCAIs caused by S.aureus was 6.5%(20 patients).Malignancy was an independent risk factor associated with mortality in the multivariate analysis(OR 5.446,95%CI 1.573-18.849).Conclusions:Our findings demonstrate that MSSA remained the most causative agent of HCAIs caused by S.aureus.The mortality rate was 6.5%,the antibiotic resistance rate was quite high for penicillin and diagnosis of malignancy was the main risk factor for increasing mortality in children.These findings could help improve the management of HCAIs caused by S.aureus in children.
基金National Natural Science Foundation of China (No.8176011)。
文摘In recent years,the relationship between intestinal flora and liver disease has become an important research direction of liver diseases.A growing body of evidence indicates that gut bacteria play a key role in the pathophysiology of liver disease,this article combed the at home and abroad in recent years,the changes of intestinal flora and autoimmune liver disease,alcoholic liver disease,fatty liver disease related to metabolism,hepatitis b viral hepatitis,cirrhosis and liver cancer occurrence and progress of relationship of related research,And the new progress of regulating intestinal microecology in the treatment of liver diseases.Dysregulation of intestinal flora plays an important role in the occurrence and development of liver diseases.Regulating intestinal flora to improve the prognosis of liver diseases will be an important development direction in the future.
文摘Background: Sickle cell disease is one of the most common monogenic diseases in the world, affecting approximately 70 million people, 80% in sub-Saharan Africa and 1 in 10 in Senegal. Sickle cell anemia causes functional asplenia (associated with repeated thrombosis of splenic vessels), resulting in increased susceptibility to infection. However, several studies have reported differences in the spectrum of bacterial infections in malaria-endemic areas. Therefore, we proposed to conduct a study to determine the rate of positive blood cultures and the bacteriological spectrum in sickle cell patients. Materials and Method: This is a descriptive cross-sectional study of blood culture samples from patients who received a request for hemoglobin electrophoresis as part of their treatment at the Principal’s hospital in Dakar. The study took place from January 2008 to December 2021. For each patient, we collect demographic information, including age, gender, and the service from which the analysis request originated. Data were collected in the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: Our study included 1419 patients. The most common types of hemoglobin profiles were: normal profile (n = 1025), AS profile (n = 283), SS profile (n = 104), SC profile (n = 7). This corresponds to the proportions of 72%, 20%, 0.5% and 7.5% for the profiles Normal, AS, SC and SS. The male proportion was 61.1%, 61.5%, 57.1, respectively %, 55.8% for Normal, SA, SC, and SS profiles. A total of 19,090 individual blood culture bottles were collected from 1419 impatient patients as follows: Normal profile (n = 18,042 bottles), AS profile (n = 677 culture bottles), SS profile (n = 362 bottles). The majority of blood culture orders come from pediatric services, accounting for 70% of the total number of orders. Of 19,090 vials examined in this current study, 19.6% developed a positive blood culture. Overall, the most commonly isolated bacteria were Staphylococci (41.1%), Enterobacteriaceae (36.7%), Bacillaceae (10.2%), unfermented (6.30%), Streptococci (5.01%), and a small proportion of yeast (0.75%). There is no significant difference in bacterial spectrum between the SS profile and the normal profile of individuals (p = 0.104). Coagulase-negative staphylococci accounted for 32%, 24%, and 40% of the species isolated in the normal AS and SS profiles. respectively. Coagulase-negative staphylococci were the most commonly isolated organisms in SS. Group E and sptagged streptococci each account for less than 2% of the organisms isolated in SS. Pneumococci were not found. Bacillus accounts for 25% of isolates in SS subjects compared to 9% in normal and AS subjects, respectively. Pseudomonas aeruginosa and Burkholderia cepacia then make up 10% of the isolates in the subjects of the SS profile as non-fermenters. Conclusion: Our study shows that enterobacteria and staph are prevalent in people with sickle cell disease. There is no significant difference in bacterial spectrum between SS subjects compared to subjects with a normal profile. The rarity of Streptococcus pneumoniae in bacteremia isolates underlines the need for further studies with larger patient numbers to better understand the spectrum of bacterial infections in patients with sickle cell disease in West Africa.
文摘Co-infections of the central nervous system (CNS) caused by bacterial and viral pathogens are considered to be rare. Herpes simplex virus type-1 (HSV-1) reactivation following Streptococcus pneumoniae infection is well described but most cases are related to oral or cutaneous lesions or in respiratory samples. HSV-1 CNS reactivation after Streptococcus pneumoniae meningitis is a very rare event and may have significant morbidity and mortality. In this case report, we describe a 71-year-old female patient that presented with a history of abdominal pain and confusion/disorientation that had tonic-clonic seizures while in the Emergency Department. The diagnostic work-up confirmed CNS co-infection caused by Streptococcus pneumoniae and HSV-1. Of note, beyond age, the patient had no known risk factors for both entities and recovered fully after antibiotic and antiviral therapy. This case underlines that clinicians must be aware of CNS co-infection despite being a rare diagnosis. This should be suspected particularly in patients who present an unusual clinical course of CNS infection.
