International Journal of Infectious Diseases最新文献

{"title":"A comparative analysis of the impact of climate change on emergence of infectious diseases and outbreaks in remote areas of Sindh, Pakistan","authors":"Miss Hafsa Faruqui, Dr. Saeed Khan","doi":"10.1016/j.ijid.2024.107430","DOIUrl":"10.1016/j.ijid.2024.107430","url":null,"abstract":"<div><h3>Introduction</h3><div>Remote areas in the Sindh province of Pakistan are characterized by challenging terrain, limited access to healthcare, and poor infrastructure. These regions often face a higher burden of infectious diseases due to the lack of proper healthcare facilities. Diagnostic surveillance plays a crucial role in monitoring disease prevalence since it enables early detection, timely intervention, and developing effective public health strategies. Among other factors, climate change also influences disease distribution and severely impacts the incidence of several illnesses. For instance, recent flooding in Sindh caused a surge in waterborne diseases, due to contaminated water sources and inadequate sanitation that act as breeding grounds for pathogens. Comparative analysis of disease surveillance pre- and post-floods can help in understanding the changes in disease dynamics which are instrumental in refining public health strategies and optimizing resource allocation in the face of environmental challenges. This study was designed to compare and analyze disease distribution before and after the 2022 floods in remote areas of Sindh, Pakistan. By comparing the two time periods, the study aimed to identify seasonal trends for infectious diseases to design effective strategies that minimize transmission rates and reduce healthcare burden.</div></div><div><h3>Methods</h3><div>To access the rough terrain in the remote areas of Sindh, a USAID funded, fully-equipped BSL-2 mobile laboratory with a team of microbiologists from the Provincial Public Health Laboratory, Dow University of Health Sciences visited Ratodero, Aarija Taluka, Kambar, Nasirabad, Dokery, Sukkur, and Gadap. This study happened in two phases, before and after the 2022 floods. Diagnostic tests for HIV, malaria, hepatitis B, hepatitis C, typhoid, and COVID-19 antibody were performed, along with complete blood count.</div></div><div><h3>Results</h3><div>A total of 2858 tests were performed out of which 56% were males and 44% females. During phase I (pre-floods), 5.2% had malaria, 1.9% had HCV, and 12% were positive for COVID-19 antibody. During phase II (post-floods), 46.6% were positive for malaria, 31.7% for COVID-19 antibody, 9.2% for HCV, 8% COVID-19 antigen, and few cases of HIV, hepatitis B, and typhoid were also detected.</div></div><div><h3>Discussion</h3><div>This study highlights the pressing health challenges faced by remote areas in Sindh, Pakistan, exacerbated by climate change-induced events like floods. The comparative analysis of disease distribution before and after the 2022 floods underscores the vulnerability of these regions to infectious diseases like malaria and COVID-19.</div></div><div><h3>Conclusion</h3><div>Climate change poses a significant threat to low-income countries, especially remote areas, worsening the already considerable disease burden they face. Routine monitoring and surveillance of disease prevalence is crucial to create targeted","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107430"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520659","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":"Targeting cytokine signaling in mice infected with bunyaviruses provides protection from severe disease and death","authors":"Dr Joseph Golden, Dr. Xiankun Zeng, LTC Curtis Cline, Dr. Charles Shoemaker, Dr. Jun Liu, Mr. Collin Fitzpatrick, Dr Christopher Stefan, Dr. Aura Garrison, Dr. Brian Carey","doi":"10.1016/j.ijid.2024.107415","DOIUrl":"10.1016/j.ijid.2024.107415","url":null,"abstract":"<div><h3>Introduction</h3><div>Crimean-Congo hemorrhagic fever virus (CCHFV) is an important human pathogen in the Bunyavirales order. CCHFV causes a spectrum of disease in humans that can range from minimally symptomatic to a catastrophic and lethal infection. Factors dictating why some develop mild illness and others succumb to disease are unclear. The cytoplasmic RNA sensor, retinoic acid-inducible gene I (RIG-I), has been shown to sense CCHFV in cell culture. When recognized by RIG-I an adaptor molecule, mitochondrial antiviral signaling (MAVS), induces pro-inflammatory responses as well as type I interferon (IFN-I).</div></div><div><h3>Methods</h3><div>We used a mouse model of CCFHV infection in various pathogen sensing and cytokine deficient animals to examine their role in the disease process. We also used antibodies targeting cytokines to show their importance in the disease process.</div></div><div><h3>Results</h3><div>We found that MAVS-deficient mice are not susceptible to CCHFV infection and show no signs of disease when IFN-I signaling was active. However, in an antibody mediated IFN-I suppressed mouse model, mice were uniformly protected from lethal disease (albeit with significant weight loss) and showed significantly blunted cytokine signaling, specifically TNF-α. All control mice succumbed to infection and displayed high cytokine levels. Additionally, we found that a disease causing but non-murine lethal strain of CCHFV (Kosova Hoti) produced more blunted inflammatory cytokine responses compared to a lethal strain (Afg09-2990) in mice. Subsequent investigation revealed that CCHFV infected mice lacking TNF-α receptor signaling (TNFA-R-deficient) had reduced liver pathology and were largely protected from lethal outcomes. Further, treatment of mice with an anti-TNF-α neutralizing antibody conferred partial protection in a post-virus exposure setting. Finally, interleukins 1 and 6 (IL-1, IL-6) were shown to be significantly downregulated in MAVS and TNFA-R deficient mice, which led us to explore their potential protective activity in CCHFV infected mice. We are also exploring the effects of suppression of IL-6 and IL-1 in mice infected with other bunyaviruses.</div></div><div><h3>Discussion</h3><div>Our work suggests specific pathogen sensing pathways or important inflammatory cytokine signaling pathways contribute to severe viral disease. We also found that a strain of CCHFV that does not cause lethal disease in mice does not induce as potent of an inflammatory cytokine response compared to lethal strains, despite similar levels of replication. This work highlights the host inflammatory pathway induced by viral infection as a component of the pathological process and should be consider important targets for medical intervention. Furthermore, CCHFV strains attenuated in the host failed to activate inflammatory pathway to a high degree, further implicating them in the severe disease process.</div></div><div><h3>Conclusions</h3><div>O","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107415"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520761","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":"Machine learning algorithm for the rapid and accurate detection of Plasmodium falciparum","authors":"Mr Andrew Hill","doi":"10.1016/j.ijid.2024.107439","DOIUrl":"10.1016/j.ijid.2024.107439","url":null,"abstract":"<div><h3>Background</h3><div>Manual cell counting is a malaria diagnostic bottleneck which could be alleviated by assistance from automated labelling. The high prevalence of malaria in under-developed regions requires highly precise and computationally efficient models to achieve rapid and accurate diagnosis, which in turn has the potential to be developed into a smartphone app.</div></div><div><h3>Methods</h3><div>Machine learning algorithms (MLA) consisting of a family of tiny (3,911 to 100,000 parameters) hybrid convolutional neural network / encoder-decoder models were developed which output a both a label {Parasite, Normal} and a confidence. The models were evaluated (k-fold validation) against an established Plasmodium falciparum cell dataset from the NIH.</div></div><div><h3>Results</h3><div>The models achieve between 95% and 98.5% accuracy. Labelling cells with a probability of malaria of 10-99% as uncertain, and ignoring them in analysis resulted in &gt;99% accuracy for the remaining cells. Accuracy measurement is limited by mislabelled cells, with as little as 120 cells in 27,000 (0.4%) confident but wrong. Consensus between 8 independent models suggests at least 150 training cells (more than 50% of all “confident but wrong” cells) are mislabelled, and training without these cells improves model convergence and reliability.</div></div><div><h3>Discussion</h3><div>MLAs that assist diagnosis can be relied upon if they output certainty, and a confident diagnosis can be formed from only certain labels. In many cases a low percentage of cells with uncertain labels will not change diagnosis. Knowing that almost all cell labelling errors occur within the uncertain cells would enable a clinical workflow where expert time is focused on marginal cells within marginal cases. Larger models are prone to overfitting while their size limits the hardware they can be run on.</div></div><div><h3>Conclusion</h3><div>Accurate Plasmodium falciparum parasite identification is possible with 12,000 parameter models. Automation of bulk labelling work would allow expert time to be focused on cases where uncertainty would affect diagnosis. A path to reliable, rapid and mobile malaria diagnosis has been identified based on tiny models suitable for mobile phone deployment in poor malaria affected countries. Further work to enable rapid response to malaria is required.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107439"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520813","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":"Evaluating the probiotic potential of Lactobacilli from yoghurts and their antagonistic activity against multidrug-resistant enteric bacteria, Yaounde, Cameroon","authors":"Dr Rhoda Bughe ,&nbsp;Miss Kellybright Enih Fokwen ,&nbsp;Mr. Marius Dongmo ,&nbsp;Mr. Osee Guistamou ,&nbsp;Mr. Calvino Fomboh ,&nbsp;Mr. Arnaud Carter Takoundjou ,&nbsp;Prof. Wilfred Fon Mbacham","doi":"10.1016/j.ijid.2024.107412","DOIUrl":"10.1016/j.ijid.2024.107412","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Microbiota of the human gastrointestinal tract has health benefits. Enteric bacterial infection and consumption of antibiotics reduce their load. Fermented foods contain some beneficial bacteria that balance the dysbiosis and thus boost human health. This study aimed at identifying Lactobacilli from yoghurts in Yaoundé, evaluating their probiotic potential, and antagonistic effect against multidrug resistant enteric pathogens.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a pilot research in which 12 yoghurts(six each) of two distinct industries, in Cameroon, were purchased from supermarkets. 20g of each sample was mixed with 18 mL of Man, Rogosa, and Sharp-cysteine (MRS-cysteine) broth and incubated anaerobically at 37°C for 48 hours. A 0.1mL of 10-4 serial dilution of the incubated broth was spread on an MRS-cysteine agar plate and incubated anaerobically at 37°C for 48 hours. On an MRS-cysteine agar plate, discrete creamy colonies were detected and purified. The isolates were identified using conventional PCR as well as the Vitek 2 compact technique.&lt;/div&gt;&lt;div&gt;The isolates' probiotic capacity was assessed based on their tolerance to acid, bile salt, NaCl, stimulated gastric juice, and intestinal fluid. The spot method was used to determine their antagonistic activity in multidrug-resistant Salmonella enterica and Escherichia coli.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Four coccobacilli and three rod–shaped isolates were gram positive. They were identified as follows: three Lactobacillus plantarum, two L. buchneri and one L. parabuchneri and one L. fermentum. All isolates were non-haemolytic in defibrinated sheep blood. Five and three isolates could tolerate up to 3% and 4% sodium chloride respectively. L. buchneri2 had the highest mean percentage survival rate (MPSR) at pH 2 after 3 hours (103.67±0.26), while L. plantarum2 decreased to 99.47±0.22. L. plantarum3 had the greatest MPSR (82.35±2.33) in 0.3% bile salt after 3 hours, followed by L. buchneri1 and L. parabuchneri (34.87±3.33 and 31.39±1.15, respectively).The MPSR of Lactobacilli in stimulated gastric juice at pH 2.5 after 4 hours varied between species. L. plantarum3 cells were highly tolerant to stimulated gastric juice at pH 2.5 (131.86±16.3), whereas L. plantarum2 cells showed the least (92.89±1.27). In stimulated intestinal fluid at pH8 after 6hours, the isolate with least MPSR was L. buchneri 1 (57.52±52) while L. plantarum2 was the highest (97.01 ± 0.2). L. plantarum3 was the best Lactobacillus with antibacterial activities against multidrug resistant bacteria; Salmonella enterica (44 ±0.14), and E. coli (34±1.6).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The viability of L. plantarum after gastrointestinal fluid treatment and bile salt, among others, is suggestive of a good probiotic candidate, these findings tie with the report Lang et al. (2022), and Hassan et al. (2020). Research is required to explore additional probiotic criteria.&lt;/div&gt;&lt;/div&gt;&lt;di","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107412"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520894","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":"Female genital schistosomiasis: Addressing diagnostic and programmatic gaps to advance elimination efforts","authors":"Martha Mberu ,&nbsp;Kelly Zongo ,&nbsp;Ellie Leaning ,&nbsp;Louise Makau-Barasa ,&nbsp;Kimberly Kamara ,&nbsp;Julie Jacobson","doi":"10.1016/j.ijid.2025.107798","DOIUrl":"10.1016/j.ijid.2025.107798","url":null,"abstract":"<div><div>This report underscores the critical need to include Female Genital Schistosomiasis (FGS) within schistosomiasis elimination frameworks and sexual and reproductive health programs. Affecting an estimated 40-56 million women, mainly in sub-Saharan Africa, FGS is often underdiagnosed and neglected in public health programs. This paper highlights FGS as a vital gap in schistosomiasis control and comprehensive sexual and reproductive health services, advocating for integrated approaches that address FGS awareness and diagnosis within disease elimination initiatives and health services. Enhanced diagnostic and treatment capabilities for FGS in endemic regions are essential to alleviate the physical, psychological, and reproductive health impacts on affected women and to advance global schistosomiasis elimination goals.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107798"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052427","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":"First reports of urogenital schistosomiasis in the Ndikiniméki health district, Centre-Cameroon","authors":"Mr Bienvenu Balifeli","doi":"10.1016/j.ijid.2024.107444","DOIUrl":"10.1016/j.ijid.2024.107444","url":null,"abstract":"<div><h3>Introduction</h3><div>Schistosomiasis is still a public health problem in Sub-Saharan Africa, particularly in Cameroon. In this context, a cross-sectional study was carried out from June 2023 to July 2023 in the Ndikiniméki subdivision with the aim of knowing the status of this locality in relation to Schistosoma haematobium infection.</div></div><div><h3>Methods</h3><div>Parasitological analysis of S. haematobium eggs was carried out on urine samples using the sedimentation technique.</div></div><div><h3>Results</h3><div>A total of 402 urine samples were collected from households. The age range of participants was 1 to 96 years, with the most signified age group being 1 to 9 years. Women were the most represented, with a proportion of 56.47%. Of the 402 people examined, 18 (4.45%) were affected, with an average intensity of 54.43±85.30 eggs/10ml urine. Women were the most affected, with a prevalence and average parasite intensity of 3.73% and 53.10±131.27 eggs/10ml of urine. The most affected age group was 10 to 19-year-olds, with a prevalence and intensity of 4.60% and 49.49±67.00 eggs per 10 ml of urine, respectively. Of those infected, 72.22% were lightly infected and 27.28% were heavily infected.</div></div><div><h3>Conclusions</h3><div>This study indicates that this locality is a risk area for urinary schistosomiasis despite its low prevalence.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107444"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520495","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":"Bionomics of Aedes mosquito species in three eco-epidemiological settings of Cameroon and their susceptibilities profiles to insecticides","authors":"Ms Bertille Djapoum ,&nbsp;Ms Gisele Aurelie Foko Dadji ,&nbsp;Mr Borel DJIAPPI-TCHAMEN ,&nbsp;Mr Christophe ANTONIO-NKONDJIO","doi":"10.1016/j.ijid.2024.107437","DOIUrl":"10.1016/j.ijid.2024.107437","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Arboviruses represent a serious concern in tropical/subtropical countries. In Cameroon, port cities and cities surrounded by forests constitute the main hot-spot of dengue and yellow fever. Due to the absence of effective treatments and vaccines against most arboviruses diseases, vector control remains the most effective measure to prevent further resurgence. To date, little is known about the bionomics of their main vectors Aedes aegypti and Aedes albopictus in such environments. This study aim to assess the bioecology, distribution and susceptibility profiles to insecticides of these vectors in three cities of Cameroon.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Entomological surveys were undertaken from September 2021 to October 2022 in Bertoua (savanna area), Kribi (city port) and Sangmelima (forested area). Immature stages of Aedes spp. were collected by deeping and Stegomyia indexes were estimated. After emergence and morphological identification, F0 and F1 of Aedes aegypti and Aedes albopictus progeny will be used to assess the current phenotypic resistance status to the commonly used insecticides using WHO bioassays and mortality rates were assess according to the different insecticides tested.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total 475 breeding sites in Sangmelima (41.47%), Kribi (33.47%) and Bertoua (25.05%) were identified. Tires and plastic containers were most abundant. A total of 2364 mosquitoes belonging to 4 genera and 9 species were collected. Aedes species recorded (1864) included Ae. albopictus (72%), Ae. aegypti (25.91%), and Aedes spp. (2.09%). These main vectors were present in all the study sites. Ae. albopictus was predominant in Sangmelima and Kribi while Ae. aegypti was mostly found in Bertoua. According to house indexes, transmission of dengue and yellow fever were high in Kribi and Bertoua. Ae. aegypti across study sites were found to be resistant to permethrin, deltamethrin and DDT, while Ae. albopictus was resistant to bendiocarb in Kribi and Bertoua. However, all these species were susceptible to malathion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The study shows that Ae. albopictus and Ae. aegypti larvae live in a wide variety of breeding sites (Ngo et al., 2020), those species are largely distributed across the country(Tedjou et al., 2019). Ae. albopictus and Aedes aegypti were sensitive to organophosphates (malathion). These results are similar to previous studies (Kamgang et al., 2017). The tolerance and resistance observed could be due to the use of insecticides such as sprays and reminders, which are becoming more and more common(Nchoutpouen et al., 2019).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The implementation of surveillance and control programmes for arbovirus vectors is urgent required in view of the increase in cases of arboviroses. To control arboviruses effectively, a targeted approach is needed to limit the spread of these vectors in our environment. This work is a contri","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107437"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520557","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":"Challenges in Managing Multidrug-Resistant Gram-Negative Infections","authors":"Dr George Varghese","doi":"10.1016/j.ijid.2025.107820","DOIUrl":"10.1016/j.ijid.2025.107820","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Multidrug-resistant Gram-negative infections pose significant challenges, particularly in developing countries where carbapenem-resistant organisms, such as Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa (CRE, CRAB, and CRPA), are prevalent. The World Health Organization has highlighted these as priority pathogens due to their high rates of resistance and the urgent need for new antibiotics to treat them. This talk will address the challenges in managing these infections and explore current treatment options through instructive case scenarios and literature reviews.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a comprehensive review of current literature on the global epidemiology and management of carbapenem-resistant infections, particularly with polymyxin-based therapies and newer beta-lactam/beta-lactamase inhibitor (BL/BLI) combinations. The molecular mechanisms responsible for carbapenem-resistant infections, the uniqueness of different pathogens, and the distribution of resistance across geographical locations were examined. Clinical outcomes from recent studies and trials were analyzed to assess the effectiveness and limitations of available treatment options to help clinicians choose appropriate treatment strategies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In 2019, there were 4.95 million deaths related to global antimicrobial resistance (AMR), and it was projected that by 2050, there will be 10 million annual deaths attributable to AMR. Developing nations experience a disproportionately higher burden of AMR-related deaths. In India alone, 297,000 deaths in 2019 were attributable to AMR, with 1,042,500 deaths associated with it. Most AMR-associated deaths were due to three priority pathogens: Escherichia coli (152,700 deaths), Klebsiella pneumoniae (123,200 deaths), and Acinetobacter baumannii (103,500 deaths). ESBL resistance among Enterobacterales was around 80%, with carbapenem resistance rates of 40-50% and 70-80% among Klebsiella and Acinetobacter strains, respectively. Although treatment with Polymyxin-based therapies is a mainstay in developing countries, it presents significant challenges due to dosing issues, poor drug concentration, and nephrotoxicity. Newer BL/BLIs, such as ceftazidime-avibactam and meropenem-vaborbactam, are promising alternatives but come with poor availability and high costs. They are also less effective against metallo-beta-lactamase-producing organisms like NDM, which are common in South and Southeast Asia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The management of carbapenem-resistant infections varies significantly between developed and developing countries. Despite their limitations, polymyxin-based therapies are commonly prescribed in developing countries due to their accessibility and low cost. Newer BL/BLIs show promise but have limitations, such as cost, availability and efficacy. The efficacy of these treatment options is further complicated b","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107820"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520467","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":"Exploring challenges in implementing antimicrobial stewardship interventions across eight African nations: A multi case study","authors":"Ms Maxencia Nabiryo ,&nbsp;Miss Maxencia Nabiryo ,&nbsp;Dr Helena Rosado ,&nbsp;Miss Frances Garraghan ,&nbsp;Miss Claire Brandish ,&nbsp;Miss Victoria Rutter","doi":"10.1016/j.ijid.2024.107394","DOIUrl":"10.1016/j.ijid.2024.107394","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, funded by the UK Department of Health and Social Care's Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education trust (THET), currently supports 24 health partnerships (HPs) developing and implementing antimicrobial stewardship (AMS) interventions in 73 health facilities across eight African countries: Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia. This study assesses the barriers and challenges experienced by HPs in designing and implementing AMS interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A qualitative case-study design was adopted, with data collection undertaken between June 2023 and March 2024 by in-person (THET and CPA) visits. Data collection methods included non-participant observations, formal and informal feedback from key stakeholders, semi-structured interviews and focus groups. Interview guides were designed based on the Consolidated Framework for Implementation Research to encourage systematic data collection and reporting, track progress and identify barriers encountered during implementation of AMS interventions. Qualitative data underwent thematic analysis using NVivo 14®.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Since the introduction of CwPAMS, a total of 15 AMS committees, 52 Point Prevalence Surveys (PPS) on antimicrobial use, and 21 AMS action plans have been developed and established across 73 health facilities, with 884 healthcare professionals completing AMS training. Key barriers reported by HPs included: challenges in PPS data collection due to lack, or inadequacy, of electronic patient record systems; delays in permissions and approvals (e.g. ethical approval); competing priorities (e.g. institutional priorities vs quality improvement initiatives); limited funding; challenges with procurement of medicines/reagents; over-ambitious projects as well as monitoring and evaluation plans. Health facilities also reported obstacles in antibiogram development due to inadequate sample sizes, secondary to limited access to diagnostics, reagents and consumables. HPs reported issues such as inconsistent access to running water, costly laboratory reagents with short expiry dates, staff shortages, and antibiotic stockouts. Reluctance to behavior change (especially prescribing practices), as well as time required for behavior change while implementing AMS interventions, were also commonly cited as barriers by HPs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Buy-in from multiple stakeholders across all levels and scope of practices have facilitated change management and supported implementation of AMS interventions. In addition, realignment of project plans when and where needed, as well as efforts to secure additional funding and resources are underway to address the challenges identified.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Multi-case study an","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107394"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520318","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":"Emerging infections in children","authors":"Prof Helena Maltezou","doi":"10.1016/j.ijid.2024.107378","DOIUrl":"10.1016/j.ijid.2024.107378","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Infectious diseases are a significant cause of morbidity and mortality in children.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Recent studies were reviewed, and new epidemiological and clinical facts of the following emerging infectious diseases are discussed: vaccine-preventable diseases (VPDs), post-COVID syndrome, respiratory syncytial virus (RSV) infections, dengue, and Crimean-Congo hemorrhagic fever (CCHF).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Vaccine-preventable diseases: A modelling study which quantified the impact of 50 years of the Expanded Programme on Immunization showed that vaccinations accounted for 40% of the reduction of infant mortality during 1974-2024. Measles vaccines accounted for most of the averted infant morbidity and mortality the past 50 years. Nevertheless, from 2018 onwards, vaccination rates in children have been decreasing in several countries globally, which resulted in local re-emergence of several VPDs and the onset of disruptive outbreaks. Regarding the second topic, post-COVID syndrome, a recent meta-analysis found a prevalence rate of 23.36% in children. Major symptoms in affected children are dyspnea, headache, fatigue, shortness of breath, abdominal pain, concentration difficulties, and sleep disorders. Post-COVID syndrome has a multifactorial pathogenesis, involves most systems, and has a negative impact on child's well-being, school attendance and educational activities. Regarding the third topic, RSV, a comparison of 1451 pediatric cases that occurred 2018-2019 with 1102 cases that occurred in 2023 in China, found that the post-COVID-pandemic group was significantly older, more frequently had fever and complications (acute otitis media, seizures), and more frequently had raised inflammation markers. Overall, the post-COVID RSV cases more frequently developed severe lower respiratory tract infection, were admitted to an intensive care unit, and received invasive mechanical intubation. Similarly, infants with RSV hospitalized in France during the COVID-19 pandemic more frequently received oxygen and remained in-hospital for longer periods compared to infants with RSV hospitalized in the pre-COVID era. A prospective cohort study showed that RSV remains a cause of substantial morbidity, leading to the hospitalization of one in every 56 healthy full-term infants in high-income countries. Regarding dengue, a large school-based cross-sectional serosurvey in Kerala, India among 5236 children 9-12 years old found an overall seroprevalence rate of 30.9%, with wide variation across districts. Advanced age and male sex were significantly associated with higher seroprevalence rates. Of note, 40% of children had IgG antibodies against multiple dengue virus serotypes. Lastly, although CCHF is considered a mild disease in children, a recent study from Turkey found that 12 children with CCHF hospitalized during 2020-2021 developed severe illness (all had hepatosplenomegaly) and highly impaired la","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"152 ","pages":"Article 107378"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520393","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}