Therapeutic Advances in Infectious Disease最新文献

{"title":"Prevalence of advanced HIV disease and associated factors among antiretroviral therapy naïve adults enrolling in care at public health facilities in Kampala, Uganda.","authors":"Bridget Ainembabazi, Elizabeth Katana, Felix Bongomin, Phillip Wanduru, Roy William Mayega, Aggrey David Mukose","doi":"10.1177/20499361241251936","DOIUrl":"10.1177/20499361241251936","url":null,"abstract":"<p><strong>Background: </strong>Despite adoption of the 'test-and-treat' strategy, a high proportion of antiretroviral therapy (ART) naïve people living with HIV (PLHIV) enrol in care with, and die of advanced HIV disease (AHD) in Uganda. In this study, we aimed to determine the prevalence of AHD among ART naïve adults enrolling in care and associated factors at selected public health facilities in Kampala, Uganda.</p><p><strong>Methods: </strong>From April to July 2022, we conducted a mixed-methods study at Kiswa Health Centre III, Kitebi Health Centre III, and Kawaala Health Centre IV. The study involved cross-sectional enrolment and evaluation of 581 participants, utilizing an interviewer-administered questionnaire and chart reviews. Modified Poisson regression was employed to identify factors associated with AHD, complemented by a qualitative component comprising fifteen in-depth interviews, with data analysed through thematic analysis.</p><p><strong>Results: </strong>Overall, 35.1% (204/581) of the study participants had AHD. Being male [adjusted prevalence ratio (aPR): 1.4, 95% CI: 1.04-1.88] and aged 35-50 years (aPR: 1.81, 95% CI: 1.14-2.88) were associated with AHD. Participants with no personal health perception barriers had 37% lower odds of presenting to care with AHD (aPR: 0.63, 95% CI: 0.46-0.85). Qualitative findings indicated that individual factors, such as waiting until physical health deteriorated and initially opting for alternative therapies, took precedence in contributing to enrolment in care with AHD.</p><p><strong>Conclusion: </strong>Over one in every three ART naïve adults presents to public health facilities in Uganda with AHD. Male gender, age 35-50 years, and personal health perception barriers emerged as significant factors associated with AHD; emphasizing the need for targeted interventions to address these disparities and enhance early detection and engagement in care. Routine HIV testing should be emphasized and incentivized especially for men and persons aged 35-50 years.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241251936"},"PeriodicalIF":5.7,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072266","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":"Examining biopsychosocial predictors of risk for cognitive impairment among a racially diverse sample of men who have sex with men living with HIV.","authors":"Casey D Xavier Hall, Beth Okantey, Zhuo Meng, Crim Sabuncu, Brittany Lane, Eugenia Millender, Artur Queiroz, Jung Hyo Kim, Lorie Okada, Avrum Gillespie, Gina Simoncini, John 'Jack' P Barile, Grace X Ma, Frank 'Frankie' Y Wong","doi":"10.1177/20499361241249657","DOIUrl":"10.1177/20499361241249657","url":null,"abstract":"<p><strong>Background: </strong>Cognitive decline among people living with HIV (PLWH) is growing concern as world populations become increasing older including higher proportions of PLWH. It is vitally important to understand psychosocial predictors of age-related cognitive decline men who have sex with men (MSM) living with HIV.</p><p><strong>Objectives: </strong>The current study seeks to examine psychosocial risk factors the contribute to the risk of age-related cognitive impairment as measured by Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score in a racially diverse sample of MSM living with HIV.</p><p><strong>Design: </strong>The present analysis utilizes data from the baseline (<i>n</i> = 196) and 6-month follow-up (<i>n</i> = 135) time points of a longitudinal cohort study of PLWH.</p><p><strong>Methods: </strong>Using a self-report survey, we examine the associations between psychosocial predictors (e.g. trauma, mental health, chronic pain, sleep disturbance, etc.) and risk of dementia using the CAIDE risk score. Analyses include linear and logistic regression.</p><p><strong>Results: </strong>In adjusted model stress, chronic pain, Black racial identity, and having a sexual identity that is bisexual or another category are all positively associated with CAIDE scores. Childhood sexual abuse history was negatively associated with CAIDE scores indicating a protective effect. Sleep disorder has a positive association with CAIDE scores after adjusting for the baseline CAIDE scores.</p><p><strong>Conclusion: </strong>These results indicate modifiable correlates of cognitive risk (stress and chronic pain). Interventions should seek to address these comorbid factors including the consideration of minority stress and stigma. Interventions should seek to reach Black and bisexual men living with HIV, including possible cultural tailoring to interventions and messaging. Lastly, future research should examine the impact of variation within childhood sexual abuse histories to better understand their association with cognitive impairment later in life. This may include considering the nature, severity, and potential treatment of trauma symptoms.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241249657"},"PeriodicalIF":3.8,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945817","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":"Measles in the Democratic Republic of the Congo needs urgent attention.","authors":"Khadija Motunrayo Musa, Malik Olatunde Oduoye, Muhammad Saeed Qazi, Komal Zulfiqar","doi":"10.1177/20499361241252534","DOIUrl":"10.1177/20499361241252534","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241252534"},"PeriodicalIF":5.7,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945871","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":"Age-related factors associated with intention to initiate pre-exposure prophylaxis among cisgender women in Washington D.C.","authors":"Jennifer L Zack, Shawnika J Hull, Megan E Coleman, Peggy Peng Ye, Pamela S Lotke, Adam Visconti, Jason Beverley, Ashley Brant, Patricia Moriarty, Rachel K Scott","doi":"10.1177/20499361241252351","DOIUrl":"10.1177/20499361241252351","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) utilization among cisgender women (subsequently 'women') is low across age groups, relative to their risk of HIV acquisition. We hypothesize that age-related differences in psychosocial factors also influence women's intention to initiate oral PrEP in Washington, D.C.</p><p><strong>Methods: </strong>A secondary analysis of a cross-sectional survey data was performed to evaluate factors influencing intention to initiate oral PrEP among women seen at a family planning and a sexual health clinic. A bivariate analysis was performed to identify differences by age group in demographic characteristics, indications for PrEP, and attitudes toward PrEP; we then performed additional bivariate analysis to assess these variables in relation to PrEP intention.</p><p><strong>Results: </strong>Across age groups, perceived risk of HIV acquisition was not significantly different and was not associated with intention to initiate PrEP. Awareness of and attitude toward PrEP, injunctive norms, descriptive norms, and self-efficacy were not different across age, however there were significant age-associated differences in relation to PrEP intention. Specifically, among 18-24-year-olds, intention to start PrEP was associated with support from provider (<i>p</i> = 0.03), main sexual partner (<i>p</i> < 0.01), and peers (<i>p</i> < 0.01). For women 25-34 years old, having multiple sexual partners (<i>p</i> = 0.03) and support from casual sexual partners (<i>p</i> = 0.03) was also important. Among women 35-44 years old, prior awareness of PrEP (<i>p</i> = 0.02) and their children's support of PrEP uptake (<i>p</i> < 0.01) were associated with intention to initiate PrEP. Among 45-55 year-old women intention to initiate PrEP was positively associated with engaging in casual sex (<i>p</i> = 0.03) and negatively associated with stigma (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Overall, there were more similarities than differences in factors influencing intention to initiate PrEP across age groups. Observed differences offer an opportunity to tailor PrEP delivery and HIV prevention interventions to increase awareness and uptake for cisgender women.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241252351"},"PeriodicalIF":5.7,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945809","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":"Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features.","authors":"Sanaz Morovati, Arezoo Bozorgomid, Arman Mohammadi, Forouzan Ahmadi, Leila Arghand, Fatemeh Khosravi Shadmani, Babak Sayad","doi":"10.1177/20499361241246937","DOIUrl":"10.1177/20499361241246937","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Brucellosis is a common global zoonotic disease with a wide range of complex and nonspecific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). The patients with &lt;i&gt;Brucella&lt;/i&gt; arthritis had a significantly higher frequency of arthralgia and radiculopathy (&lt;i&gt;p&lt;/i&gt; ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis (&lt;i&gt;p&lt;/i&gt; ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis (&lt;i&gt;p&lt;/i&gt; ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis &lt;i&gt;versus&lt;/i&gt; patients without arthritis or sacroiliitis, but the difference was not significant (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm&lt;sup&gt;3&lt;/sup&gt;, 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients s","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241246937"},"PeriodicalIF":5.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877631","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 characteristics, outcome, and factors associated with mortality of pulmonary mucormycosis: a retrospective single-center study from Pakistan.","authors":"Rameesha Khalid, Iffat Khanum, Kiren Habib, Akbar Shoukat Ali, Joveria Farooqi, Nousheen Iqbal, Taymmia Ejaz, Kauser Jabeen, Muhammad Irfan","doi":"10.1177/20499361241251744","DOIUrl":"10.1177/20499361241251744","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Pulmonary mucormycosis is a rare but rapidly progressive fatal disease. Limited data exist on the outcomes and factors associated with poor prognosis of pulmonary mucormycosis. The objective of this study was to evaluate clinical characteristics, factors associated with mortality, and outcomes of pulmonary mucormycosis at a tertiary care hospital in Pakistan.</p><p><strong>Methods: </strong>This was a retrospective observational study conducted at a tertiary care hospital in Karachi, Pakistan. Medical records of hospitalized patients diagnosed with proven or probable pulmonary mucormycosis between January 2018 and December 2022 were reviewed. Univariate and regression analyses were performed to identify factors associated with mortality.</p><p><strong>Results: </strong>Fifty-three pulmonary mucormycosis patients (69.8% male) were included, with mean age of 51.19 ± 21.65 years. Diabetes mellitus was the most common comorbidity [<i>n</i> = 26 (49.1%)]. Chronic lung diseases were present in [<i>n</i> = 5 (9.4%)], and [<i>n</i> = 16 (30.2%)] had concurrent coronavirus disease 2019 (COVID-19) pneumonia. The predominant isolated Mucorales were <i>Rhizopus</i> [<i>n</i> = 32 (60.3%)] and <i>Mucor</i> species [<i>n</i> = 9 (17%)]. Main radiological findings included consolidation [<i>n</i> = 39 (73.6%)] and nodules [<i>n</i> = 14 (26.4%)]. Amphotericin B deoxycholate was prescribed in [<i>n</i> = 38 (71.7%)], and [<i>n</i> = 14 (26.4%)] of patients received combined medical and surgical treatment. The median [interquartile range (IQR)] hospital stay was 15.0 (10.0-21.5) days. Intensive care unit (ICU) care was required in [<i>n</i> = 30 (56.6%)] patients, with 26 (49.1%) needing mechanical ventilation. Overall mortality was seen in 29 (54.7%) patients. Significantly higher mortality was found among patients requiring mechanical ventilation 20/29 (69%, <i>p</i> = 0.002). Immunosuppression (<i>p</i> = 0.042), thrombocytopenia (<i>p</i> = 0.004), and mechanical ventilation (<i>p</i> = 0.018) were identified as risk factors for mortality on multivariable analysis.</p><p><strong>Conclusion: </strong>This study provides essential insights into the clinical characteristics, outcomes, and mortality factors associated with pulmonary mucormycosis. The mortality rate was high (54.7%), particularly in patients with immunosuppression, thrombocytopenia, and those who required mechanical ventilation.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241251744"},"PeriodicalIF":5.7,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877567","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":"Fungal infections in patients after recovering from COVID-19: a systematic review.","authors":"Juan R Ulloque-Badaracco, Cesar Copaja-Corzo, Enrique A Hernandez-Bustamante, Juan C Cabrera-Guzmán, Miguel A Huayta-Cortez, Ximena L Carballo-Tello, Rosa A Seminario-Amez, Miguel Hueda-Zavaleta, Vicente A Benites-Zapata","doi":"10.1177/20499361241242963","DOIUrl":"https://doi.org/10.1177/20499361241242963","url":null,"abstract":"<p><strong>Background and aims: </strong>The presence of fungal infections has been described in patients after recovering from COVID-19. This study aims to conduct a systematic review of studies that reported fungal infections (<i>Mucor</i> spp., <i>Pneumocystis jirovecii</i>, or <i>Aspergillus</i> spp.) in adults after recovering from COVID-19.</p><p><strong>Methods: </strong>We performed a systematic review through PubMed, Web of Science, OVID-Medline, Embase, and Scopus. The study selection process was performed independently and by at least two authors. We performed a risk of bias assessment using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Joanna Briggs Institute's Checklists for Case Series and Case Reports.</p><p><strong>Results: </strong>The systematic search found 33 studies meeting all inclusion criteria. There was a total population of 774 participants, ranging from 21 to 87 years. From them, 746 developed a fungal infection. In 19 studies, <i>Mucor</i> spp. was reported as the main mycosis. In 10 studies, <i>P. jirovecii</i> was reported as the main mycosis. In seven studies, <i>Aspergillus</i> spp. was reported as the main mycosis. Regarding the quality assessment, 12 studies were classified as low risk of bias and the remaining studies as high risk of bias.</p><p><strong>Conclusion: </strong>Patients' clinical presentation and prognosis after recovering from COVID-19 with fungal infection differ from those reported patients with acute COVID-19 infection and those without COVID-19 infection.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241242963"},"PeriodicalIF":5.7,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858678","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":"A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus.","authors":"Areeba Fareed, Samia Rohail, Ushna Zameer, Abdul Wahid, Syed Muhammad Muneeb Akhtar, Waniyah Masood","doi":"10.1177/20499361241247470","DOIUrl":"https://doi.org/10.1177/20499361241247470","url":null,"abstract":"<p><p>Powassan virus (POWV), a tick-borne flavivirus transmitted primarily by Ixodes ticks, poses a significant threat as it can lead to severe neuroinvasive illness. This review delves into the nuanced clinical presentation of Powassan infection, a challenge in diagnosis exacerbated by the absence of an available vaccine. Over the past decade, the prevalence of POWV has surged in North America, necessitating a thorough examination of its neurological manifestations alongside tick-borne encephalitis virus (TBEV). A comprehensive literature search conducted up to January 2024 revealed 135 cases of neurological symptoms associated with either Powassan or TBEV infection. Notably, severe occipital headache emerged as the most prevalent symptom (22.75%), followed by meningoencephalitis (10.34%), seizures (8.27%), and flaccid paresis (6.8%). Additional manifestations included poor balance, wide gait, dysarthria, facial nerve palsy, seizure, slurred speech, and absent deep tendon reflexes. Tragically, nine cases resulted in fatal outcomes attributed to POWV infection. This analysis highlights the intricate spectrum of neurological symptoms associated with Powassan infection and underscores the necessity for heightened awareness among medical practitioners, particularly in regions with a higher prevalence of the virus. The complexity of symptoms emphasizes the need for further research to unravel the factors contributing to this diversity. Additionally, exploring potential treatment avenues and vaccine development is crucial in addressing the rising threat posed by POWV, ultimately enhancing our ability to manage and prevent severe neurological outcomes.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241247470"},"PeriodicalIF":5.7,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11062229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854073","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>Fixing a Hole</i>: a retrospective cohort study evaluating HAV, HBV, tetanus screening, and vaccination during hospitalization in persons who use substances.","authors":"Amber C Streifel, Jose Eduardo Rivera Sarti, Monica K Sikka, Michael Conte, Bradie Winders, Cara D Varley","doi":"10.1177/20499361241245822","DOIUrl":"https://doi.org/10.1177/20499361241245822","url":null,"abstract":"<p><strong>Background: </strong>Rates of serious injection-related infections in persons who use drugs have increased. Resulting admissions are an opportunity for screening and vaccination of preventable infections such as hepatitis A virus (HAV), hepatitis B virus (HBV), and tetanus.</p><p><strong>Design and methods: </strong>We conducted a retrospective review of adults with documented substance use admitted for bacterial infection between July 2015 and March 2020. We evaluated HAV, HBV, and tetanus vaccination status at admission, along with screening for HAV and HBV infection and immunity. We identified the proportion of patients at risk for infection who received HAV, HBV, and tetanus vaccines during admission and patient-level factors associated with vaccination.</p><p><strong>Results: </strong>We identified 280 patients who met our inclusion criteria. Of the 198 (70.7%) patients at risk for HAV, infectious disease providers recommended vaccination for 21 (10.6%) and 15 (7.6%) received HAV vaccine. Of the 174 (62.1%) patients at risk for HBV, infectious disease providers recommended vaccination for 32 (18.3%) and 25 (14.4%) received HBV vaccine. A large proportion of patients (31.4%, 88) had no documentation of prior tetanus vaccination, and infectious disease providers recommended tetanus vaccination for three (1.1%) and five patients (1.8%) received a tetanus booster. Infectious disease consult vaccine recommendations were statistically significantly associated with HAV or HBV vaccination prior to discharge.</p><p><strong>Conclusion: </strong>Over 70% of our population is at risk for one or more of these preventable infections. Efforts are needed to maximize inpatient screening and vaccination for HAV, HBV, and tetanus in patients with barriers to care.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241245822"},"PeriodicalIF":5.7,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872953","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":"Four-year variation in pathogen distribution and antimicrobial susceptibility of urosepsis: a single-center retrospective analysis.","authors":"Yu-Yun Wu, Pei Li, Zi-Ye Huang, Jian-He Liu, Bo-Wei Yang, Wen-Bo Zhou, Fei Duan, Guang Wang, Jiong-Ming Li","doi":"10.1177/20499361241248058","DOIUrl":"https://doi.org/10.1177/20499361241248058","url":null,"abstract":"<p><strong>Background: </strong>Urosepsis is a common disease in urology, which is characterized by high treatment costs and high mortality. In the treatment of sepsis, anti-infection therapy is the most important means. However, the effect of empirical anti-infection therapy is often not ideal. Therefore, it is necessary to continuously monitor the prevalence of bacterial isolates in the blood culture of patients with urinary sepsis and their sensitivity to antibacterial drugs. This is of great significance to improve the efficacy of empirical antibiotic therapy for urosepsis.</p><p><strong>Objective: </strong>To elucidate the landscape of prevailing bacterial profiles and their antimicrobial susceptibilities in urosepsis cases, and to furnish robust clinical evidence to underpin the timely initiation of empirical antibiotic treatment.</p><p><strong>Methods: </strong>Collect the basic information and blood culture results of patients with urosepsis hospitalized from 2017 to 2020. Retrospective analysis of bacterial species and antimicrobial susceptibility in urosepsis and changes over 4 years.</p><p><strong>Results: </strong>Gram-negative bacteria (178 isolates, 75.11%) constituted the main pathogens causing urosepsis, followed by Gram-positive bacteria (46 isolates, 19.41%) and fungus (13 isolates, 5.48%). The sensitivity of ertapenem, meropenem, amikacin, and imipenem to Gram-negative bacteria all exceeded 85%. The sensitivity rates of levofloxacin, gentamicin, and ciprofloxacin are decreasing every year (<i>p</i> < 0.05). Tigecycline, vancomycin, and linezolid exhibited excellent sensitivity against Gram-positive bacteria. Among fungi, fluconazole demonstrated universal sensitivity, while itraconazole-resistant isolates have been found, and amphotericin B is still effective.</p><p><strong>Conclusion: </strong>Analysis of blood culture results of patients more accurately reflected the etiology of urosepsis, mainly <i>Escherichia coli</i>, <i>Enterococcus</i>, and <i>Klebsiella pneumoniae</i>. If there are no definitive blood culture results, empiric treatment of urosepsis should not include fluoroquinolone antibiotics. Cefepime, cefoxitin, and ceftazidime are the most sensitive antibiotics to Gram-negative bacteria besides carbapenem antibiotics. In addition, the current situation regarding extended-spectrum β-lactamase-producing bacteria and carbapenem-resistant Enterobacteriaceae bacteria resistance is extremely concerning with limited therapeutic options available. Strengthening antibiotic management practices and exploring novel antibacterial agents can help mitigate this issue.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241248058"},"PeriodicalIF":5.7,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866797","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}