Therapeutic Advances in Infectious Disease最新文献

{"title":"Fungal contamination of the water distribution system of a tertiary hospital water supply system in a resource-limited setting.","authors":"Kolapo S Olawale, Rita O Oladele, Rebecca F Peters, Bassey E Ekeng, Folasade T Ogunsola","doi":"10.1177/20499361241265953","DOIUrl":"10.1177/20499361241265953","url":null,"abstract":"<p><strong>Background: </strong>Fungal contamination of hospital water distribution systems has been implicated in outbreaks of healthcare-associated infections.</p><p><strong>Objectives: </strong>To evaluate the prevalence of fungi in the water distribution system of a tertiary hospital in Nigeria.</p><p><strong>Design: </strong>This was a descriptive cross-sectional study.</p><p><strong>Methods: </strong>Swabs and water samples were collected from taps and faucets in the hospital categorized into low (Accidents and Emergency Unit, Children Emergency Unit, Acute Stroke Unit and the 24 in-patient hospital wards) and high-risk (Renal Dialysis Unit, Central Sterile Services Department, Theatres and Intensive Care Units (ICUs)) units based on the vulnerability of patients being managed there. The membrane filtration method for water analysis was used. Where possible, isolates cultured were identified to species level. In total, 105 water and 49 swab samples were collected for analysis.</p><p><strong>Results: </strong>All analysed water samples grew fungi. A total of 289 (high-risk; <i>n</i> = 178; low-risk; <i>n</i> = 111) and 76 fungi isolates were recorded from water and swab samples, respectively, with 31 different species identified. <i>Aspergillus</i> was the most predominant genus with five different species: <i>Aspergillus niger</i> (9.9%), <i>terreus</i> (4.4%), <i>flavus</i> (3.3%), <i>fumigatus</i> (8.8%) and <i>versicolor</i> (2.20%) isolated. Twenty-five and 18 species of fungi were identified in the low and high-risk units, respectively. The labour ward (<i>n</i> = 46; 25.8%) and modular theatre (<i>n</i> = 47; 42.3%) were the most contaminated units. <i>Cladosporium</i> spp. and <i>Paecilomyces</i> spp. were the most frequently isolated fungi in the low and high-risk units, respectively. The dialysis centre (<i>n</i> = 9; 8.1%) and renal transplant theatre (<i>n</i> = 7; 6.31%) had the lowest contamination rates in the high-risk units. <i>Aspergillus niger</i>, <i>Cephalosporium curtipes</i>, <i>Penicillium chrysogenum</i> and <i>Penicillium glabrum</i> were each identified in 4/6 units from which swabs were taken. The facility had no documented protocol for its water safety and quality.</p><p><strong>Conclusion: </strong>Our data reveal a high rate of contamination of hospital water sources by fungi, some of which are known to cause life-threatening infections. For better water treatment and water tank cleaning and disinfection, a standard protocol is advised. Ensuring that the water distribution systems in hospital settings are free of fungal contaminants is important to prevent the possibility of waterborne mycosis outbreaks.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241265953"},"PeriodicalIF":3.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789444","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":"Spectrum and management of rare <i>Candida</i>/yeast infections in Kuwait in the Middle East.","authors":"Suhail Ahmad, Mohammad Asadzadeh, Noura Al-Sweih, Ziauddin Khan","doi":"10.1177/20499361241263733","DOIUrl":"10.1177/20499361241263733","url":null,"abstract":"<p><p>Invasive fungal infections (IFIs) are associated with high mortality rates and mostly affect patients with compromised immunity. The incidence of IFIs is increasing worldwide with the expanding population of susceptible patients. <i>Candida</i> and other yeast infections represent a major component of IFIs. Rare <i>Candida</i>/yeast infections have also increased in recent years and pose considerable diagnostic and management challenges as they are not easily recognized by routine phenotypic characteristic-based diagnostic methods and/or by the automated yeast identification systems. Rare <i>Candida</i>/yeasts also exhibit reduced susceptibility to antifungal drugs making proper management of invasive infections challenging. Here, we review the diagnosis and management of 60 cases of rare <i>Candida</i>/yeast IFIs described so far in Kuwait, an Arabian Gulf country in the Middle East. Interestingly, majority (34 of 60, 56.7%) of these rare <i>Candida</i>/yeast invasive infections occurred among neonates or premature, very-low-birth-weight neonates, usually following prior bacteremia episodes. The clinical details, treatment given, and outcome were available for 28 of 34 neonates. The crude mortality rate among these neonates was 32.2% as 19 of 28 (67.8%) survived the infection and were discharged in healthy condition, likely due to accurate diagnosis and frequent use of combination therapy. Physicians treating patients with extended stay under intensive care, on mechanical ventilation, receiving broad spectrum antibiotics and with gastrointestinal surgery/complications should proactively investigate IFIs. Timely diagnosis and early antifungal treatment are essential to decrease mortality. Understanding the epidemiology and spectrum of rare <i>Candida</i>/yeast invasive infections in different geographical regions, their susceptibility profiles and management will help to devise novel diagnostic and treatment approaches and formulate guidelines for improved patient outcome.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241263733"},"PeriodicalIF":3.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789445","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>Aspergillus terreus</i> pulmonary infection in a patient with late-onset combined immunodeficiency: a case report with literature review.","authors":"Naman Lodha, Durga Shankar Meena, Pyrus Bhellum, Neetha T R, Sadiya F C, Yash Khatod, Vidhi Jain, Deepak Kumar, Taruna Yadav","doi":"10.1177/20499361241265932","DOIUrl":"10.1177/20499361241265932","url":null,"abstract":"<p><p>Common variable immunodeficiency (CVID) is the most common humoral immune deficiency in adults, characterized by recurrent sinopulmonary bacterial infections. Invasive fungal infections are rarely associated with CVID. Late-onset combined immunodeficiency (LOCID) is a recently recognized variant of CVID with low CD4 counts and immunoglobulins deficiency. The current study reveals the first documented case of invasive pulmonary aspergillosis (<i>Aspergillus terreus</i>) in a patient with LOCID. A 52-year-old female with a recurrent history of sinopulmonary infections presented with acute onset fever and shortness of breath. Blood culture and bronchoalveolar lavage culture grew <i>A. terreus</i>. Further evaluation revealed low immunoglobulins (IgG, IgM and IgA). Moreover, she also had low CD4 counts (<200 cells/µL). The patient was successfully treated with voriconazole and immunoglobulin therapy. Finally, the study discusses LOCID as a potential risk factor for invasive fungal infections, which can be easily overlooked and cause poor outcomes.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241265932"},"PeriodicalIF":3.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789441","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":"Corrigendum to Prevalence of syphilis among people living with HIV who attend a large urban antiretroviral therapy clinic in Panama: a cross-sectional epidemiological study.","authors":"","doi":"10.1177/20499361241263641","DOIUrl":"https://doi.org/10.1177/20499361241263641","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/20499361241256290.].</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241263641"},"PeriodicalIF":3.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444116","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":"Chronic pulmonary aspergillosis: comprehensive insights into epidemiology, treatment, and unresolved challenges.","authors":"Masato Tashiro, Takahiro Takazono, Koichi Izumikawa","doi":"10.1177/20499361241253751","DOIUrl":"10.1177/20499361241253751","url":null,"abstract":"<p><p>Chronic pulmonary aspergillosis (CPA) is a challenging respiratory infection caused by the environmental fungus <i>Aspergillus</i>. CPA has a poor prognosis, with reported 1-year mortality rates ranging from 7% to 32% and 5-year mortality rates ranging from 38% to 52%. A comprehensive understanding of the pathogen, pathophysiology, risk factors, diagnosis, surgery, hemoptysis treatment, pharmacological therapy, and prognosis is essential to manage CPA effectively. In particular, <i>Aspergillus</i> drug resistance and cryptic species pose significant challenges. CPA lacks tissue invasion and has specific features such as aspergilloma. The most critical risk factor for the development of CPA is pulmonary cavitation. Diagnostic approaches vary by CPA subtype, with computed tomography (CT) imaging and <i>Aspergillus</i> IgG antibodies being key. Treatment strategies include surgery, hemoptysis management, and antifungal therapy. Surgery is the curative option. However, reported postoperative mortality rates range from 0% to 5% and complications range from 11% to 63%. Simple aspergilloma generally has a low postoperative mortality rate, making surgery the first choice. Hemoptysis, observed in 50% of CPA patients, is a significant symptom and can be life-threatening. Bronchial artery embolization achieves hemostasis in 64% to 100% of cases, but 50% experience recurrent hemoptysis. The efficacy of antifungal therapy for CPA varies, with itraconazole reported to be 43-76%, voriconazole 32-80%, posaconazole 44-61%, isavuconazole 82.7%, echinocandins 42-77%, and liposomal amphotericin B 52-73%. Combinatorial treatments such as bronchoscopic triazole administration, inhalation, or direct injection of amphotericin B at the site of infection also show efficacy. A treatment duration of more than 6 months is recommended, with better efficacy reported for periods of more than 1 year. In anticipation of improvements in CPA management, ongoing advances in basic and clinical research are expected to contribute to the future of CPA management.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241253751"},"PeriodicalIF":3.8,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427922","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 utility of procalcitonin for identifying secondary infections in patients with influenza or COVID-19 receiving extracorporeal membrane oxygenation.","authors":"Kajal D Patel, James K Aden, Michal J Sobieszczyk, Joseph E Marcus","doi":"10.1177/20499361241255873","DOIUrl":"10.1177/20499361241255873","url":null,"abstract":"<p><strong>Background: </strong>Identifying secondary infections in patients receiving extracorporeal membrane oxygenation (ECMO) presents challenges due to the ECMO circuit's influence on traditional signs of infection.</p><p><strong>Objectives: </strong>This study evaluates procalcitonin as a diagnostic marker for secondary infections in patients receiving ECMO with influenza or COVID-19 infection.</p><p><strong>Design: </strong>Single-center retrospective cohort study.</p><p><strong>Methods: </strong>All adult patients receiving veno-venous ECMO with underlying influenza or COVID-19 from November 2017 to October 2021 were included. Patient demographics, time receiving ECMO, culture data, and procalcitonin levels were examined. The first procalcitonin within 3 days of infection was compared to negative workups that were collected at least 10 days from the last positive culture. Furthermore, we compared procalcitonin levels by the type of pathogen and site of infection.</p><p><strong>Results: </strong>In this study, 84 patients with influenza or COVID-19 who received ECMO were included. A total of 276 procalcitonin labs were ordered in this cohort, with 33/92 (36%) of the secondary infections having an associated procalcitonin value. When comparing procalcitonin levels, there was no significant difference between the infection and negative workup groups [1 ng/mL (interquartile ranges, IQR: 0.4-1.2) <i>versus</i> 1.3 (0.5-4.3), <i>p</i> = 0.19]. Using 0.5 ng/mL as the cut-off, the sensitivity of procalcitonin was 67% and the specificity was 30%. In our cohort, the positive predictive value of procalcitonin was 14.5% and the negative predictive value was 84%. There was no difference in procalcitonin by type of organism or site of infection. Procalcitonin levels did not routinely decline even after an infection was identified.</p><p><strong>Conclusion: </strong>While procalcitonin is a proposed potential diagnostic marker for secondary infections in patients receiving ECMO, this single-center study demonstrated low sensitivity and specificity of procalcitonin in identifying secondary infections. Furthermore, there was no association of procalcitonin levels with etiology of infection when one was present. Procalcitonin should be used cautiously in identifying infections in veno-venous ECMO.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241255873"},"PeriodicalIF":5.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332198","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":"Noma disease among internally displaced persons in Northeast Nigeria: a retrospective descriptive study.","authors":"Mohammed A S Abdullahi, Muhammad R Balarabe, Jennifer A Tyndall, Faith O Alele, Abdulrazaq G Habib, Oyelola A Adegboye","doi":"10.1177/20499361241261269","DOIUrl":"10.1177/20499361241261269","url":null,"abstract":"<p><strong>Background: </strong>Recently recognized by the World Health Organization as a neglected tropical disease, Noma, an acute and destructive gangrenous disease affecting the gums and facial structures within the oral cavity, has a high mortality rate if untreated.</p><p><strong>Objectives: </strong>To investigate the prevalence and impact of Noma among internally displaced populations in Northeastern Nigeria.</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Methods: </strong>This retrospective study investigates the prevalence and impact of Noma among internally displaced populations in Northeastern Nigeria. Noma is endemic in Northern Nigeria, Africa, and its occurrence has been linked to extreme poverty, malnutrition, poor hygiene, and inadequate healthcare - conditions exacerbated by the ongoing Boko Haram conflict.</p><p><strong>Results: </strong>The retrospective descriptive cross-sectional analysis of 17 cases reveals a median age of 8 years, with most of the patients being children who suffer significant social stigmas, such as difficulties in speaking, eating, and social integration, including reduced school attendance and marital prospects.</p><p><strong>Conclusion: </strong>The study highlights the urgent need for comprehensive research into the etiology of Noma and its socio-economic impact. It emphasizes the necessity for early and effective intervention strategies, particularly in conflict-stricken areas with limited healthcare access.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241261269"},"PeriodicalIF":5.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332197","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":"Distribution of <i>Aspergillus</i> species and risk factors for aspergillosis in mainland China: a systematic review.","authors":"Sabir Khan, Hazrat Bilal, Muhammad Shafiq, Dongxing Zhang, Muhammad Awais, Canhua Chen, Muhammad Nadeem Khan, Qian Wang, Lin Cai, Rehmat Islam, Yuebin Zeng","doi":"10.1177/20499361241252537","DOIUrl":"10.1177/20499361241252537","url":null,"abstract":"<p><strong>Background: </strong><i>Aspergillus</i>, a widespread fungus in the natural environment, poses a significant threat to human health by entering the human body <i>via</i> the airways and causing a disease called aspergillosis. This study comprehensively analyzed data on aspergillosis in published articles from mainland China to investigate the prevalence of <i>Aspergillus</i>, and risk factors, mortality rate, and underlying condition associated with aspergillosis.</p><p><strong>Methods: </strong>Published articles were retrieved from Google Scholar, PubMed, and Science Direct online search engines. In the 101 analyzed studies, 3558 <i>Aspergillus</i> isolates were meticulously collected and classified. GraphPad Prism 8 was used to statistically examine the epidemiology and clinical characteristics of aspergillosis.</p><p><strong>Results: </strong><i>Aspergillus fumigatus</i> was prominently reported (<i>n</i> = 2679, 75.14%), followed by <i>A. flavus</i> (<i>n</i> = 437, 12.25%), <i>A. niger</i> (<i>n</i> = 219, 6.14%), and <i>A. terreus</i> (<i>n</i> = 119, 3.33%). Of a total of 9810 patients, 7513 probable cases accounted for the highest number, followed by confirmed cases (<i>n</i> = 1956) and possible cases (<i>n</i> = 341). In patients, cough emerged as the most common complaint (<i>n</i> = 1819, 18.54%), followed by asthma (<i>n</i> = 1029, 10.48%) and fever (1024, 10.44%). Of total studies, invasive pulmonary aspergillosis (IPA) was reported in 47 (45.53%) studies, exhibiting an increased prevalence in Beijing (<i>n</i> = 12, 25.53%), Guangdong (<i>n</i> = 7, 14.89%), and Shanghai (<i>n</i> = 6, 12.76%). Chronic pulmonary aspergillosis (CPA) was reported in 14 (13.86%) studies. Among the total of 14 studies, the occurrence of CPA was 5 (35.71%) in Beijing and 3 (21.42%) in Shanghai. Allergic bronchopulmonary aspergillosis (ABPA), was reported at a lower frequency (<i>n</i> = 8, 7.92%), Guangdong recorded a relatively high number (<i>n</i> = 3, 37.5%), followed by Beijing (<i>n</i> = 2, 25.0%), and Shanghai (<i>n</i> = 1, 12.5%). Percentage of death reported: IPA had the highest rate (<i>n</i> = 447, 68.87%), followed by CPA (<i>n</i> = 181, 27.88%) and ABPA (<i>n</i> = 14, 2.15%). Among the aspergillosis patients, 6220 had underlying conditions, including chronic lung disease (<i>n</i> = 3765, 60.53%), previous tuberculosis (<i>n</i> = 416, 6.68%), and organ transplant or organ failure (<i>n</i> = 648, 10.41%). Aspergillosis was also found in patients using corticosteroid therapy (<i>n</i> = 622, 10.0%).</p><p><strong>Conclusion: </strong>This review sheds light on the prevalence patterns of <i>Aspergillus</i> species, risk factors of aspergillosis, and gaps in surveillance that could be helpful for the control and treatment of aspergillosis and guide the researchers in future studies.</p><p><strong>Registration: </strong>This systematic review was prospectively registered on PROSPERO: Registration ID CRD42023476870.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241252537"},"PeriodicalIF":5.7,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248825","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 syphilis among people living with HIV who attend a large urban antiretroviral therapy clinic in Panama: a cross-sectional epidemiological study.","authors":"Amanda Gabster, Félix Fernández Díaz, Yamitzel Zaldívar, Michelle Hernández, Juan Miguel Pascale, Angelique Orillac, Samuel Moreno-Wynter, Casey D Xavier Hall, Mónica Jhangimal, Anyi Yu-Pon, Cristel Rodríguez-Vargas, Diogenes Arjona-Miranda, Bárbara Fuentes, Germán Henestroza, Ana Belén Araúz","doi":"10.1177/20499361241256290","DOIUrl":"10.1177/20499361241256290","url":null,"abstract":"<p><strong>Background: </strong>Syphilis is a serious global public health challenge. Despite prior progress in syphilis control, incidence has been increasing in recent years. Syphilis is a common coinfection among people living with HIV (PLHIV). In Panama, few data describe syphilis prevalence among PLHIV. We describe syphilis antibody and high-titer (⩾1:8) active syphilis prevalence and associated factors among individuals who attended an antiretroviral clinic.</p><p><strong>Methods: </strong>A cross-sectional study was undertaken during February-March 2022 and September-October 2022 for adults (⩾18 year) assigned male and female at birth, respectively. Participants provided peripheral blood samples and self-administered a questionnaire. Samples were screened using immunochromatography; antibody-positive samples were tested using rapid plasma regain to 1:512 dilutions. Logistic regression was used to identify factors associated with syphilis antibody and high-titer active syphilis.</p><p><strong>Results: </strong>In all, 378 participants gave blood samples; 377 individuals participated in the questionnaire (216 self-reported male sex [males], 158 female [females], and three intersex individuals). Median age was 36 years (interquartile range: 28-45 years). Overall, syphilis antibody prevalence was 32.3% (122/378) (males, 50.7% [108/2013]; females, 5.7% [9/158]; intersex individuals, 100.0% (3/3)], <i>p</i> < 0.01. High-titer active syphilis was found among 24.6% (<i>n</i> = 30) of samples with positive antibody test (males 27.8% [<i>n</i> = 30], females 0.0% [0/9], intersex individuals 0.0% [0/3]). Antibody positivity was associated in the multivariable model with males (50.7%, AOR = 24.6, 95%CI: 1.57-384.53). High-titer active syphilis was associated with younger participant age (18-30 years, 13.2%, OR = 4.82, 95%CI: 1.17-19.83); 31-40 years, 7.8%, OR = 4.24, 95%CI: 1.04-17.21 <i>versus</i> 3.2% >40 years), homosexual identity (16.0% OR = 34.2, 95%CI: 4.50-259.27 <i>versus</i> 0.6% among heterosexual identity); in the multivariable model, associated with sexual identity (bisexual 19.1%, AOR = 10.89, 95%CI: 1.00-119.06) compared to heterosexual identity (0.6%) and weakly associated with concurrency (⩾1 ongoing sexual relationships, 15.9%, AOR = 3.09, 95%CI: 0.94-10.14).</p><p><strong>Conclusion: </strong>This study found very high prevalence of syphilis antibodies and high-titer syphilis among PLHIV in Panama. Those most affected are males, younger in age, those who practice concurrent sexual relationships, and those who reported homosexual and bisexual identity. Targeted interventions should include repetitive testing and treatment, especially among individuals who may be at increased infection risk.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241256290"},"PeriodicalIF":3.8,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200887","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":"Distribution and antifungal susceptibility profile of oropharyngeal <i>Candida</i> species isolated from people living with HIV in the era of universal test and treat policy in Uganda.","authors":"Musinguzi Benson, Laban Turyamuhika, Alex Mwesigwa, Pauline Petra Nalumaga, Immaculate Kabajulizi, Israel Kiiza Njovu, Edson Mwebesa, Tonny Luggya, Francis Ocheng, David Patrick Kateete, Herbert Itabangi, Gerald Mboowa, Obondo James Sande, Beatrice Achan","doi":"10.1177/20499361241255261","DOIUrl":"10.1177/20499361241255261","url":null,"abstract":"<p><strong>Background: </strong>Despite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal <i>Candida</i> species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate <i>Candida</i> species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of <i>Candida</i> isolates to six antifungal drugs was determined using VITEK® (Marcy-l'Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto.</p><p><strong>Results: </strong>The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which <i>Candida albicans</i> comprised of 20 (57.1%) while <i>C. tropicalis</i> and <i>C. glabrata</i> comprised 4 (11.4%) each. <i>C. parapsilosis</i>, <i>C. dubliniensis</i> and <i>C. krusei</i> accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like <i>C. albicans</i> showed 20% (4/20), <i>C. glabrata</i> 50% (2/4) and <i>C. krusei</i> 50% (1/2) resistance to fluconazole. Additionally, <i>C. krusei</i> showed 50% resistance to flucytosine.</p><p><strong>Conclusion: </strong>The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. <i>C. albicans</i> was the most frequently isolated oropharyngeal <i>Candida</i> species. <i>C. glabrata</i> and <i>C. krusei</i> exhibited the highest AFR among the non-<i>albicans Candida</i> species. The highest resistance was demonstrated to fluconazole.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241255261"},"PeriodicalIF":5.7,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176349","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}