Therapeutic Advances in Infectious Disease最新文献

{"title":"Antileishmanial activity of 5-nitroindazole derivatives.","authors":"Niurka Mollineda-Diogo,&nbsp;Claudia Sissely Chaviano-Montes de Oca,&nbsp;Sergio Sifontes-Rodríguez,&nbsp;Teresa Espinosa-Buitrago,&nbsp;Lianet Monzote-Fidalgo,&nbsp;Alfredo Meneses-Marcel,&nbsp;Aliuska Morales-Helguera,&nbsp;Yunierkis Perez-Castillo,&nbsp;Vicente Arán-Redó","doi":"10.1177/20499361231208294","DOIUrl":"https://doi.org/10.1177/20499361231208294","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is no safe and effective vaccine against leishmaniasis and existing therapies are inadequate due to high toxicity, cost and decreased efficacy caused by the emergence of resistant parasite strains. Some indazole derivatives have shown <i>in vitro</i> and <i>in vivo</i> activity against <i>Trichomonas vaginalis</i> and <i>Trypanosoma cruzi</i>. On that basis, 20 indazole derivatives were tested <i>in vitro</i> against <i>Leishmania amazonensis</i>.</p><p><strong>Objective: </strong>To evaluate the <i>in vitro</i> activity of twenty 2-benzyl-5-nitroindazolin-3-one derivatives against <i>L. amazonensis</i>.</p><p><strong>Design: </strong>For the selection of promising compounds, it is necessary to evaluate the indicators for <i>in vitro</i> activity. For this aim, a battery of studies for antileishmanial activity and cytotoxicity were implemented. These results enabled the determination of the substituents in the indazole derivatives responsible for activity and selectivity, through the analysis of the structure-activity relationship (SAR).</p><p><strong>Methods: </strong><i>In vitro</i> cytotoxicity against mouse peritoneal macrophages and growth inhibitory activity in promastigotes were evaluated for 20 compounds. Compounds that showed adequate selectivity were tested against intracellular amastigotes. The SAR from the results in promastigotes was represented using the SARANEA software.</p><p><strong>Results: </strong>Eight compounds showed selectivity index >10% and 50% inhibitory concentration <1 µM against the promastigote stage. Against intracellular amastigotes, four were as active as Amphotericin B. The best results were obtained for 2-(benzyl-2,3-dihydro-5-nitro-3-oxoindazol-1-yl) ethyl acetate, with 50% inhibitory concentration of 0.46 ± 0.01 µM against amastigotes and a selectivity index of 875. The SAR study showed the positive effect on the selectivity of the hydrophilic fragments substituted in position 1 of 2-benzyl-5- nitroindazolin-3-one, which played a key role in improving the selectivity profile of this series of compounds.</p><p><strong>Conclusion: </strong>2-bencyl-5-nitroindazolin-3-one derivatives showed selective and potent <i>in vitro</i> activity, supporting further investigations on this family of compounds as potential antileishmanial hits.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427773","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":"Intention to use PrEP among men who have sex with men and engage in chemsex: an international descriptive study.","authors":"Álvaro Francisco Lopes de Sousa,&nbsp;Caíque Jordan Nunes Ribeiro,&nbsp;Guilherme Reis de Santana Santos,&nbsp;Layze Braz de Oliveira,&nbsp;Emerson Lucas Silva Camargo,&nbsp;Shirley Verônica Melo Almeida Lima,&nbsp;Inara Viviane de Oliveira Sena,&nbsp;Márcio Bezerra-Santos,&nbsp;Odinéa Maria Amorim Batista,&nbsp;Anderson Reis de Sousa,&nbsp;Isabel Amélia Costa Mendes","doi":"10.1177/20499361231206918","DOIUrl":"https://doi.org/10.1177/20499361231206918","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) is a valuable tool in the response to the HIV epidemic, recommended for groups with a higher risk of HIV infection, such as men who have sex with men (MSM), particularly in the context of high-risk sexual behavior such as chemsex.</p><p><strong>Purpose: </strong>This study aimed to analyze the prevalence and factors associated with the intention to use PrEP among MSM who engage in chemsex in Brazil and Portugal.</p><p><strong>Methods: </strong>This was a cross-sectional study of a secondary dataset from a larger study conducted between January 2020 and May 2021 throughout Brazil and Portugal involving 1852 MSM who engage in chemsex. An initial descriptive analysis was performed to calculate the absolute and relative frequencies of independent variables related to the intention to use PrEP among MSM. A multivariate regression model was developed to identify factors independently associated with the intention to use PrEP.</p><p><strong>Results: </strong>Although a high level of PrEP knowledge (85.75%) was observed among MSM who engage in chemsex, the prevalence of intention to use PrEP was only 59.07%. Five variables were associated with a higher prevalence of intention to use PrEP [engaging in double penetration - adjusted prevalence ratio (aPR): 1.56, 95% CI: 1.44-1.69; being assigned female sex at birth - aPR: 1.34, 95% CI: 1.12-1.61; cruising - aPR: 1.21, 95% CI: 1.06-1.38; not using condoms - aPR: 1.20, 95% CI: 1.05-1.36; and being an immigrant - aPR: 1.16; 95% CI: 1.07-1.25], while having knowledge of postexposure prophylaxis (aPR: 0.91; 95% CI: 0.84-0.98), having a casual sexual partner (aPR: 0.86 and 0.85; 95% CI: 0.74-0.99 and 0.74-0.98), and engaging in group sex (aPR: 0.81; 95% CI: 0.73-0.90) were associated with a lower intention to use PrEP.</p><p><strong>Conclusion: </strong>The intention to use PrEP among MSM who engage in chemsex was high, and several factors were associated with this intention. Understanding the factors associated with the intention to use PrEP among MSM practicing chemsex is crucial for developing targeted interventions to increase PrEP uptake in this population. The results of this study suggest that tailored approaches are necessary to promote PrEP use in this population.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414664","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":"Bacterial bloodstream infection in critically ill patients with COVID-19: a retrospective cohort study.","authors":"Mateusz Bartoszewicz,&nbsp;Sławomir Lech Czaban,&nbsp;Klaudia Bartoszewicz,&nbsp;Damian Kuźmiuk,&nbsp;Jerzy Robert Ładny","doi":"10.1177/20499361231207178","DOIUrl":"10.1177/20499361231207178","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19), have a high risk of developing bloodstream infections (BSIs). However, the characteristics of and risk factors for BSIs in these patients remain unclear.</p><p><strong>Objective: </strong>We aimed to identify prevalent causative pathogens of BSI and related factors in critically ill patients with COVID-19.</p><p><strong>Design: </strong>This was a single-center, retrospective cohort study.</p><p><strong>Methods: </strong>We analyzed the clinical characteristics and outcomes of 201 ICU patients with COVID-19. Logistic regression analysis was conducted to identify factors associated with BSI occurrence. Furthermore, we identified the primary causative pathogens of BSIs. The study outcomes were death or ICU discharge.</p><p><strong>Results: </strong>Among the 201 included patients, 43 (21.4%) patients developed BSI. The mortality rate was non-significantly higher in the BSI group than in the BSI group (65.1% <i>versus</i> 58.9%, <i>p</i> = 0.487). There were significant between-group differences in the obesity prevalence and sex distribution, but not corticosteroid usage. BSI occurrence was significantly associated with duration of mechanical ventilation (MV), presence of ventilator-associated pneumonia, use of neuromuscular blocking agents, length of stay in ICU (ICU LOS), high body mass index (BMI), and male sex. The main causative pathogens were <i>Klebsiella pneumoniae</i>, <i>Acinetobacter baumannii</i>, and <i>Enterococcus faecalis</i>. Multi-drug-resistant pathogens were found in 87% of cases. Regardless of the origin, the common risk factors for BSI were ICU LOS and MV duration. All BSIs were acquired within the hospital setting, with ≈60% of the cases being primary BSIs. A small proportion of the BSI cases were catheter-related (four cases, 6.2%). Ventilator-associated pneumonia and urinary tract infections were present in 25% and 9.4% of the BSI cases, respectively. On average, the first positive blood culture appeared ≈11.4 (±9.7) days after ICU admission.</p><p><strong>Conclusion: </strong>Elucidating the risk factors for and common pathogens of BSI can inform prompt management and prevention of BSIs.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/99/10.1177_20499361231207178.PMC10590042.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692946","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":"Recent Nipah virus outbreak in India: lessons and imperatives.","authors":"Shriyansh Srivastava,&nbsp;Novonil Deb,&nbsp;Poulami Roy,&nbsp;Vikash Jaiswal,&nbsp;Sanjit Sah,&nbsp;Yogesh Pandey,&nbsp;Ravi Sankar Reddy Edara,&nbsp;Aroop Mohanty,&nbsp;Andrés F Henao-Martínez,&nbsp;Ranjit Sah","doi":"10.1177/20499361231208535","DOIUrl":"10.1177/20499361231208535","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the Sage and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). TherapeuTic advances in infectious disease","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/79/10.1177_20499361231208535.PMC10576419.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239769","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":"What is the role of the clinical microbiology laboratory in the care of diagnostically challenging OPAT patients? Illustrative cases and literature review.","authors":"Priya Nori, Phyu Thwe, Jaime Mogollon, Rachel Bartash, Wendy Szymczak, Erika Orner, Musa Bolkent, Robin Patel","doi":"10.1177/20499361231205092","DOIUrl":"10.1177/20499361231205092","url":null,"abstract":"<p><p>Optimal care of patients requiring long-term outpatient parenteral or oral antimicrobial therapy by infectious diseases (ID) specialists is facilitated by an accurate microbiologic diagnosis. Close collaboration between ID specialists and the clinical microbiology laboratory for routine or specialized molecular testing can result in more accurate diagnoses, streamlined antimicrobial regimens, and improved patient outcomes.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/46/10.1177_20499361231205092.PMC10571669.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239770","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":"Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications.","authors":"Osaro Mgbere, Ogbonna Collins Nwabuko, Olajumoke A Olateju, Omolola E Adepoju, Winston Liaw, Charles Darkoh, Ekere James Essien","doi":"10.1177/20499361231202116","DOIUrl":"10.1177/20499361231202116","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic.</p><p><strong>Methods: </strong>This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and <i>Our World in Data</i> for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios.</p><p><strong>Results: </strong>A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, <i>n</i> = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% (<i>n</i> = 15) with medium burden and 22.6% (<i>n</i> = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/10⁵ population and mortality rate of 5.96/10⁵ population were recorded during the first 1-year period with significant variations (<i>p</i> < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/10⁵ and 315.933/10⁵ populations were recorded with significant correlation (<i>r</i> = 0.863, <i>p</i> < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels.</p><p><strong>Conclusion: </strong>Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/85/10.1177_20499361231202116.PMC10540606.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153807","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":"Exploring the advancements of Australian OPAT.","authors":"Tony Lai,&nbsp;Horst Thiele,&nbsp;Benjamin A Rogers,&nbsp;Nadine Hillock,&nbsp;Suman Adhikari,&nbsp;Alexander McNamara,&nbsp;Matthew Rawlins","doi":"10.1177/20499361231199582","DOIUrl":"https://doi.org/10.1177/20499361231199582","url":null,"abstract":"<p><p>Outpatient parenteral antimicrobial therapy (OPAT) in Australia has evolved from modest beginnings to a well-established health service with proven benefits in patient outcomes. This is a comprehensive review of the current state of art Australian OPAT with vignettes of the types of OPAT models of care, antimicrobial prescribing and antimicrobial use. In addition, we highlight the similarities and differences between OPAT to other countries and describe Australian OPAT experiences with COVID-19 and paediatrics. Australian OPAT continues to advance with OPAT antifungals, novel treatment options and upcoming high-impact research.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/f3/10.1177_20499361231199582.PMC10515521.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160094","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":"\"I know my body better than anyone else\": a qualitative study of perspectives of people with lived experience on antimicrobial treatment decisions for injection drug use-associated infections.","authors":"Amy Eckland, Michael Kohut, Henry Stoddard, Deb Burris, Frank Chessa, Monica K Sikka, Daniel A Solomon, Colleen M Kershaw, Ellen F Eaton, Rebecca Hutchinson, Peter D Friedmann, Thomas J Stopka, Kathleen M Fairfield, Kinna Thakarar","doi":"10.1177/20499361231197065","DOIUrl":"10.1177/20499361231197065","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) are at risk for severe bacterial and fungal infections including skin and soft tissue infections, endocarditis, and osteomyelitis. PWID have high rates of self-directed discharge and are often not offered outpatient antimicrobial therapies, despite studies showing their efficacy and safety in PWID. This study fills a gap in knowledge of patient and community partner perspectives on treatment and discharge decision making for injection drug use (IDU)-associated infections.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with patients (<i>n</i> = 10) hospitalized with IDU-associated infections and community partners (<i>n</i> = 6) in the Portland, Maine region. Community partners include peer support workers at syringe services programs (SSPs) and outreach specialists working with PWID. We transcribed and thematically analyzed interviews to explore perspectives on three domains: perspectives on long-term hospitalization, outpatient treatment options, and patient involvement in decision making.</p><p><strong>Results: </strong>Participants noted that stigma and inadequate pain management created poor hospitalization experiences that contributed to self-directed discharge. On the other hand, patients reported hospitalization provided opportunities to connect to substance use disorder (SUD) treatment and protect them from outside substance use triggers. Many patients expressed interest in outpatient antimicrobial treatment options conditional upon perceived efficacy of the treatment, perceived ability to complete treatment, and available resources and social support. Finally, both patients and community partners emphasized the importance of autonomy and inclusion in medical decision making. Although some participants acknowledged their SUD, withdrawal symptoms, or undertreated pain might interfere with decision making, they felt these medical conditions were not justification for health care professionals withholding treatment options. They recommended open communication to build trust and reduce harms.</p><p><strong>Conclusion: </strong>Patients with IDU-associated infections desire autonomy, respect, and patient-centered care from healthcare workers, and may self-discharge when needs or preferences are not met. Involving patients in treatment decisions and offering outpatient antimicrobial options may result in better outcomes. However, patient involvement in decision making may be complicated by many contextual factors unique to each patient, suggesting a need for shared decision making to meet the needs of hospitalized patients with IDU-associated infections.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/f6/10.1177_20499361231197065.PMC10492466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213215","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":"Pre-exposure prophylaxis use among female sex workers in Gulu city, Uganda: a community-based cross-sectional study.","authors":"Felix Bongomin, Winnie Kibone, Jerom Okot, Simple Ouma, Grace Madraa, Francis Williams Ojara, David Musoke, Pebalo Francis Pebolo","doi":"10.1177/20499361231199550","DOIUrl":"10.1177/20499361231199550","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) is an important intervention for reducing the risk of HIV transmission among high-risk populations such as female sex workers in Africa, where HIV prevalence remains high. We aimed to assess the use of PrEP among female sex workers in Gulu, Uganda.</p><p><strong>Methods: </strong>In this community-based cross-sectional study, we included HIV-negative female sex workers purposely selected from hotspots within Gulu city, Uganda between February and March 2023. A semi-structured questionnaire was administered to collect data on sociodemographic characteristics, reproductive data, sexual practices, and self-reported PrEP use in the past 3 months. Symptoms of depression were screened using Patient Health Questionnaire-2 tool. Predictors of PrEP use was determined using modified Poisson regression analysis model. <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>We enrolled 273 female sex workers with a median age of 27 (interquartile range: 24-32) years. Overall, 181 (66.3%) participants used PrEP. PrEP use was associated with; regular source of income beside sex work [adjusted prevalence ratio (aPR): 3.7, 95% confidence interval (CI): 2.11-6.35, <i>p</i> < 0.001], being in a polygamous marriage (aPR: 6.9, 95% CI: 1.32-35.77, <i>p</i> = 0.022), practicing sex work in both rural and urban areas (aPR: 2.5, 95% CI: 1.49-4.35, <i>p</i> < 0.001), having symptoms of depression (aPR: 3.3, 95% CI: 1.43-7.74, <i>p</i> = 0.005), and use of postexposure prophylaxis (PEP) in the past 12 months (aPR: 0.31, 95% CI: 0.17-0.59, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Almost two in three of the female sex workers in Gulu city were currently using PrEP. Previous use of PEP was associated with lower use of PrEP. These findings suggest the need for targeted interventions to increase PrEP uptake and decrease HIV acquisition in this high-risk population among female sex workers, especially those with low income and limited access to healthcare.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/3f/10.1177_20499361231199550.PMC10492468.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221545","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":"Retrospective analysis of the management of pelvic decubitus ulcers and their outcomes.","authors":"Laura Damioli, Zachary Shepard, Melissa P Wilson, Kristine M Erlandson","doi":"10.1177/20499361231196664","DOIUrl":"10.1177/20499361231196664","url":null,"abstract":"<p><strong>Background: </strong>Many patients with decubitus-related osteomyelitis are ineligible for myocutaneous flapping, and optimal management in this population is unknown. We describe treatments and outcomes of hospitalized patients with decubitus ulcer-related osteomyelitis who did not undergo surgical reconstruction or coverage.</p><p><strong>Methods: </strong>We systematically identified hospitalized patients with diagnoses of pelvic, sacral, or femoral osteomyelitis due to decubitus ulceration between 1 January 2018 and 31 December 2018. Demographics, comorbidities, laboratory data, and outcomes were collected by manual chart review. T-tests or Chi-square tests were used for descriptive statistical comparisons; logistic regressions were used to explore the odds of readmission, osteomyelitis-related readmission, and death.</p><p><strong>Results: </strong>Of 89 patients meeting inclusion criteria, 34 (38%) received surgical debridement and ⩾6 weeks of antibiotics; 55 (62%) received either antibiotics alone or debridement and <6 weeks of antibiotics. Mean age was 55 (standard deviation 18) years, 55% of patients were male, and 69% had spinal cord injury or other form of paralysis. Within 1 year, 56 (63%) patients were readmitted, 38 (44%) patients were readmitted due to complications from osteomyelitis, and 15 (17%) died. We found no significant differences in readmission (OR = 1.33, 95% CI: 0.54-3.21, <i>p</i> = 0.53), readmission related to osteomyelitis (OR = 1.64, 95% CI: 0.69-4.04, <i>p</i> = 0.27), subsequent sepsis (OR = 2.27, 95% CI: 0.83-6.93, <i>p</i> = 0.13), or death (OR = 2.88, 95% CI: 0.83-13.4, <i>p</i> = 0.12) by treatment group.</p><p><strong>Conclusions: </strong>Among patients with decubitus-related osteomyelitis who did not undergo myocutaneous flapping, outcomes were generally poor regardless of treatment, and not significantly improved with prolonged antibiotics. Prospective studies are needed to assess best practice strategies for this challenging patient population.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/9d/10.1177_20499361231196664.PMC10483971.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221543","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}