Southern African Journal of Infectious Diseases最新文献

{"title":"Clinical application of Vitek-derived minimum inhibitory concentration values: Proof of concept study.","authors":"Warren Lowman","doi":"10.4102/sajid.v38i1.498","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.498","url":null,"abstract":"<p><strong>Background: </strong>Minimum inhibitory concentration (MIC) values are useful in guiding appropriate antimicrobial therapy however, routine provision and interpretation of MIC values to guide clinical decision-making is challenging.</p><p><strong>Objectives: </strong>This proof of concept study aims to demonstrate the clinical utility and application of Vitek^®-derived MIC values through categorisation of clinical isolates as wild type.</p><p><strong>Method: </strong>A random selection of clinically relevant Gram negative isolates routinely tested on the Vitek^® instrument were included. The Vitek^® MIC values, for selected antimicrobials at the lowest calling range of that card, were compared to the broth microdilution reference method. The specified end-point was concordance between the two results if the reference MIC was less than or equal to the EUCAST-defined epidemiological cut-off value (ECOFF) for that drug-bug combination.</p><p><strong>Results: </strong>A total of 525 isolates were included (468 Enterobacterales and 57 <i>Pseudomonas aeruginosa</i>), with an overall concordance rate of 96.4% (508/525). Correct ECOFF categorisation by the Vitek^® was highest for ceftazidime and piperacillin (100%, <i>n</i> = 48 and <i>n</i> = 55, respectively) and lowest for cefepime (81.8%, <i>n</i> = 66).</p><p><strong>Conclusion: </strong>Vitek^®-derived MIC values can be used to categorise organisms as wild-type if the MIC is reported at the card's lowest calling range (≤) as there is high likelihood that the MIC is at or below the ECOFF. This has important implications for antimicrobial management, assisting in choice of agent and in improving probability of target attainment for desired pharmacodynamic targets which can translate into improved clinical outcomes.</p><p><strong>Contribution: </strong>Minimum inhibitory concentration data from an automated antimicrobial susceptibility testing instrument can be used to guide clinical decisions.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"498"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308997","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":"Accuracy of C-reactive protein and a differentiated white cell count in diagnosing tuberculosis.","authors":"Gideon Ruder,&nbsp;Richard M N Carter,&nbsp;Gina Joubert","doi":"10.4102/sajid.v38i1.481","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.481","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is treatable with a high cure rate. In South Africa, 70% of pulmonary TB is microbiologically confirmed. Autopsy studies of HIV-positive people found 45.7% undiagnosed TB cases.</p><p><strong>Objectives: </strong>The primary objective investigated whether CRP and a differentiated white cell count (WCC) and ratios thereof are useful screening tools for TB.</p><p><strong>Method: </strong>This retrospective cross-sectional study included adult patients admitted to two tertiary hospitals in Bloemfontein with TB workups between April 2016 and September 2019. National Health Laboratory Service (NHLS) provided laboratory data. Tuberculosis Xpert^® MTB/RIF, Xpert^® MTB/RIF Ultra and TB culture were used as reference standard for TB diagnosis.</p><p><strong>Results: </strong>The study population comprised 1294 patients; 15.1% had TB, 56.0% were male and 63.1% HIV-positive. Patients with TB were younger (<i>p</i> < 0.0001; 95% CI: -8;-3 years). In the total population, WCC had the highest area under the curve (0.59). White cell count (<i>p</i> < 0.0001), neutrophils (<i>p</i> = 0.0003) and lymphocytes (<i>p</i> = 0.0394) were lower in TB patients, and CRP-WCC ratio (CWR) (<i>p</i> = 0.0009) and CRP-lymphocyte ratio (CLR) (<i>p</i> = 0.0386) higher. In HIV-positive patients, WCC (<i>p</i> = 0.0003), neutrophils (<i>p</i> = 0.002) and lymphocytes (<i>p</i> = 0.0491) were lower in TB patients and CWR (<i>p</i> = 0.0043) higher. No parameter reached the World Health Organization screening targets of 70% specificity with 90% sensitivity.</p><p><strong>Conclusion: </strong>Differentiated WCC and CRP are not useful in screening hospitalised patients for TB in our setting.</p><p><strong>Contribution: </strong>Our study guides future research to augment current screening and diagnostic algorithms for TB, specifically in advanced HIV disease.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"481"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965046","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":"Adult intussusception in the era of HIV/AIDS: A case report.","authors":"Tshepang A Motsepe,&nbsp;Thekganang A Machete,&nbsp;Noluthando Ziqubu","doi":"10.4102/sajid.v38i1.534","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.534","url":null,"abstract":"<p><p>The high incidence of HIV infection in South Africa has been associated with a proportional increase in AIDS-defining cancers, including non-Hodgkin's lymphomas (NHL). Intussusception is a rare presentation of NHL, accounting for 1% - 5% of all cases of small bowel obstruction.</p><p><strong>Contribution: </strong>To our knowledge, this is the first reported case of B-cell NHL presenting with intussusceptions and small bowel obstruction in South Africa.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"534"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160212","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":"Cutaneous tuberculosis: An infrequent manifestation of a common pathogen in South Africa.","authors":"Jennifer K van Heerden,&nbsp;Alistair G B Broadhurst,&nbsp;Ruan S de Jager,&nbsp;Wesley du Plessis,&nbsp;Nabilah Ebrahim,&nbsp;Ayanda T Mnguni,&nbsp;Denzil Schietekat,&nbsp;Graeme Meintjes","doi":"10.4102/sajid.v38i1.526","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.526","url":null,"abstract":"<p><p>Cutaneous tuberculosis is an infrequent form of extra-pulmonary tuberculosis, even in high-prevalence settings. We present the case of a patient living with advanced HIV who developed extensive cutaneous tuberculosis. The polymorphic skin lesions were the most striking clinical manifestation of underlying disseminated tuberculosis.</p><p><strong>Contribution: </strong>This case report highlights an unusual presentation of tuberculosis. Cutaneous tuberculosis has a wide spectrum of clinical presentations and may be under-recognised by clinicians. We recommend early biopsy for microbiological diagnosis.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"526"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812385","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":"Colistin use in a carbapenem-resistant <i>Enterobacterales</i> outbreak at a South African neonatal unit.","authors":"Ilhaam Abrahams,&nbsp;Angela Dramowski,&nbsp;Kedisaletse Moloto,&nbsp;Lizel Lloyd,&nbsp;Andrew Whitelaw,&nbsp;Adrie Bekker","doi":"10.4102/sajid.v38i1.487","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.487","url":null,"abstract":"<p><strong>Background: </strong>Colistin is increasingly prescribed for neonates with carbapenem-resistant <i>Enterobacterales</i> (CRE) infections.</p><p><strong>Objectives: </strong>We described patient demographics, infection episodes, treatment and clinical outcomes, colistin related adverse events and relatedness of isolates in neonates with clinically confirmed or clinically suspected CRE infections.</p><p><strong>Method: </strong>The authors retrospectively reviewed culture-confirmed and clinically suspected culture-negative CRE infections at a South African neonatal unit during a CRE outbreak.</p><p><strong>Results: </strong>Fifty-three neonates (median gestational age 29 weeks and birth weight 1185 g) were included. Twenty-three of 53 neonates (43%) had culture-confirmed CRE (17 received colistin; 6 died without receiving colistin) and 30 (57%) received colistin for clinically suspected CRE infection but were ultimately culture-negative. Prior respiratory support and surgical conditions were present in 37/53 (70%) and 19/53 (36%) neonates, respectively. Crude mortality was high (20/53; 38%) with no significant difference between culture-confirmed CRE versus clinically suspected culture-negative CRE groups (10/23 [44%] vs 10/30 [33%]; <i>p</i> = 0.45). Hypomagnesaemia (10/38; 26%) and hypokalaemia (15/38; 40%) were frequent; acute kidney injury was rare (1/44; 2%). Three CRE infection clusters were identified by genotypic analysis of 20 available isolates (18 [90%] <i>bla</i> _NDM-1 [New Delhi metallo-beta-lactamase], 2 [10%] <i>bla</i> _OXA [oxacillinase]-48).</p><p><strong>Conclusion: </strong>Neonates receiving colistin therapy were predominantly preterm, with multiple risk factors for infection. Colistin-associated electrolyte derangement was frequent. Over one-third of neonates died. <i>Bla</i> _NDM-1 was the most frequent carbapenemase gene identified in the outbreak isolates.</p><p><strong>Contribution: </strong>Colistin was safely used during an <i>Enterobacterales</i> outbreak in predominantly premature and surgical neonates. The mortality was high.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"487"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237809","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":"Performance of the school-based human papillomavirus vaccine uptake in Tshwane, South Africa.","authors":"Tladi D Ledibane,&nbsp;Neo R Ledibane,&nbsp;Moliehi Matlala","doi":"10.4102/sajid.v38i1.492","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.492","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) vaccine is an effective preventive measure against HPV infection and HPV-associated cervical cancer. South Africa introduced its HPV vaccination programme in 2014.</p><p><strong>Objectives: </strong>The authors assessed the uptake of HPV vaccine in the school-based HPV vaccination programme in Tshwane Health District for the year 2019 and compared the vaccine uptake (VU) between fee-paying and no-fee public schools.</p><p><strong>Method: </strong>The study method was cross-sectional, using routine electronic health records of the HPV vaccination programme. The study population included all Grade 4 school-girls between the ages of 9 and 14 years who attended public schools in 2019 in the Tshwane Health District.</p><p><strong>Results: </strong>The pooled VU for the Tshwane Health District was 72.0%, considerably lower than the target of 80.0%. The number of girls who received dose one and dose two in 2019 was 16 122 (73.0%) and 15 734 (71.0%), respectively, excluding the catch-up figures. In addition, 82.2% of fee-paying schools achieved VU of above 80% versus 65.5% of no-fee schools (<i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>The lower than target levels of VU for HPV among girls in Tshwane Health District, particularly in those attending no-fee schools, is concerning. Interventions should be adopted to optimise programme performance so as to achieve the target VU of 80%.</p><p><strong>Contribution: </strong>This study showed the need to strengthen sensitisation and social mobilisation efforts, particularly among no-fee schools to improve the VU.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"492"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252878","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":"Prevalence of <i>Staphylococcus</i> spp. from human specimens submitted to diagnostic laboratories in South Africa, 2012-2017.","authors":"Themba T Sigudu,&nbsp;James W Oguttu,&nbsp;Daniel N Qekwana","doi":"10.4102/sajid.v38i1.477","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.477","url":null,"abstract":"<p><strong>Background: </strong>Although staphylococci are commensals of the skin and mucosa of humans and animals, they are also opportunistic pathogens. Some coagulase-negative <i>Staphylococcus</i> spp. (CoNS), such as <i>S. haemolyticus</i> and <i>S. epidermidis</i>, are reported to be zoonotic.</p><p><strong>Objectives: </strong>The prevalence of coagulase positive (CoPS), CoNS and coagulase-variable <i>Staphylococcus</i> spp. isolated from human clinical cases in South Africa was investigated.</p><p><strong>Method: </strong>Retrospective records of 404 217 diagnostic laboratory submissions from 2012 to 2017 were examined and analysed in terms of time, place and person.</p><p><strong>Results: </strong>Of the 32 different species identified, CoPS were the most frequently isolated (74.7%), followed by CoNS (18.9%). Just over half (51.2%) of the <i>Staphylococcus</i> isolates were from males, while females contributed 44.8%. Patients aged 0-4 years contributed the most (21.5%) isolates, with the highest number coming from KwaZulu-Natal (32.8%). Urinary specimens accounted for 29.8% of the isolates reported. There was no variation in the number of <i>Staphylococcus</i> isolates reported in the autumn (25.2%), winter (25.2%), spring (25.1%) and summer (24.5%) seasons.</p><p><strong>Conclusion: </strong>This study demonstrated the diversity of <i>Staphylococcus</i> spp. isolated from humans and the magnitude of infection, with the most predominant species being <i>S. aureus</i> and <i>S. epidermidis.</i></p><p><strong>Contribution: </strong>Although most isolates were CoPS, the isolation of CoNS seen in this study suggests a need to improve infection control measures in a South African context. More research is needed to investigate the determinants of the observed variations in the study.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"477"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237810","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":"Men's utilisation of sexual and reproductive health services in low- and middle-income countries: A narrative review.","authors":"Mpumelelo Nyalela,&nbsp;Thembelihle Dlungwane","doi":"10.4102/sajid.v38i1.473","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.473","url":null,"abstract":"<p><strong>Background: </strong>Men have poor access to sexual and reproductive health (SRH) services globally, particularly in low- and middle-income countries (LMICs). Nevertheless, in LMIC and high-income countries (HICs), low SRH utilisation happens on account of several factors, such as individual, health system-related, and sociocultural factors. Identifying and addressing men's SRH service underutilisation remains essential to improving their sexual health and averting higher mortality and early morbidity associated with poor health seeking behaviour (HSB) among men.</p><p><strong>Aim: </strong>This narrative review identifies factors influencing whether men do or do not utilise SRH services in LMICs.</p><p><strong>Setting: </strong>We report on articles published in LMICs: Africa, Asia and South America.</p><p><strong>Method: </strong>In this narrative review, we searched for quantitative and qualitative articles published between 2004 and 2021 from international databases, including Google Scholar, ScienceDirect, EBSCOhost, Scopus, PubMed, Medline, and reference lists of retrieved published articles.</p><p><strong>Results: </strong>A total of 2219 articles were retrieved, from which 36 met the inclusion criteria. Factors contributing to poor uptake of SRH services by men included: a lack of access and availability of SRH services, poor health-seeking behaviour among men, and SRH facilities not being perceived as 'male-friendly spaces'. Furthermore, our review reveals that decreased use of SRH services is attributed to factors such as a lack of focus on men's SRH.</p><p><strong>Conclusion: </strong>The current underutilised state of SRH services calls for urgent implementation of evidence-based interventions. Identifying men's SRH service inhibitors and enablers will assist programme managers and policymakers in designing SRH services tailored to their sexual health needs.</p><p><strong>Contribution: </strong>Despite numerous global interventions to motivate men, the findings provide insight into the underutilisation of SRH services. The study also reveals the inadequate comprehensive investigation of men's SRH service utilisation, especially older men, to comprehend men's problems fully. Further research needs to be conducted on SRH issues, including vasectomy, mental health, and chronic conditions related to sexual and reproductive health. The analysis can assist SRH policymakers and program managers in strengthening the policies to motivate men to engage better with SRH services.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"473"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812381","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":"Intensive care unit nurses' knowledge, attitudes and practices of COVID-19 infection prevention and control.","authors":"Onga Bangani,&nbsp;René English,&nbsp;Angela Dramowski","doi":"10.4102/sajid.v38i1.478","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.478","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units (ICUs) had to rapidly adapt infection prevention and control (IPC) practices during the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Objectives: </strong>To determine ICU nurses' COVID-19 IPC-related knowledge, attitudes, practices, and perceptions.</p><p><strong>Method: </strong>A mixed-methods study was conducted at the Groote Schuur Hospital ICU, Cape Town, South Africa (20 April 2021 and 30 May 2021). Participants completed anonymous, self-administered, knowledge, attitudes and practices (KAP) questionnaires. Individual interviews were conducted regarding nurses' lived experiences and perceptions of COVID-19 IPC in critical care.</p><p><strong>Results: </strong>In total, 116 ICU nurses participated (93.5% response rate) including 57 professional nurses (49%), 34 enrolled nurses (29%) and 25 enrolled nursing assistants (22%); young females (31-49 years) predominating (<i>n</i> = 99; 85.3%). Nurses' overall COVID-19 IPC knowledge scores were moderately good (78%); professional nurses had greater knowledge of COVID-19 transmission (<i>p</i> < 0.001). Intensive care unit nurses' attitude scores towards COVID-19 IPC were low (55%), influenced by limited IPC training, insufficient time to implement IPC and shortages of personal protective equipment (PPE). Respondents' scores for self-reported COVID-19 IPC practices were moderate (65%); highest compliance rates were for hand hygiene after touching patient surroundings (68%). Only 47% ICU nurses underwent N95 respirator fit-testing despite working in a COVID-19 ICU.</p><p><strong>Conclusion: </strong>Regular COVID-19 IPC training is needed to equip ICU nurses with the knowledge and skills to prevent healthcare-associated COVID-19 transmission. Enhanced IPC training and consistent PPE availability may support more favourable attitudes and better IPC practices. Comprehensive IPC and occupational health support should be offered to ensure ICU nurses' wellbeing during pandemics.</p><p><strong>Contribution: </strong>Enhanced IPC training and consistent PPE availability may support better attitudes and IPC practices.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"478"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10318607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817934","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":"Prescribing patterns of echinocandins in adult patients in a private hospital in Gauteng, South Africa.","authors":"Anja Grey,&nbsp;Rianda Joubert,&nbsp;Stephan Steyn,&nbsp;Marlene Julyan","doi":"10.4102/sajid.v38i1.470","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.470","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the leading cause of invasive candidiasis and the fourth leading cause of hospital-acquired infections are the Candida species (spp.) group. One of the most important tools in fighting such drug-resistant fungi is the appropriate use of antifungal agents.</p><p><strong>Objectives: </strong>The study aimed to determine echinocandins' general prescribing patterns and how they are associated with the treatment period.</p><p><strong>Method: </strong>A quantitative, observational, and descriptive was used, and included patients receiving antifungal treatment in a private hospital in Gauteng, South Africa between 01 January 2015 to 31 December 2015.</p><p><strong>Results: </strong>Of the 146 patient files included, 102 patients (69.9%) received caspofungin and 44 patients (30.1%) were treated with anidulafungin. For the former, 99 (97.1%) patients received a loading dose (LD) of 70 mg, while 200 mg anidulafungin was only prescribed to 30 patients (68.2%). In line with maintenance dose guidelines, the majority (98.1%) of caspofungin-treated patients received 50 mg IV daily, whereas 4 (3.9%) patients were treated at higher doses (70 mg daily). Anidulafungin was administered at various maintenance doses, including 400 mg (2.3% of patients), 200 mg (52.3%), 100 mg (43.2%) and 50 mg (2.3%) IV daily.</p><p><strong>Conclusion: </strong>Our results can be utilised to produce a hospital-specific algorithm in terms of Candida-infected patients.</p><p><strong>Contribution: </strong>These findings contribute to our understanding of prescribing patterns of antifungal agents and the impact thereof on treating <i>Candida</i> spp. Infections.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"470"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316209","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}