GERMS最新文献

{"title":"Clinical and bacteriological profiles of neonatal sepsis in a tertiary hospital, south-western Nigeria.","authors":"Temitope O Obadare, Ebunoluwa A Adejuyigbe, Adeyemi T Adeyemo, Adewale A Amupitan, Osagie J Ugowe, Chinemere H Anyabolu, Aaron O Aboderin","doi":"10.18683/germs.2023.1377","DOIUrl":"https://doi.org/10.18683/germs.2023.1377","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic-resistant bacteria complicate treatment options in neonatal sepsis, especially in developing countries. This study determined the epidemiology and bacteriological characteristics of neonatal sepsis at a tertiary hospital, in southwest Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional study from December 2017 to April 2019 among admitted babies with clinical neonatal sepsis. Blood culture was performed by semi-automated system, sepsis biomarker assay (serum procalcitonin) by a semi-quantitative kit while proforma was used to capture clinico-demographic data. Bacterial identification, antibiotic susceptibility patterns, determination of genetic elements mediating resistance, were performed by standard methods and polymerase chain reaction protocols, respectively. Quantitative data were expressed as frequencies, mean; bivariate and multivariate analyses were performed by Chi-square or Fishers' exact test and logistic regression.</p><p><strong>Results: </strong>Of the 192 cases of neonatal sepsis enrolled, 42.7% (82/192) were blood culture positive. Factors associated with blood culture positivity included respiratory rate ≥60 bpm (60/82; p<0.03), lethargy/unconsciousness (59/82; FE=7.76; p<0.001), grunting respiration (54/82; p=0.04), meconium passage before birth (17/82; p=0.03) and prolonged rupture of membranes ≥24 hours (50/82; FE=6.90; p=0.01). On the other hand, mortality in the neonates was associated with elevated serum procalcitonin assay (>0.5 ng/mL) χ²=13.58; p=0.03] and Gram-negative bacteremia (χ²=24.64; p<0.001). The most common bacterial isolates were <i>Staphylococcus aureus</i> (42/82), coagulase-negative <i>Staphylococcus</i> spp. (17/82), <i>Enterobacter</i> spp. (8/82), and <i>Acinetobacter</i> spp. (6/82). Methicillin resistance was present in 85.7% (36/42) of <i>Staphylococcus aureus</i> and 52.9% (9/17) of coagulase-negative <i>Staphylococcus</i>, while extended-spectrum beta-lactamase (ESBL) and AmpC enzymes were present in (21.1%; 4/19) of the Gram-negative bacilli.</p><p><strong>Conclusions: </strong>Almost half of the cases of clinically diagnosed neonatal sepsis have bacterial etiologic confirmation of sepsis. Gram-negative bacteremia and high serum procalcitonin predict mortality in neonatal sepsis. There was high resistance to common antibiotics for the treatment of neonatal sepsis in our settings.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"137-150"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032693","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":"Challenges in the implementation of mother-to-child HIV/AIDS prevention programs in Indonesia.","authors":"Iin Khoiriyah Ulfah, Renaldy Raditya Indrawan, Novi Anggraeni, Afif Nurul Hidayati, Nasronudin, Siti Qamariyah Khairunisa","doi":"10.18683/germs.2023.1379","DOIUrl":"https://doi.org/10.18683/germs.2023.1379","url":null,"abstract":"<p><strong>Introduction: </strong>The HIV/AIDS prevention program among pregnant mothers aims to reduce the risk of HIV transmission from mother to baby. It also aims to reduce stigma and discrimination, as well as deaths due to HIV/AIDS. This paper aimed to find out obstacles that occur in the implementation of HIV/AIDS transmission program in Indonesia.</p><p><strong>Methods: </strong>Online literature search was done on Google Scholar, Science Direct and PubMed databases with the keywords related to \"HIV/AIDS\" and transmission prevention program among mothers to children. The search resulted in a total of 343 articles.</p><p><strong>Results: </strong>After the abstracts were reviewed, there were only 16 articles selected.</p><p><strong>Conclusions: </strong>The implementation of the program in Indonesia has been run but is not yet optimal because of several obstacles i.e., the insufficient number of health workers and poor knowledge of health workers. Figuring out solutions to the obstacles could ease the program implementation to reduce the cases of HIV/AIDS. Obstacles were found in the implementation of the HIV/AIDS prevention program among mothers and children in Indonesia.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"158-167"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032692","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 occurrence of a fatal tuberculous pancreatic abscess simulating a pancreatic tumor in an immunocompromised patient.","authors":"Elmostafa Benaissa, Adil Maleb, Mostafa Elouennass","doi":"10.18683/germs.2023.1382","DOIUrl":"https://doi.org/10.18683/germs.2023.1382","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis is currently undergoing a worrying recovery in Morocco. It is becoming a tropical disease again and can take deceptive clinical forms and involve unusual localizations. We report a rare case of pancreatic abscess due to <i>Mycobacterium tuberculosis</i> in an immunocompromised patient.</p><p><strong>Case report: </strong>The patient was 48 years old and was diagnosed with HIV infection 16 months previously during a systematic check-up. He had no notable pathological history, no notion of tuberculosis contagion and no signs of tuberculosis impregnation, and was admitted for the management of epigastric pain associated with an altered general condition. Abdominal CT scan showed a bulbar perforation and multiple deep necrotic adenopathies of infectious or tumoral origin. Direct examination of the pus with Ziehl Neelsen stain was positive (1-10 BAAR/field). Molecular study using the GeneXpert MTB/RIF technique revealed <i>M. tuberculosis</i> complex without rifampicin resistance. The patient was put on antibacillary treatment based on isoniazid, rifampicin, ethambutol and pyrazinamide. The patient died of septic shock with multiple organ failure.</p><p><strong>Conclusions: </strong>The diagnosis of a tuberculous pancreatic abscess may be overlooked because of its rarity and its clinical state simulating a pancreatic tumor, so it should be considered especially in endemic countries like ours.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"177-182"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032701","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":"Achieving pre-eminence of antimicrobial resistance among non-fermenting Gram-negative bacilli causing septicemia in intensive care units: A single center study of a tertiary care hospital.","authors":"Harit Kumar, Narinder Kaur, Nitin Kumar, Jyoti Chauhan, Rosy Bala, Shubham Chauhan","doi":"10.18683/germs.2023.1374","DOIUrl":"https://doi.org/10.18683/germs.2023.1374","url":null,"abstract":"<p><strong>Introduction: </strong>Bloodstream infections in the intensive care unit have always been a global healthcare challenge. The present study was conducted with the aim to evaluate the yearly trend of antibiotic resistance in non-fermenting Gram-negative bacilli (NFGNB) causing septicemia in intensive care units.</p><p><strong>Methods: </strong>Blood samples were collected from the patients admitted in various intensive care units and processed for isolation and identification of non-fermenting Gram-negative bacilli. The isolated bacterial strains were subjected to antibiotic susceptibility testing as per standard operating procedures.</p><p><strong>Results: </strong>Out of 3632 blood samples, 977 (26.9%) samples showed microbial growth, of which 10.1% were Gram positive cocci, 8.7% were Gram negative bacilli (Enterobacterales), 7% were NFGNB and 1% were <i>Candida</i> spp. Increasing resistance among <i>Acinetobacter baumannii</i> complex was observed to ceftazidime, cefepime, amikacin, ciprofloxacin, levofloxacin, meropenem and trimethoprim-sulfamethoxazole. Moreover, <i>Pseudomonas aeruginosa</i> strains were found to be associated with increased resistance to ciprofloxacin, levofloxacin, ceftazidime and meropenem. A substantial increase in resistance levels was observed among <i>Stenotrophomonas maltophilia</i> and <i>Sphingomonas paucimobilis</i> as well.</p><p><strong>Conclusions: </strong>An increasing trend of antimicrobial resistance in NFGNB envisages the worst consequences in ICUs in the coming years. Therefore, reviewing and strict implementation of the antimicrobial policies including 'rational use of antibiotics' is recommended.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"108-120"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032690","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":"Risk mitigation for vaccine-preventable diseases in the dental clinic.","authors":"Oana Săndulescu, Mihai Săndulescu","doi":"10.18683/germs.2023.1373","DOIUrl":"https://doi.org/10.18683/germs.2023.1373","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"104-107"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032700","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":"Clinical challenge of co-infection of SARS-CoV-2 with influenza during the influenza circulation season: suggestions for prevention.","authors":"Shabnam Dehghan Tarzjani, Sara Kamalzadeh, Majid Taati Moghadam, Mohammad Taghi Ashoobi","doi":"10.18683/germs.2023.1384","DOIUrl":"https://doi.org/10.18683/germs.2023.1384","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"188-191"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032694","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":"Genotyping of Whipple's disease presenting as sclerosing mesenteritis: A case report.","authors":"Areti Kalfoutzou, Sofia Makka, Theodora Stivarou, Myrto Koutantou, Panagiota Kelidi, Maria Papanikolaou, Nikolaos Chaleplidis, Christos Tekedis, Eleni Mostratou, Emmanouil Angelakis, Panagiotis Petrikkos","doi":"10.18683/germs.2023.1383","DOIUrl":"https://doi.org/10.18683/germs.2023.1383","url":null,"abstract":"<p><strong>Introduction: </strong>There are very few reported cases of Whipple disease (WD), a rare chronic disease in Greece. In this report, we present a classic WD case in a Greek firefighter and the detection of an autochthonous <i>Tropheryma whipplei</i> genotype in this Greek autochthonous citizen.</p><p><strong>Case report: </strong>We describe a patient with chronic diarrhea and arthritis who was misdiagnosed with sclerosing mesenteritis three years previously and was unsuccessfully treated with corticosteroids. After the effectuation of histopathologic examination and PCR against <i>T</i>. <i>whipplei</i>, he was diagnosed with classic WD. Moreover, for the first time in Greece, we proceeded with <i>T. whipplei</i> genotyping targeting four highly variable genomic sequences and we concluded that the patient was infected <i>by T. whipplei</i> genotype 120.</p><p><strong>Conclusions: </strong>We highlight the necessity to explore <i>T. whipplei</i> presence and its genotypes through the Greek population and to identify if genotype 120 is the predominant strain in the Hellenic territory.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 2","pages":"183-187"},"PeriodicalIF":2.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10746342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033169","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":"Facial nerve palsy: An early sign of COVID-19.","authors":"Michael Somero, Elisa Akagi, Ashish Bhargava","doi":"10.18683/germs.2023.1367","DOIUrl":"https://doi.org/10.18683/germs.2023.1367","url":null,"abstract":"<p><strong>Introduction: </strong>Bell's palsy is a peripheral lower motor neuron (LMN) facial nerve palsy, characterized by the acute onset (72 hours or less) of unilateral peripheral facial paresis without other neurologic signs. Bell's palsy has been described at three clinical junctures of COVID-19 infection: as the unique initial signal of COVID-19, as an accompanying feature during the acute phase of COVID-19 when respiratory and systemic symptoms predominate, or during the recuperative phase beginning 2-3 weeks after resolution of respiratory and systemic covid symptoms.</p><p><strong>Case report: </strong>We present a unique case of a COVID-19-related facial nerve palsy that occurred 3 weeks prior to the onset of pneumonia caused by COVID-19.</p><p><strong>Conclusions: </strong>This case report suggests an association between early COVID-19 presenting as facial nerve palsy and alerts physicians about the ways in which COVID-19 may cause this phenomenon.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 1","pages":"60-64"},"PeriodicalIF":2.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463422","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 tetanus is not gone yet, but could be ready to leave: A case-series from central India.","authors":"Mahadev Meena, Vaibhav Yadav, Manish M Yadav, Rajnish Joshi, Prachi Singh, Rajesh Panda, Saurabh Saigal","doi":"10.18683/germs.2023.1371","DOIUrl":"https://doi.org/10.18683/germs.2023.1371","url":null,"abstract":"<p><strong>Introduction: </strong>Adult tetanus is a neurotoxin mediated infectious disease, that continues to be seen despite availability of a highly efficacious vaccine. In India population-based burden estimates for adult tetanus are not available. Elimination of neonatal and maternal tetanus from India was achieved in 2015 with DPT (diphtheria, pertusis, and tetanus) vaccine during childhood and tetanus toxoid (TT) during antenatal care. Vaccine coverage in adults is uneven. While pregnant women receive the vaccine as part of ante-natal care, booster dose coverage in all other non-pregnant women and men is poor.</p><p><strong>Case report: </strong>We describe four cases of adult tetanus that presented to our tertiary care hospital in central India. Out of four cases, two were homemakers, one was a farmer, another was a student. Three of them were not aware regarding primary tetanus vaccination and none of the four received any booster dosages of tetanus vaccine.</p><p><strong>Conclusions: </strong>These cases highlight complexity of disease management and reinforce the need for adult booster immunization against tetanus.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 1","pages":"86-89"},"PeriodicalIF":2.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463405","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":"Adverse events following immunization (AEFI): COVID-19 vaccine dose and characteristics in Central Java, Indonesia.","authors":"Firdaus Wahyudi, Arwinda Nugraheni, Ani Margawati, Dodik Pramono, Dea Amarilisa Adespin, Teddy Wahyu Nugroho, Cipta Pramana","doi":"10.18683/germs.2023.1365","DOIUrl":"https://doi.org/10.18683/germs.2023.1365","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccination is an effort to control the COVID-19 pandemic. Although vaccines can be effective prevention, they can have potential side effects, or adverse events following immunization (AEFI). CoronaVac, BBIBP-CorV, BNTb262-BioNTech, mRNA-1273, and ChAdOx1NCoV-19 were vaccines used in Indonesia when this study was conducted. This study aimed to analyze the factors associated with AEFI for the COVID-19 vaccines for each dose in the community.</p><p><strong>Methods: </strong>This study used a cross-sectional design. The study was conducted in Central Java Province, Indonesia from August to October 2021. The variables included respondent characteristics, COVID-19 infection history, COVID-19 vaccine AEFI, dose, and type. Data collection was performed through questionnaires and data was analyzed by a logistic regression test.</p><p><strong>Results: </strong>The percentage of AEFI was 21.1% after the first dose, 14.1% after the second dose, and 83.9% after the third dose of the vaccine. The factors associated with higher odds of COVID-19 vaccine AEFI were different for each dose, as follows: for the first dose: age group >45 years (p=0.009; OR=2.837; 95%CI: 1.301-6.187) and overweight (p=0.007; OR=3.323; 95%CI: 1.242-8.689); for the second dose: overweight (p=0.007; OR=9.118; 95%CI: 1.827-45.5), female sex (p=0.011; OR=2.885; 95%CI: 1.274-6.531), age group >45 years (p=0.017; OR=3.257; 95%CI: 1.24-8.555) and prior episode of COVID-19 (p=0.044; OR=2.459; 95%CI: 1.026-5.893); and for the third dose: female sex (p=0.040; OR=3.650; 95%CI: 1.062-12.550).</p><p><strong>Conclusions: </strong>The factors that were associated with AEFI of COVID-19 vaccine were sex, age, nutritional status and prior history of COVID-19.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 1","pages":"40-49"},"PeriodicalIF":2.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463406","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}