Southern African Journal of Infectious Diseases最新文献

{"title":"Adherence to a care bundle for <i>Staphylococcus aureus</i> bacteraemia: A retrospective cohort study.","authors":"Elizabeth M Gatley,&nbsp;Tom Boyles,&nbsp;Sipho Dlamini,&nbsp;Marc Mendelson,&nbsp;Phiona E Namale,&nbsp;Peter J Raubenheimer,&nbsp;Sean Wasserman","doi":"10.4102/sajid.v37i1.445","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.445","url":null,"abstract":"<p><strong>Background: </strong><i>Staphylococcus aureus</i> bacteraemia is associated with high hospital mortality. Improvements in outcome have been described with standardised bundles of care.</p><p><strong>Objectives: </strong>To study the adherence of a standardised bundle of care (BOC) recommendations using a consultation pro forma, for all patients admitted with <i>S. aureus</i> bacteraemia to Groote Schuur Hospital over a year. The study further aimed to describe the 90-day mortality in these patients and to assess for an association between adherence to the bundle of care and outcome.</p><p><strong>Method: </strong>A retrospective audit of all unsolicited infectious disease consultations for patients with <i>S. aureus</i> bacteraemia admitted to Groote Schuur Hospital during 2018. Adherence to recommendations of a standard bundle of care was audited.</p><p><strong>Results: </strong>A total of 86 patients were included in the study: 61 (71%) with hospital-associated infection and 25 (29%) with community-associated infection. Over 80% of adherence to treatment recommendations was achieved regarding antibiotic (including vancomycin) usage, source control and use of echocardiography as required. In-hospital mortality was 16%, while the overall 90-day mortality was 18%, with only age as an independent predictor of mortality. No association between adherence to the bundle of care and outcome was found.</p><p><strong>Conclusion: </strong>Adherence to a simple, structured bundle of care was good when using standardised pro forma as communication tools for advice and a structured antibiotic chart for vancomycin administration. Although adherence was not associated with outcome, the overall mortality for <i>S. aureus</i> bacteraemia was improving in the institution under study.</p><p><strong>Contribution: </strong>Our findings support feasibility and ongoing use of bundles of care for <i>S. aureus</i> bacteraemia in similar settings.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"37 1","pages":"445"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10379737","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":"Multisystem cytomegalovirus end-organ disease in a patient with advanced HIV.","authors":"Ruan Spies,&nbsp;Pierre Joubert,&nbsp;Dharshnee Chetty,&nbsp;Sipho Dlamini,&nbsp;Muhammed S Moosa","doi":"10.4102/sajid.v37i1.468","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.468","url":null,"abstract":"<p><p>Cytomegalovirus (CMV) infection is common in people living with HIV, but multisystem CMV end-organ disease (EOD) is rare following the introduction of effective antiretroviral therapy. We present the case of a patient with advanced HIV and multisystem manifestations of CMV EOD.</p><p><strong>Contributions: </strong>This case report highlights the potential morbidity and mortality associated with CMV disease in patients with advanced HIV. Clinicians should be vigilant in considering CMV EOD in patients with advanced HIV and visual, neurological and gastointestinal symptoms.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"37 1","pages":"468"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10379736","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":"Case Report: A woman with pelvic hydatid disease.","authors":"Nabeela Adam","doi":"10.4102/sajid.v37i1.455","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.455","url":null,"abstract":"<p><p>Hydatid disease is found in many low-income countries, where humans are deemed accidental hosts. Bone hydatid disease is a rare entity as the lungs and liver are usually the target organs. However, there are currently a handful of case reports around the world with bone hydatid disease.</p><p><strong>Contribution: </strong>We present South Africa's first case report of pelvic hydatid disease and looking to uncover some treatment options for this patient.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"37 1","pages":"455"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371692","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":"The preference of women living with HIV for the HPV self-sampling of urine at a rural HIV clinic in Uganda.","authors":"Agnes Nyabigambo,&nbsp;Roy W Mayega,&nbsp;Hilbert Mendoza,&nbsp;Aslam Shiraz,&nbsp;John Doorbar,&nbsp;Lynn Atuyambe,&nbsp;Themba G Ginindza","doi":"10.4102/sajid.v37i1.414","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.414","url":null,"abstract":"<p><strong>Background: </strong>Women living with HIV have a double risk of acquiring cervical cancer (CC) due to repeated human papilloma virus (HPV) infections resulting from reduced immunity, with CC screening being low at 46.7%.</p><p><strong>Objectives: </strong>To determine the factors associated with the preference for HPV self-sampling using urine as well as establish its feasibility among women living with HIV attending a rural HIV clinic in Uganda.</p><p><strong>Method: </strong>A cross-sectional study design using quantitative data collection methods was used at the HIV clinic, Luweero District Hospital, among 426 women aged between 30 and 65 years. Data were analysed using descriptive statistics and modified Poisson regression. Urine samples were analysed using a Liferiver high-risk HPV genotyping real-time polymerase chain reaction (PCR) kit to determine the prevalence of the 15 HPV subtypes. Cervical intraepithelial neoplasia 2 (CIN2) was determined by visual inspection under acetic acid (VIA) using the nurse-led approach.</p><p><strong>Results: </strong>Most women (296/426, 70%) preferred nurse-led screening. Preference for HPV self-sampling using urine was associated with older age (46-65 years) (adjusted prevalence risk ratios [aPRR] 1.59; 95% confidence interval [CI]: 1.13-2.24), history of sexually transmitted infections (aPRR 0.74: 95% CI: 0.55-0.98) and acquisition of CC information from the television (aPRR 1.48: 95% CI: 1.09-2.02). Approximately 97% (68/70) of women living with HIV tested HPV positive with one or more subtypes. The most prevalent subtype of HPV was HPV 58 (87.1%). Only one woman tested positive with VIA.</p><p><strong>Conclusion: </strong>Nurse-led CC screening is preferred among women living with HIV, and HPV self-sampling using urine is feasible at the HIV clinic. Therefore, educational programmes to reassure the masses about urine HPV self-sampling need to be designed.</p><p><strong>Contribution: </strong>This study's findings provide early insights into the merits and demerits of the current HPV sample collection approaches. Hence, HPV testing should be tailored to routine HIV care in rural communities.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"37 1","pages":"414"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435860","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":"Progress with the <i>Southern African Journal of Infectious Diseases</i>: Where are we in 2021?","authors":"Charles Feldman","doi":"10.4102/sajid.v36i1.352","DOIUrl":"https://doi.org/10.4102/sajid.v36i1.352","url":null,"abstract":"No abstract available.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"36 1","pages":"352"},"PeriodicalIF":0.9,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8689377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39772465","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":"Exogenous fungal endophthalmitis in a potato farm worker.","authors":"Ghowa Booley,&nbsp;Raphael Chanda,&nbsp;Priscilla Daries,&nbsp;Clive Misland,&nbsp;Adrian J Brink,&nbsp;Leandri Linde,&nbsp;Christoffel J Opperman","doi":"10.4102/sajid.v36i1.329","DOIUrl":"https://doi.org/10.4102/sajid.v36i1.329","url":null,"abstract":"No abstract available.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"36 1","pages":"329"},"PeriodicalIF":0.9,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8689375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39772464","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":"Sexually transmitted infections in pregnant women from sub-Saharan Africa.","authors":"Bongekile Ngobese,&nbsp;Nathlee S Abbai","doi":"10.4102/sajid.v36i1.312","DOIUrl":"https://doi.org/10.4102/sajid.v36i1.312","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted infections (STIs) are a major health problem in most countries of the world, particularly in developing countries where the resources and technology to diagnose and treat them are limited. Currently, there is limited data on STIs and risk factors for these infections in pregnant women living with human immunodeficiency virus (HIV), especially in sub-Saharan Africa (SSA). This review provides data on the prevalence and risk factors for STIs in pregnant women living with HIV from SSA. This review also describes the association between STIs and HIV on pregnancy and birth outcomes as well as highlights the importance of laboratory-based diagnosis of STIs.</p><p><strong>Method: </strong>An electronic search of online databases was used to find and collect relevant research articles connected to the prevalence, adverse pregnancy and birth outcomes, health complications and risk factors associated with STIs and HIV in pregnant women from SSA. The search was limited to articles published in English. Relevant studies were identified by searching literature from January 2001 to date. The search yielded 4709 results.</p><p><strong>Results: </strong>In SSA, STIs are highly prevalent in pregnant women and are widely known to be linked with an increased risk of poor maternal and neonatal outcomes. These infections are often asymptomatic and highly prevalent in pregnant women. The screening of STIs in pregnant women living with HIV can reduce the risk of mother-to-child transmission (MTCT) and screening and treatment for STIs can also prevent adverse perinatal outcomes. It is important to recognise regional and national STI epidemics in order to promote STI prevention and control interventions considering the test and treat approach as opposed to syndromic management.</p><p><strong>Conclusion: </strong>This review highlights the need to use diagnostic screening methods instead of syndromic STI management in SSA. Moreover, more research into effective prevention and treatment measures for STIs in pregnant women is urgently required.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"36 1","pages":"312"},"PeriodicalIF":0.9,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39734307","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":"Trends in the epidemiology of urinary tract infections in pregnancy at a tertiary hospital in Johannesburg: Are contemporary treatment recommendations appropriate?","authors":"Trusha Nana, Shastra Bhoora, Vindana Chibabhai","doi":"10.4102/sajid.v36i1.328","DOIUrl":"10.4102/sajid.v36i1.328","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are common during pregnancy and are associated with maternal and foetal complications. Empiric antibiotic choices in pregnancy require consideration of efficacy and safety, resulting in limited oral options. With rapidly evolving antibiotic resistance, surveillance to guide empiric treatment recommendations is essential.</p><p><strong>Methods: </strong>A retrospective analysis of urine culture isolates from the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) Obstetrics Department for 1 January 2015 to 31 December 2020 was performed.</p><p><strong>Results: </strong>The top 3 pathogens were <i>Escherichia coli, Enterococcus faecalis</i> and <i>Klebsiella pneumoniae</i>. For <i>E. coli</i> susceptibility to cefuroxime declined (95% to 81%, <i>p</i> < 0.0001). Similarly, the <i>E. coli</i> extended spectrum beta-lactamase rate increased from 5% to 10% (<i>p</i> = 0.04). <i>E. coli</i> susceptibility to nitrofurantoin (93%) and fosfomycin (96%) remained high. In 2019, carbapenem-resistant <i>K. pneumoniae</i> emerged. Ampicillin susceptibility was high amongst the <i>E. faecalis</i> isolates. Amoxicillin-clavulanate demonstrated high levels of activity against the top 3 uropathogens.</p><p><strong>Conclusion: </strong>The Essential Drug List recommended antibiotics for lower UTIs, nitrofurantoin and fosfomycin, are appropriate empiric options for <i>E. coli</i>, the most common uropathogen in the CMJAH obstetric population. The high rate of <i>E. faecalis</i> susceptibility to nitrofurantoin reported from other Gauteng tertiary obstetric patients, suggests that nitrofurantoin will provide adequate empiric cover for a large proportion of UTIs. However, the determination of the <i>E. faecalis</i> nitrofurantoin and fosfomycin susceptibility rates in the CMJAH obstetric population will provide useful data. Periodic surveillance at the various levels of antenatal care in different regions of South Africa and the determination of risk factors for infections with resistant uropathogens is needed.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"36 1","pages":"328"},"PeriodicalIF":0.9,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766466","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, incidence and seroconversion of HIV and Syphilis infections among pregnant women of South Africa.","authors":"Monjurul Hoque,&nbsp;Muhammad E Hoque,&nbsp;Guido van Hal,&nbsp;Somaya Buckus","doi":"10.4102/sajid.v36i1.296","DOIUrl":"https://doi.org/10.4102/sajid.v36i1.296","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women in South Africa suffer from HIV and syphilis infections resulting in negative pregnancy outcomes. Little is known about the prevalence, incidence, seroconversion, and associated risk factors for those attending a midwife run obstetric unit.</p><p><strong>Methods: </strong>A retrospective cohort study was undertaken among pregnant women attending antenatal clinic from January to December 2018. Logistic regression was conducted to determine the risk factors for HIV and syphilis.</p><p><strong>Results: </strong>The prevalence of HIV and syphilis were 44.3% (95% confidence interval [CI]; 41.6:46.7) and 3.8% (95% CI; 3.1:4.1), respectively. The seroconversion and incidence for HIV were 4.0% (95% CI; 3.6:4.6) and 17.1 per 100 person-years, and for syphilis 2.6% (95% CI; 2.3:2.8) and 10.9 per 100 person-years, respectively. Significant predictors for HIV prevalence were ages: ages < 20 years, Odds ratio (OR) = 0.11 (<i>p</i> < 0.05), ages 20-24 years, OR = 0.19 (<i>p</i> < 0.05) and ages 25-29 years, OR = 0.38 (<i>p</i> < 0.05); gestational age: second trimester, OR = 0.68 (<i>p</i> < 0.05) and non-reactive syphilis, OR = 0.45 (<i>p</i> < 0.05). Age was the predictor for HIV incidence or seroconversion (age < 20 year, OR = 0.12, <i>p</i> = 0.01). Predictors for syphilis were ages < 20 years, OR = 0.11 (<i>p</i> < 0.05), ages 20-24 years and HIV status. Gestational age > 27 weeks were nine times (OR = 9.2, <i>p</i> = 0.03) more likely to seroconvert to syphilis.</p><p><strong>Conclusions: </strong>The present study found high rates of seroprevalence, seroconversion and incidence of HIV and syphilis among pregnant women.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"36 1","pages":"296"},"PeriodicalIF":0.9,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39733346","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":"Impact of an antibiotic stewardship programme in a surgical setting.","authors":"Muhammad A Bashar,&nbsp;Jacqui Miot,&nbsp;Evan Shoul,&nbsp;Robyn L van Zyl","doi":"10.4102/sajid.v36i1.307","DOIUrl":"https://doi.org/10.4102/sajid.v36i1.307","url":null,"abstract":"<p><strong>Background: </strong>Antibiotics are miracles of science and critical for many surgical procedures. However, the emergence of multidrug resistant pathogens resulting from inappropriate antibiotic use is a threat to modern medicine. This study aimed to determine the appropriateness of antibiotic use, cost, consumption and impact of an antibiotic stewardship intervention round in a surgical ward setting.</p><p><strong>Methods: </strong>Baseline antibiotic utilisation was determined with a retrospective cross-sectional study in two surgical wards in a tertiary academic hospital in South Africa where medical records of 264 patients who received antibiotics were reviewed. In the second stage of the study, records of 212 patients who received antibiotics were reviewed during a weekly antibiotic stewardship intervention round. The volume of antibiotics consumed was determined using defined daily doses (DDDs)/1000 patients' days, and the appropriateness of the antibiotic prescription for treatment was also determined using a quality-of-use algorithm.</p><p><strong>Results: </strong>There was a reduction in the volume of antibiotic consumption from a total 739.30 DDDs/1000 to 564.93 DDDs/1000 patient days, with reduction in inappropriate antibiotic use from 35% to 26% from baseline to antibiotic stewardship programme stages, respectively. There was an overall increase in culture targeted therapy in both wards in the antibiotic stewardship programme stage.</p><p><strong>Conclusion: </strong>The implementation of an antibiotic stewardship programme led to a reduction in antibiotic consumption and improvement in appropriate use of antibiotics.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"36 1","pages":"307"},"PeriodicalIF":0.9,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39733347","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}