International Journal of Infectious Diseases最新文献

{"title":"Transient Expression of Recombinant Antimicrobial Peptide Meucin18 in Nicotiana tabacum and its Antimicrobial Susceptibility Testing","authors":"Mr Parthiban Subramanian, Ms Sakshi Chavhan, Mr Rudranil Saha, Dr. SATHISHKUMAR RAMALINGAM","doi":"10.1016/j.ijid.2024.107406","DOIUrl":"10.1016/j.ijid.2024.107406","url":null,"abstract":"<div><h3>Introduction</h3><div>Scorpion venom peptides as antimicrobial peptides (AMPs) possess high bactericidal activity against a broad range of Gram-positive and Gram-negative bacteria. Meucin-18, a venom peptide of molecular weight 2.1 kDa from Mesobuthus eupeus, shows high bacteriolytic potential, and so recombinant production in E. coli is highly unlikely. Hence, recombinant Meucin-18 is transiently expressed in an efficient alternate host, Nicotiana tabacum plant system, to test its antibacterial efficacy.</div></div><div><h3>Methods</h3><div>The gene sequence (54 bp) coding Meucin18 fused with a C-terminal 6X histidine tag and an ER localization signal KDEL, was codon optimized, synthesized de novo and custom cloned into pENTR-D-TOPO Gateway vector. Gateway LR cloning was performed to produce expression construct pEAQ-HT-DEST3-Meucin18. A quantity of 100 ng expression construct was transformed into electrocompetent Agrobacterium tumefaciens GV3101 through electroporation, pulsed at 1800V for 5 ms. Agrosuspension was prepared with 1X MES infiltration medium containing 100 µM acetosyringone. Leaves of N. tabacum plants maintained at 26°C were syringe infiltrated with agrosuspension in abaxial side. Total protein was extracted from 5 days post infiltration (dpi) leaves using extraction buffer (Tris-HCl 100mM; pH 7.5 and 0.1M KH2PO4; pH 6.4). Recombinant Meucin18 AMP was purified by Ni-NTA affinity chromatography and analyzed on tricine-SDS-PAGE, and Western blot using anti-His6 peroxidase antibody. Recombinant fusion AMP will be tested for its efficacy against bacteria (pathogenic and non-pathogenic) using classical agar diffusion and broth microdilution assays.</div></div><div><h3>Results</h3><div>Plant expression construct pEAQ-HT-DEST3-Meucin18 was transformed into E. coli DH5ɑ for propagation and confirmed through PCR and restriction digestion analysis. pEAQ-HT-DEST3-Meucin18 from A. tumefaciens GV3101 was isolated and confirmed using PCR analysis. Total crude protein from 5 dpi N. tabacum leaf sample was measured, at A280 using an Epoch Take3 spectrophotometer, to be 11.51 mg/g and 20.76 mg/g of fresh leaf tissue and the protein content from uninfiltrated leaf sample was measured to be 8.90 mg/g of fresh leaf tissue. The quantity of purified sample was found to be 21.4 µg/g that will be confirmed using 16% tricine-SDS-PAGE and Western blot. Further, recombinant Meucin18 will be tested for its bactericidal potential using agar diffusion and broth microdilution assays.</div></div><div><h3>Discussion</h3><div>Scorpion venom peptides have been assessed for their potential to act against a broad range of bacteria including Methicillin resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Bacillus subtilis, Micrococcus luteus, Pseudomonas aeruginosa and E. coli. N. tabacum plant system proves to be a better host system for transient expression of recombinant functional antimicrobial peptides such as protegrin-1. Further optimiz","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107406"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Tract Infections at Mass Gatherings","authors":"Prof Jaffar Al-tawfiq","doi":"10.1016/j.ijid.2025.107819","DOIUrl":"10.1016/j.ijid.2025.107819","url":null,"abstract":"<div><h3>Introduction</h3><div>Large-scale events that bring people together, like music festivals, athletic competitions, and religious pilgrimages, can foster the spread of respiratory pathogens by drawing large crowds of people in close quarters. Planning and implementing public health interventions and plans effectively requires an understanding of the dynamics and effects of RTIs in these contexts.</div></div><div><h3>Methods</h3><div>A thorough literature review was done to look at reports and studies about RTIs at large gatherings. Using electronic databases like PubMed, Scopus, and Google Scholar, pertinent articles were found. \"Respiratory tract infections,\" \"mass gatherings,\" \"outbreaks,\" and associated keywords were among the search terms used. The review included studies that looked at the epidemiology, risk factors, transmission patterns, and interventions for RTIs in situations involving large crowds.</div></div><div><h3>Results</h3><div>The analysis produced a number of important conclusions. First off, respiratory viruses like influenza, respiratory syncytial virus (RSV), and coronaviruses are the main causes of RTIs, which are frequently observed during large crowds. Second, the quick spread of respiratory pathogens is facilitated by close contact between attendees, insufficient ventilation, and overcrowding. Third, elements including the length of the event, the type of activities, and the participants' demographics all have an impact on the risk of RTI transmission. Fourth, successful preventive initiatives have demonstrated encouraging outcomes in lowering the incidence of RTIs at large gatherings. These initiatives include vaccination campaigns, hand hygiene promotion, and respiratory etiquette.</div></div><div><h3>Discussion</h3><div>In order to lessen the impact of RTIs at large gatherings, it is crucial to conduct proactive surveillance, evaluate risks, and put preventive measures in place. Combining public health strategies like case isolation, early detection, and contact tracing can help manage outbreaks and reduce the spread of respiratory pathogens. Furthermore, the implementation of technology-driven monitoring platforms and crowd control techniques can facilitate the prompt detection and remediation of possible epidemics.</div></div><div><h3>Conclusion</h3><div>Since mass gatherings are high-density events, respiratory tract infections are a significant risk. To lessen the effects of RTIs and safeguard the public's and participants' health, thorough planning is necessary. This includes providing an appropriate healthcare infrastructure, communicating effectively, and implementing targeted preventive interventions. Subsequent investigations ought to concentrate on assessing the efficacy of interventions and improving tactics to augment respiratory infection control during large-scale assemblies.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107819"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Pillbox-enabled Self-administered Therapy Versus Standard Directly Observed Therapy for Tuberculosis Medication Adherence and Treatment Outcomes in Ethiopia: a Multicenter Randomized Controlled Trial","authors":"Dr Tsegahun Manyazewal ,&nbsp;Dr. Yimtubezinash Woldeamanuel ,&nbsp;Mr. Tewodros Getinet ,&nbsp;Ms Alison Hoover ,&nbsp;Dr Kidist Bobosha ,&nbsp;Mr Oumer Fuad ,&nbsp;Dr. Belete Getahun ,&nbsp;Prof. Abebaw Fekadu ,&nbsp;Dr. David Holland ,&nbsp;Prof. Vincent Marconi","doi":"10.1016/j.ijid.2024.107397","DOIUrl":"10.1016/j.ijid.2024.107397","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The prolonged and complex nature of anti-tuberculosis regimens contributes to suboptimal medication adherence, leading to poor treatment outcomes and drug resistance. Trials evaluating the effectiveness of digital adherence technologies are urgently needed. This study aimed to evaluate the effectiveness of pillbox-enabled self-administered therapy (SAT) compared to standard DOT on adherence to tuberculosis medication and treatment outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this multicenter, randomized controlled trial, adults diagnosed with new or previously treated, bacteriologically-confirmed, drug-sensitive pulmonary tuberculosis and eligible to commence anti-tuberculosis therapy were enrolled from 10 healthcare facilities across Ethiopia. Participants were allocated in a 1:1 ratio to either receive a 15-day supply of tuberculosis medication dispensed with an evriMED500® digital medication event reminder and monitor (MERM) device for self-administration and return every 15 days, or to undergo standard DOT. The MERM device integrates an electronic module and medication container, serving to record adherence, securely store medication, emit audible and visual alarms onboard to prompt patients for timely intake and refills, and facilitates healthcare providers in downloading data for monitoring adherence closely. Both groups were monitored throughout the standard two-month intensive treatment phase. The primary endpoints, analyzed following the intention-to-treat (ITT) principle, included were individual-level percentage adherence during the two-month intensive phase, and sputum smear conversion. Secondary endpoints were a negative IsoScreen urine isoniazid test, adverse treatment outcomes, and self-reported adherence. ClinicalTrials.gov: NCT04216420.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 337 patients underwent eligibility screening, with 114 randomly assigned and included in the final analysis (57 in the control group and 57 in the intervention group). Adherence to tuberculosis medication showed comparable rates between the intervention arm (geometric mean percentage [GM%] 99.01%, geometric standard deviation [GSD] 1.02) and the control arm (GM% 98.97%, GSD 1.04), falling within the predefined margin for non-inferiority [mean ratio (MR) 1.00 (95% CI 0.99-1.01); p=0.954]. Urine isoniazid testing was conducted on 443 (97%) samples obtained from 114 participants, revealing that 13 participants yielded at least one negative result. A negative test was more prevalent among the control group compared to the intervention group (p=0.008). There were no significant difference observed regarding smear conversion, adverse treatment outcomes, and self-reported non-adherence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;In this randomized controlled trial involving patients with drug-susceptible pulmonary tuberculosis, self-administered therapy facilitated by the MERM device demonstrated treatment adherence comparable","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107397"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Societal values for health inequality aversion via vaccine and non-vaccine interventions in Canada – a benefit trade-off analysis","authors":"Prof Beate Sander ,&nbsp;Dr Shehzad Ali ,&nbsp;Dr Sharmistha Mishra ,&nbsp;Dr Beate Sander","doi":"10.1016/j.ijid.2024.107454","DOIUrl":"10.1016/j.ijid.2024.107454","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Canada is committed to reducing avoidable health inequalities associated with infectious diseases. However, conventional economic evaluation, a critical component of health technology assessments informing health resource allocation, fails to account for health equity issues. Conducting equity-informative economic evaluation requires understanding the extent to which Canadians are averse to health inequalities. Therefore, the objective of our study was to elicit Canadians’ aversion to reduce health inequalities, and whether these preferences varied when evaluating interventions specific to infectious diseases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted three online surveys among representative samples of adult Canadians to elicit value judgements about reducing health inequality between populations with the highest and lowest income (i.e., household income quintiles) vs. improving overall health irrespective of its distribution (i.e., life expectancy). The first survey was specific to infectious diseases, and respondents were asked to choose between a universal and a tailored vaccination program. Tailored vaccination (e.g., special outreach for underserved populations) had a more equitable distribution of additional life years, while universal vaccination was more efficient. The second survey compared universal vs. tailored prevention programs. Finally, the third survey presented generic health programs (program A vs. program B). We used benefit trade-off analysis to estimate health inequality aversion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We recruited 3,000 adult Canadians (1,000 for each survey). Preferences for the vaccine, prevention, and generic programs were distributed as follows: minimizing inequalities (i.e., egalitarians): 54%, 55%, and 57%, respectively; maximizing the health of the population with the highest income (i.e., pro-rich): 31%, 22%, and 16% respectively; willingness to trade some health to reduce inequalities (i.e., weighted prioritarians): 13%, 19%, and 22% respectively; and maximizing total health, regardless of how life years were distributed (i.e., health maximizers): 2%, 3%, and 2%, respectively. The median respondent preferred minimizing health inequalities, across the three surveys. A stronger aversion for health inequality was observed among females, younger respondents (18-40 years old), and populations with lower income (&lt;$50,000 household income per year).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Preferences for reducing health inequality were impacted by the type of interventions being compared. When evaluating vaccine-specific programs, most respondents were located at the extremes of the distribution (i.e., pro-rich or egalitarians), while utilizing generic terminology (i.e., generic programs) reduced the proportion of inequality-seeking preferences. However, over half of the respondents were consistently willing to minimize health inequalities regardless of the cost to ","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107454"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a clinical decision support algorithm (ePOCT+) in improving quality of care for sick children in primary health facilities in Tanzania (DYNAMIC project): results from a cluster randomized trial","authors":"Dr Caroline Enos ,&nbsp;Godfrey A. Kavishe ,&nbsp;Alexandra V. Kulinkina ,&nbsp;Sabine Renggli ,&nbsp;Chacha D. Mangu ,&nbsp;Lameck Luwanda ,&nbsp;Peter Agrea ,&nbsp;Humphrey Mhagama ,&nbsp;Margaret Joram ,&nbsp;Ibrahim Mtebene ,&nbsp;Geofrey Isdory Ashery ,&nbsp;Marie-Annick Le Pogam ,&nbsp;Honorati Masanja ,&nbsp;Nyanda E. Ntinginya ,&nbsp;Valérie D'Acremont ,&nbsp;Rainer Tan","doi":"10.1016/j.ijid.2024.107409","DOIUrl":"10.1016/j.ijid.2024.107409","url":null,"abstract":"<div><h3>Introduction</h3><div>The Integrated Management of Childhood Illness (IMCI) chartbook for managing sick children under five years improves quality of care and reduces childhood mortality. However, compliance to IMCI remains a challenge. Electronic clinical decision support algorithms (eCDSAs) are a promising solution to improve IMCI compliance. We performed a cross-sectional study to evaluate whether an eCDSA based on IMCI improves quality of care compared to usual care in Tanzanian primary health facilities.</div></div><div><h3>Methods</h3><div>18 health facilities (9 intervention and 9 control, randomized 1:1) were sampled from the main cluster randomized trial. Children aged 2-59 months with an acute illness were enrolled and consultations were observed by an independent researcher. The intervention consists of the use of an electronic point of care tool (ePOCT+) and clinical mentorship. The primary outcome measure was the mean score of major IMCI symptoms and signs assessed.</div></div><div><h3>Results</h3><div>450 consultations (225 in each arm) were observed. The mean score of major IMCI symptoms and signs was 42% (95% CI: 39% - 44%) in intervention facilities and 23% (95% CI: 22% - 25%) in control facilities (p&lt;0.001). The use of ePOCT+ significantly increased the proportion of assessment of convulsions (33% vs 7%) and nutrition status assessment (60% vs 2%) compared to routine care clusters (p&lt;0.001). There were however no significant differences between the intervention and control arms for other measures such as fever assessment (91% vs 87%; p=0.148) and height measurement (1.3% vs 0.4%; p=0.315).</div></div><div><h3>Discussion</h3><div>Clinical skills and adherence to the guidelines among healthcare workers are among the major challenges in primary healthcare facilities. ePOCT+ CDSA improves adherence to IMCI, quality of clinical assessment and disease management by Improving history taking, prompting and guiding healthcare workers to assess the danger signs and improving the quality of physical examination. ePOCT+ CDSA can be an invaluable tool to improve the quality of care, clinical outcome and reduce mortality in resource-limited settings.</div></div><div><h3>Conclusion</h3><div>ePOCT+ significantly improves quality of care for sick children in primary health facilities in Tanzania.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107409"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance of H. pylori prevalence and antibiotic resistance in the urban Chinese population: a nationwide multi-center study","authors":"Dr Liang Wang","doi":"10.1016/j.ijid.2024.107411","DOIUrl":"10.1016/j.ijid.2024.107411","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;China has a high antibiotic-resistant H. pylori infection burden. The current knowledge of H. pylori prevalence and antibiotic resistance in China is mainly based on meta-analysis and systematic review. In addition, since H. pylori prevalence is tightly associated with economic development, the H. pylori infection and antibiotic resistance rates in the urban Chinese population may be significantly changed due to the rapid socioeconomic development over the past twenty-year urbanization. However, the actual situation is unknown. Therefore, this study conducted a nationwide, multi-center, cross-sectional surveillance using the string test coupled with qPCR to provide an accurate overview of H. pylori prevalence and antibiotic resistance to clarithromycin and levofloxacin in urban China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;From March to November 2023, 12,902 individuals aged from 18 to 60 years old were recruited from 52 cities belonging to 26 out of 31 provinces in mainland China. All the individuals were examined for H. pylori infection and antibiotic resistance to clarithromycin and levofloxacin via quantitative PCR of gastric fluid samples collected through string test. All results were statistically analyzed via univariate analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among all participants, the average individual-based H. pylori infection rate in urban China was 27.08%. Among 26 out of 31 provinces, the infection rates of H. pylori ranged from 15.25% in Hunan to 41.47% in Fujian. According to the division of seven geographic regions, Eastern China has the highest H. pylori infection rate of 32.45%. As for antibiotic resistance of H. pylori, the average clarithromycin resistance rate is 50.82%, while the average levofloxacin resistance rate is 47.17%.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The investigation discloses that the prevalence of H. pylori among urban Chinese is notably lower than previous reports. This variance, indicative of improvement, can be attributed to the progressive enhancement of sanitary conditions and advancements in medical care within urban regions of mainland China over the preceding two decades. In addition, it was found that the resistance rates to clarithromycin and levofloxacin are unexpectedly high in the urban Chinese population. This may be related to the increased use of antibiotics to treat gram-negative bacterial infections. It is imperative to highlight the strengths of this investigation, which encompass the application of a singular methodology for precise evaluation of the present prevalence of H. pylori and antibiotic resistance within the urban Chinese population. Meanwhile, notable limitations of this study involve discrepancies in sample sizes and the absence of data from five provinces.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study updates our understanding of the current prevalence and antibiotic resistance to clarithromycin and levofloxacin of H. pylori in urb","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107411"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of Protective Anti-Hbs Antibodies among Healthy Indian Children and Adults Immunized in Infancy","authors":"Dr Sanjay Verma ,&nbsp;Dr Nazakat Hussain ,&nbsp;Dr Amit Rawat ,&nbsp;Dr Vikas Suri ,&nbsp;Dr Vanita Suri","doi":"10.1016/j.ijid.2024.107449","DOIUrl":"10.1016/j.ijid.2024.107449","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Hepatitis-B (HB) virus infection is a serious public health problem worldwide. It's almost 20 years since HB vaccination was first introduced in our National Immunization Schedule (NIS). The study aimed to determine the proportion of subjects in various age groups (children and adults) having anti-Hbs antibody levels in the seroprotective range following early infantile hepatitis-B vaccination.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and Methods&lt;/h3&gt;&lt;div&gt;In this cross-sectional, observational study, apparently healthy subjects from OPDs of a tertiary care hospital in Northern India, over last one-year were enrolled after taking informed consent. Institute ethics committee clearance was obtained before enrolment. Only those subjects in specified age groups (4-6, 9-12, 16-20 years) were enrolled, who had completed vaccination during infancy, including a minimum of three doses of HB vaccine, and received no other dose of HB vaccination after infancy. Serum samples of subjects were used for measuring anti-Hbs titers (quantitative), anti-Hbc, and HbsAg (qualitative) by standard commercial ELISA kits. Anti-Hbs antibody titers &gt;10 mIU/ml WHO was considered as protective.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 79 subjects (M:F=48:31) were enrolled from three age groups. When tested for anti-HB antibodies in these subjects aged 4-6, 9-12, and 16-20 years, 82.7%, 73.7%, and 55% had antibodies in the protective range, respectively. This gradual decline with increasing age was also noticed in GMTs, which were 33.6, 20.9, and 19.9 mIU/mL, respectively. Out of the total subjects enrolled, 16 (20.2%) developed a subclinical natural infection shown by the presence of anti-HBc antibodies. Despite the decrease in titers of anti-HBs antibodies, such individuals remain protected against clinical illness and chronic HB virus infection upon exposure to the virus, as all of them were negative for HBsAg.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Our study shows that quite a good number of subjects developed subclinical natural infection even after primary hepatitis-B vaccination in infancy. All of them were subclinical infections, which the body could clear off, as none was HBsAg positive. Despite the disappearance of anti-HBs, such immunized individuals remain protected against clinical illness and chronic HBV infection upon exposure to the virus.&lt;/div&gt;&lt;div&gt;Experts and most available guidelines stress upon high-risk people (including HCWs) to document postvaccination serological testing of anti-HB antibodies to ensure vaccine uptake. Once they have documented evidence of immunological response to the vaccine, they don't need regular boosters for hepatitis B in the future, even if their protective titers go down, because of immunological memory and the long incubation period of HBV infection.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Infants who received Hepatitis-B vaccination in early infancy, when they become adults, may develop a mild in","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107449"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress on implementation of the World Health Organization global antimicrobial resistance surveillance system recommendations on antimicrobial resistance surveillance in Africa: Findings of preliminary analysis of a scoping review","authors":"Dr Mackline Hope,&nbsp;Dr Reuben Kiggundu,&nbsp;Mr Dickson Tabajjwa,&nbsp;Mr Fahad Lwigale,&nbsp;Mr Herman Mwanja,&nbsp;Dr Conrad Tumwine,&nbsp;Dr Jonathan Mayito,&nbsp;Dr Dathan M Byonanebye,&nbsp;Dr Andrew Kambugu,&nbsp;Dr Francis Kakooza","doi":"10.1016/j.ijid.2024.107396","DOIUrl":"10.1016/j.ijid.2024.107396","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Antimicrobial resistance (AMR) is a significant global health concern, especially impacting low- and middle-income countries. The World Health Organization (WHO) global antimicrobial resistance surveillance system (GLASS) was rolled out in 2016 to guide AMR surveillance systems. However, its implementation has not been fully evaluated. We conducted a scoping review of the current status of implementation of GLASS and present preliminary findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We developed a search strategy and retrieved articles conducted between January 2016 and November 2023 from four electronic databases (MEDLINE, SCOPUS, CINAHL, and Embase). We followed the Arksey and O'Malley's methodological framework for scoping reviews to guide analysis and reporting. We extracted data on priority samples, pathogens, pathogen-antibiotic combinations and assessed compliance to WHO GLASS recommendations on AST and AMR surveillance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;7477 articles were identified, 6868 duplicates and irrelevant articles were removed at abstract screening, and 609 studies were included for the full-text review, of which 344 were considered for data extraction. Of the 344 studies, 38/344 (11%) were included in this analysis. Majority of studies were conducted in Eastern 50% (19/38), followed by Western 34% (13/38) and Northern 16% (6/38), Africa. 95% (36/38) of studies were conducted in hospital settings. Majority 92% (35/38) of the studies involved only one priority sample type (blood 46% (16/35); urine 32% (11/35) and stool 23% (8/35); while 8% (3/38) studies involved the collection of two priority sample types, specifically urine and blood. Of the 19 studies that focused on blood as a priority sample type, 8 (42%), 11 (58%), 13 (68%), 10 (53%), 1 (5%) and 5 (26%) recovered Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Salmonella species respectively. Shigella and Salmonella species were recovered from 6 (75%) and 7 (88%) of the 8 studies that focused on stool. Escherichia coli and Klebsiella pneumoniae were also recovered from 11 (79%) of the 14 studies that focused on urine. Compliance to GLASS priority pathogen-antibiotic combinations was 13% (1/8), 9% (1/11), 8% (1/13), 70% (7/10), and 60% (3/5) of the studies that recovered Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Salmonella species from blood respectively. 17% (1/6) and 29% (2/7) of the studies that recovered Salmonella and Shigella species from stool followed the GLASS priority pathogen-antibiotic combinations for AST. None of the studies on urine followed the GLASS-recommended pathogen-antibiotic combination.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Africa has made progress in implementing the GLASS recommendations. However, adoption of GLASS recommendations including appropriate pathogen-antibiotic combinations for priority pathogens and samples, ","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107396"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibacterial Activity of Ceftazidime-avibactam against carbapenem-resistant non-fermenters Gram-negative bacteria: a cross-sectional study from a tertiary care hospital","authors":"Dr Farhan Rasheed","doi":"10.1016/j.ijid.2024.107392","DOIUrl":"10.1016/j.ijid.2024.107392","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Ceftazidime-avibactam (CAZ-AVI) is an innovative combination of the non-ß-lactam ß-lactamase inhibitor avibactam and the extended-spectrum ceftazidime. This combination is effective in treating infections resulted frommultidrug resistant (MDR) Gram-negative bacteria. Therefore, the present study was done to determine the efficacy of CAZ-AVI in carbapenem-resistant against non-fermenters Gram-negative bacteria.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;The present study was done at a tertiary care hospital in Lahore, Pakistan over the period of 2 years. Different clinical samples were processed according to standard microbiological techniques. Confirmation of bacterial isolates was done by different biochemical tests. Antimicrobial sensitivity testing was done onVitek 2® automated system. CAZ-AVI sensitivity testing was performed for carbapenem-resistant isolates on Meuller Hamilton (MH) agar according to Clinical and Laboratory Standard institute (CLSI) guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;CAZ-AVI was 100% sensitive in carbapenem sensitive isolates. Among non-fermenters, highest resistance against CAZ-AVI was found in Acinetobacterspp. (90.8%) while 75% resistance was observed in P. aeruginosa isolates. Maximum number of isolates were collected from wound (35%) followed by pus (16.8%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;In our study, 66.7% resistance was observed against CAZ-AVI among the isolates of carbapenem resistant P. aeruginosa while only 33.3% isolates were found to be susceptible. Similar to our results, reduced susceptibility rate of P. aeruginosa was also reported from several other countries. Lowest susceptibility rates were observed in Romania which was22.2%, 23.1% in Latvia/Lituania and 39.4% susceptibility rate was reported from Ukraine[19]. These results were in accordance with our findings. Contradiction to our results, a study conducted in 2018, reported only 2.9% resistance against CAZ-AVI among P. aeruginosa isolates but the isolates were carbapenem sensitive[20].However, several other studies reported higher resistance rates of 50.9% and 48.2% especially when the isolates were extensively drug resistant or resistant to carbapenems respectively[21]. Moreover, it was also found that MBL-positive isolates also showed &gt;95% resistance rate against ceftazidime-avibactam[22, 23].&lt;/div&gt;&lt;div&gt;Our study reported 74.7% resistance in A. baumanii against CAZ-AVI, consistent to our results, a study conducted by Sader et al in 2015 reported 68.8% resistance of CAZ-AVI in Acinetobacter isolates. Higher resistance was observed in isolates collected from intensive care units (ICUs) which was 73.6%[24].Moreover, MDR and blaOXA-51 gene carrying isolates were found to be completely resistant against CAZ- AVI[25]. Another study conducted on cancer patients reported 57.1% resistance of Acinetobacter spp. against CAZ-AVI. Likewise, several other antimicrobial agents were found to be of moder","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107392"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Antimicrobial Stewardship: A Survey of Distribution Practices in Dispensaries in Ghana","authors":"Ms Hannah Greene ,&nbsp;Dr. Kinga Makovi ,&nbsp;Rafiatu Abdul-Mumin ,&nbsp;Dr. Akhil Bansal ,&nbsp;Dr. Jemima Frimpong","doi":"10.1016/j.ijid.2024.107393","DOIUrl":"10.1016/j.ijid.2024.107393","url":null,"abstract":"<div><h3>Introduction</h3><div>The extent of antimicrobial stewardship practices remains uncertain in Ghana, a context where health care frequently takes place at the community level, and in private sector entities. Private medicine vendors have previously been identified as disproportionate drivers of antimicrobial misuse fueling the emergence of antimicrobial-resistant pathogen outbreaks. This study sought to assess antimicrobial distribution in dispensaries in Accra, Ghana, to determine patterns in risk for antimicrobial misuse.</div></div><div><h3>Methods</h3><div>A 72-question survey questionnaire explored the backgrounds, behaviors, and medicine dispensation patterns of dispensaries’ staff (shopkeepers). The survey also assessed economic indicators of the surrounding community, alongside an inventory of sales trends, prices, medications, and neighborhood-level socioeconomic condition. The survey was conducted with 83 pharmacies and chemical shops.</div></div><div><h3>Results</h3><div>We found that the type of medication most relied upon varied by location. The frequency of antibiotic and antimalarial sales varied widely, with average estimates that antibiotics represented 27% of sales in pharmacies. A majority of respondents asserted that medical decision-making is primarily navigated based on the amount of money on hand for a customer. Shopkeepers exercised a variety of strategies to respond to customers' insufficient funds, the most central of which was a practice of offering progressively lower-cost, generic-brand medicines. Misuse of antimicrobials appears to be relatively limited, but may still occur via over-prescription, unqualified dispensing practices, and the use of subtherapeutic quantities of antibiotics. Over 50% reported occasionally selling incomplete treatment courses to customers unable to pay for an entire course at once.</div></div><div><h3>Discussion</h3><div>Respondents revealed an overall intention to judiciously guard antibiotics, but a lack of systemic interventions, given competing forces. Key findings suggested that middle-income neighborhoods faced the highest risk of antimicrobial overuse, driven by patient-level expectations, mixed economic access, and weaker stewardship practices by shopkeepers. The findings of this study offer a more recent and detailed outlook on antimicrobial use than prior works in this context.</div></div><div><h3>Conclusion</h3><div>Shopkeepers' understanding of clients' preferences and disincentives for purchase can inform interventions in the scope of user behaviors. Expanding the diagnostic, health surveillance, and treatment capacity of shopkeepers shows promise for public health interventions seeking to improve stewardship of antimicrobials at the community level.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107393"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}