Southern African Journal of Infectious Diseases最新文献

{"title":"Deeply jaundiced: Not so surgical after all.","authors":"Wesley P du Plessis, Sa'ad Lahri, Keethal Somers, Tamsin Lovelock","doi":"10.4102/sajid.v38i1.559","DOIUrl":"10.4102/sajid.v38i1.559","url":null,"abstract":"<p><p>Leptospirosis is an under-recognised disease in sub-Saharan Africa and the diagnosis requires a high index of suspicion. This case report highlights the protean manifestations of leptospirosis. Leptospirosis should be considered in any patient presenting with fever and jaundice, especially when there has been a history of occupational or recreational exposure to water, soil or rodents.</p><p><strong>Contribution: </strong>This case report describes a typical case of leptospirosis, which often presents as a diagnostic dilemma.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"559"},"PeriodicalIF":0.9,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-fermenter Gram-negative bacilli at a tertiary hospital, South Africa.","authors":"Sinenhlanhla Ndzabandzaba, Lesego Mothibi, Nina von Knorring","doi":"10.4102/sajid.v38i1.538","DOIUrl":"10.4102/sajid.v38i1.538","url":null,"abstract":"<p><strong>Background: </strong>Non-fermenting Gram-negative bacilli (NFGNB) are a significant cause of healthcare-associated infections and are often implicated in nosocomial outbreaks. Non- fermenting Gram-negative bacilli tend to have variable susceptibility patterns that make the choice of empiric therapy difficult and thus treatment must be based on <i>in vitro</i> susceptibility testing of each antimicrobial agent.</p><p><strong>Objectives: </strong>To describe the epidemiology of the NFGNB isolated from adult patients at Chris Hani Baragwanath Hospital (CHBAH) and to assess their antimicrobial susceptibility patterns in order to guide empiric therapy and inform infection prevention and control practices.</p><p><strong>Method: </strong>Organisms isolated from sterile sites of adult in-patients between 01 January 2016 to 31 December 2018 were retrospectively analysed.</p><p><strong>Results: </strong>A total of 2005 NFGNB isolated. Blood cultures were the most common specimen type (91.4%). <i>Acinetobacter</i> species were the most commonly isolated organisms (65.1%), followed by <i>Pseudomonas</i> species (26.5%). The majority of NFGNB were isolated from patients in surgical wards (38.9%) followed by medical wards (35.2%). Most (60%) of the <i>Acinetobacter</i> species were extremely drug resistant. <i>Pseudomonas</i> species were more susceptible than the <i>Acinetobacter</i> species with an overall susceptibility rate of 86% for <i>Pseudomonas</i> species.</p><p><strong>Conclusion: </strong>The rates of antimicrobial resistance demonstrated among <i>Acinetobacter</i> and <i>Pseudomonas</i> species were high, which illustrates the threat of antimicrobial resistance also seen worldwide. An emergence of NFGNB with intrinsic multidrug resistance (<i>Stenotrophomonas maltophilia</i> and <i>Burkholderia cepacia</i>) was noted. We suggest empiric therapy with a carbapenem sparing regimen of piperacillin-tazobactam in combination with amikacin and that empiric therapy be reviewed annually when cumulative antibiograms are done.</p><p><strong>Contribution: </strong>Understanding of the distribution and antimicrobial susceptibility patterns of NFGNB at CHBAH.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"538"},"PeriodicalIF":0.9,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal reflections on a new role in infectious diseases.","authors":"Mark F Cotton","doi":"10.4102/sajid.v38i1.583","DOIUrl":"10.4102/sajid.v38i1.583","url":null,"abstract":"","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"583"},"PeriodicalIF":0.9,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive study of vancomycin use at Red Cross War Memorial Children’s Hospital, Cape Town","authors":"Leonore Greybe, Brian S. Eley, Hafsah D. Tootla, Anna M.M. Botha, Wisdom Basera, James J.C. Nuttall","doi":"10.4102/sajid.v38i1.528","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.528","url":null,"abstract":"Background Antimicrobial stewardship principles guide the clinical use of antimicrobials, including vancomycin, but paediatric vancomycin prescribing practices have not been evaluated in South Africa. Objectives To document the use, prescribing practices and monitoring of intravenous vancomycin and the spectrum of bacteria isolated on microbiological culture in children treated with intravenous vancomycin during a 12-month period at Red Cross War Memorial Children’s Hospital (RCWMCH). Method A retrospective audit of intravenous vancomycin use in children admitted to RCWMCH during 2019 was performed. Results All 158 vancomycin prescription episodes for 143 children were included. Overall usage of intravenous vancomycin was 63 days of therapy per 1000 patient days (interquartile range [IQR]: 38–72). The median starting dose was 15 mg/kg per dose (IQR: 14–15) and median daily dose was 45 mg/kg per day (IQR: 43–60). Vancomycin was prescribed as empiric (127/158, 80%) and directed (31/158, 20%) treatment. The median duration of treatment for the directed group (7 days) was longer than the empiric group (4 days) (p = 0.001). Vancomycin serum trough concentrations were performed in 65/98 (66%) episodes where vancomycin treatment exceeded 3 days, with only 16/65 (25%) of these samples obtained before the fourth dose. Prolonged antibiotic treatment of 14 days or more was not associated with Gram-positive bacteria on culture (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 0.17–4.2). Conclusion Dosing errors, prolonged empiric treatment and inappropriate vancomycin monitoring were problems associated with vancomycin prescriptions. Contribution The study identified multiple opportunities for improved vancomycin prescribing and monitoring. Further research and implementation of improved prescribing practices could contribute to the preservation of vancomycin as an effective antibiotic.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"93 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135584199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probable endometrial tuberculosis in a patient with rhupus.","authors":"Nimmisha Govind,&nbsp;Tamara Romanini,&nbsp;Lai Ling Winchow","doi":"10.4102/sajid.v38i1.543","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.543","url":null,"abstract":"<p><p>Endometrial tuberculosis (TB) is an uncommon manifestation of disseminated TB. Rhupus is the coexistence of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We describe a case of endometrial TB in rhupus patient an immunosuppressed.</p><p><strong>Contribution: </strong>We describe an uncommon presentation of disseminated TB, endometrial TB, in a rare rheumatic disease, rhupus. A high index of suspicion for TB is imperative in immunocompromised patients presenting with chronic urogenital symptoms especially in an endemic area.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"543"},"PeriodicalIF":0.9,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of pericardial schistosomiasis and non-Hodgkin high grade B-cell lymphoma.","authors":"Michael J Boyd,&nbsp;Marc Mendelson,&nbsp;Sipho K Dlamini,&nbsp;Sean Wasserman,&nbsp;Ghaalied Fakier,&nbsp;Riyaadh Roberts,&nbsp;Nectarios S Papavarnavas","doi":"10.4102/sajid.v38i1.524","DOIUrl":"10.4102/sajid.v38i1.524","url":null,"abstract":"<p><p>Chronic schistosomiasis affects either the genitourinary or gastrointestinal tract. Rarely, schistosomes cause ectopic disease, such as in the case of a South African woman from a non-endemic province, who presented with suspected pericardial tamponade because of tuberculosis. However, histology and polymerase chain reaction from pericardial biopsy confirmed <i>Schistosoma haematobium.</i> A finding of mediastinal non-Hodgkin lymphoma came to light when our patient's clinical condition unexpectedly deteriorated.</p><p><strong>Contribution: </strong>This case highlights an unusual manifestation of schistosomiasis.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"524"},"PeriodicalIF":0.9,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe efavirenz associated neurotoxicity: A retrospective cohort study.","authors":"Priyadarshini Arnab,&nbsp;Roland Croxford,&nbsp;Janet Scott,&nbsp;Sameshan Perumal,&nbsp;Zahraa Mohammed,&nbsp;Lubbe Wiesner,&nbsp;Karen Cohen,&nbsp;Sean Wasserman","doi":"10.4102/sajid.v38i1.522","DOIUrl":"10.4102/sajid.v38i1.522","url":null,"abstract":"Background Efavirenz (EFV) is associated with neuropsychiatric symptoms. Severe neurotoxicity has been reported but the clinical phenotype and risk factors are poorly defined. Objectives To characterise clinical presentations, risk factors and outcomes to help clinicians recognise severe neurotoxicity earlier. Method The authors retrospectively identified adults with supratherapeutic EFV concentrations (> 4 mg/L) obtained during routine clinical care in Cape Town, South Africa. Clinical and laboratory data at the time of EFV quantification were extracted from medical records. Logistic regression was performed to identify associations with neuropsychiatric symptoms, and with severe neurotoxicity. Results Eighty one patients were included; 62 with neuropsychiatric manifestations (most frequently ataxia [n = 20] and psychomotor slowing [n = 24]); and 19 with hepatotoxicity. Overall, 28 (34.6%) were male, 49 (60.5%) had concomitant isoniazid exposure, and median EFV concentration was 12.1 mg/L (interquartile range [IQR]: 6.6–20.0). Neuropsychiatric symptoms were associated with longer duration of EFV therapy, adjusted odds ratio (aOR) 1.3/180-day increment (95% confidence interval [CI]: 1.0–1.7); higher EFV concentrations, aOR 1.2/1 mg/L increase (95% CI: 1.0–1.4) and isoniazid exposure, aOR 8.2 (95% CI: 2.5–26.7). Severe neuropsychiatric symptoms occurred in 47 (75%) patients at a median of 5.9 months (IQR: 2.1–40.8) after EFV initiation. Severe symptoms odds were 1.2-fold higher (95% CI: 1.1–1.4) per 1 mg/L increase in EFV concentration. Symptoms resolved completely within 1 month in 25 (76%) patients with severe neurotoxicity who discontinued EFV. Conclusion A concentration–effect relationship for severe neurotoxicity exists, which occurred late and resolved in most patients after EFV discontinuation. Contribution The authors highlighted clinical heterogeneity and morbidity of EFV-associated neurotoxicity.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"522"},"PeriodicalIF":0.9,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10397354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low prevalence of <i>Schistosoma haematobium</i> infection in pregnant women in Buffalo City district.","authors":"Remco P H Peters, Mandisa Mdingi, Hyunsul Jung, Freedom Mukomana, Ranjana M S Gigi, Andrew Medina-Marino, Jeffrey D Klausner","doi":"10.4102/sajid.v38i1.521","DOIUrl":"10.4102/sajid.v38i1.521","url":null,"abstract":"Adverse pregnancy outcomes such as stillbirth, pre-term birth and low birth weight are common in South Africa. The aetiology of these conditions is multifactorial and infections play an important role. Studies have shown an increased risk of adverse pregnancy outcomes associated with sexually transmitted infection (STI) during pregnancy.1 Urogenital Schistosoma haematobium is another infection that should be considered for adverse pregnancy outcomes.2","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"521"},"PeriodicalIF":0.9,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine hesitancy among pregnant women in an antenatal clinic in Durban, South Africa.","authors":"Sahra Ashkir,&nbsp;Tashlen Abel,&nbsp;Olive P Khaliq,&nbsp;Jagidesa Moodley","doi":"10.4102/sajid.v38i1.516","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.516","url":null,"abstract":"<p><strong>Background: </strong>Mass administration of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most efficient intervention against the coronavirus disease 2019 (COVID-19) pandemic. Recently, vaccinations were shown to be safe and effective during pregnancy. However, vaccination rates are low in low- and middle-income countries, and vaccine hesitancy is a major limiting factor.</p><p><strong>Objectives: </strong>To investigate the rate of COVID-19 vaccine hesitancy among pregnant women.</p><p><strong>Method: </strong>A cross-sectional questionnaire-based investigation of 313 unvaccinated pregnant women attending an antenatal clinic in Durban, South Africa (SA). The questionnaire included clinical and socio-demographic data, and reasons for vaccine hesitancy were recorded and evaluated.</p><p><strong>Results: </strong>Of 313 women participating, 126 (40.3%) were vaccinated against COVID-19, 21/313 = 6.7%; for those unvaccinated, 21/187 (13.9%) were planning to be vaccinated. However, most unvaccinated women, 174 of 187 (93%), showed COVID-19 vaccine hesitancy.</p><p><strong>Conclusion: </strong>The COVID-19 vaccination hesitancy among pregnant women in Durban, SA, is exceptionally high. This requires urgent attention by the relevant health authorities (both professional health organisations and the SA Department of Health) as many countries experience different waves of the variants of SARS-CoV-2 and herd immunity may not have been achieved.</p><p><strong>Contribution: </strong>This study showed a high vaccine acceptance hesitancy rate among pregnant women in SA.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"516"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic profile of HIV and helminth-coinfected adults in KwaZulu-Natal, South Africa.","authors":"Miranda N Mpaka-Mbatha,&nbsp;Pragalathan Naidoo,&nbsp;Md Mazharul Islam,&nbsp;Ravesh Singh,&nbsp;Zilungile L Mkhize-Kwitshana","doi":"10.4102/sajid.v38i1.466","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.466","url":null,"abstract":"<p><strong>Background: </strong>Helminth and HIV infections are endemic among poor populations. Studies investigating the socio-demographic and economic risk factors associated with dual HIV and helminth coinfection are scarce.</p><p><strong>Objectives: </strong>This study aimed to describe risk factors associated with HIV and helminth coinfections among peri-urban South African adults residing in poorly developed areas with high poverty levels, lack of sanitation and a clean water supply.</p><p><strong>Method: </strong>Adult participants (<i>n</i> = 414) were recruited from clinics in the south of Durban, KwaZulu-Natal, South Africa. Participants' demographic, socio-economic, sanitation and household information, anthropometric measurements and HIV status were collected. Stool samples were donated for coproscopy to detect helminths using the Kato-Katz and Mini Parasep techniques. Blood was collected to confirm participants' HIV status and to determine <i>Ascaris lumbricoides</i>-specific immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) levels to improve microscopy sensitivity.</p><p><strong>Results: </strong>Overall coinfection was 15%, and single helminth and HIV prevalence were 33% and 52%, respectively. <i>Ascaris lumbricoides</i> was predominant (18%). Univariate analysis of variance (ANOVA) showed that coinfection was 11.9% and 19.8%, respectively, among the 18-34 years and 35-59 years age groups (<i>p</i> = 0.0006), 16.4% and 19.9%, respectively, for the no income and < R1000.00 groups (<i>p</i> = 0.0358) and 22.8% and 17.1%, respectively, for the pit or public toilets and toilets not connected to sewage groups (<i>p</i> = 0.0007).</p><p><strong>Conclusion: </strong>Findings suggest that the dual infection with HIV and helminth infections among adults residing in under-resourced areas with poor sanitary conditions is frequent. Older age, poor toilet use and low income are associated with coinfection. More attention is required to break the cycle of coinfections and possible disease interactions.</p><p><strong>Contribution: </strong>The study highlights the importance of determining and treating helminth infections among adult population during HIV and helminth coinfection and the influence of poor sanitation and socioeconomic status on disease transmission.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"466"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}