Canadian Journal of Infectious Diseases & Medical Microbiology最新文献

{"title":"Real-World Evaluation Study of Azvudine for the Treatment of Patients With COVID-19: A Systematic Review and Meta-Analysis.","authors":"Abiden Kapar, Huling Li, Qian He, Dandan Lin, Dandan Tang, Kai Peng, Yida Wang, Kai Wang","doi":"10.1155/cjid/3645253","DOIUrl":"10.1155/cjid/3645253","url":null,"abstract":"<p><p><b>Background:</b> Azvudine, as an antiviral drug, has been approved for the treatment of COVID-19, and multiple randomized controlled trials (RCTs) and retrospective cohort studies have been conducted. This study aimed to systematically evaluate the efficacy and safety of Azvudine in treating COVID-19 patients. <b>Methods:</b> As of December 1, 2023, we searched databases including PubMed, Web of Science, Ovid, ICTRP, Cochrane Library, Clinical Trials, MedRxiv, and Springer Link for relevant RCTs and retrospective cohort studies. EndNote X9 was used for literature screening and management, and R software was employed for meta-analysis. <b>Results:</b> A total of 1142 COVID-19 patients from five RCTs were included, with 575 patients receiving Azvudine treatment. Azvudine significantly reduced the hospitalization time and the time to nucleic acid conversion to negative in patients with mild to moderate COVID-19. However, compared to the control group, Azvudine did not significantly reduce the incidence of adverse events (AEs) (risk ratio: 0.89, 95% confidence interval [CI]: 0.80, 1.00). Additionally, eight ongoing clinical trials were included to evaluate the efficacy and safety of Azvudine. In fourteen retrospective cohort studies, a total of 6602 COVID-19 patients were analyzed, with 3118 patients receiving Azvudine treatment. Azvudine significantly reduced all-cause mortality (odds ratio [OR]: 0.49, 95% CI: 0.38, 0.63). The incidence of AEs in the Azvudine group and the Nirmatrelvir/Ritonavir group was 4.13% (60/1453) and 5.08% (67/1319), respectively, indicating that Azvudine significantly reduced the incidence of AEs compared to Nirmatrelvir/Ritonavir (OR: 0.68, 95% CI: 0.47, 0.98). <b>Conclusions:</b> Azvudine significantly reduced the hospitalization time and the time to nucleic acid conversion to negative in COVID-19 patients and significantly lowered all-cause mortality (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: high-certainty evidence). In terms of safety, Azvudine demonstrated a favorable safety profile (GRADE: moderate-certainty evidence because of suspected publication bias and residual confounding). Further large-scale studies are needed to validate its efficacy and safety.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"3645253"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes, and Practices Regarding Antimicrobial Resistance and Associated Factors Among Healthcare Workers in Addis Ababa, Ethiopia: A Cross-Sectional Study.","authors":"Abel Getu, Tesfaye Solomon, Nathan Fikre, Elizabeth Eyasu, Yaregal Fufa, Misgana Tazebachew, Zewdie Aderaw Alemu","doi":"10.1155/cjid/5354292","DOIUrl":"10.1155/cjid/5354292","url":null,"abstract":"<p><p><b>Background:</b> Antimicrobial resistance (AMR) is a growing public health concern in Ethiopia, marked by high resistance rates among common pathogens and widespread misuse of antimicrobials, particularly among healthcare providers. This study aimed to assess the knowledge, attitudes, practices (KAP), and influencing factors related to AMR among healthcare workers (HCWs) in health centers of Addis Ababa. <b>Methods:</b> A cross-sectional study design was conducted among 485 HCWs in Addis Ababa from July 1, 2023, to November 25, 2023. Participants were HCWs involved in antimicrobial prescribing at randomly selected health centers in three subcities. Data were collected using structured questionnaires and analyzed using SPSS Version 26. Multivariable logistic regression was performed to identify significant associations at <i>p</i> < 0.05, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. <b>Results:</b> A total of 473 HCWs participated, yielding a response rate of 97.5%. While 66.8% of HCWs demonstrated good knowledge about AMR, 61.3% exhibited unfavorable attitudes, and only 43.3% had satisfactory practice scores. Factors significantly associated with poor AMR practices included age (30-39 years; AOR = 0.29, 95% CI: 0.12-0.70), being a general practitioner (AOR = 4.26, 95% CI: 1.52-11.90), holding a degree (AOR = 0.47, 95% CI: 0.26-0.88), working in the outpatient department (AOR = 3.78, 95% CI: 1.82-7.86), lack of training (AOR = 0.16, 95% CI: 0.09-0.29), good knowledge (AOR = 0.45, 95% CI: 0.28-0.72), unfavorable attitudes (AOR = 1.79, 95% CI: 1.17-2.85), and lack of guideline consultation (AOR = 0.34, 95% CI: 0.22-0.52). <b>Conclusions:</b> The study found that younger HCWs, general practitioners, and those working in outpatient departments were more likely to exhibit better AMR practices. Conversely, lack of training and guideline consultation negatively impacted practices. Addressing knowledge gaps, improving attitudes, and reinforcing practices through targeted interventions are essential for effective AMR management in health centers.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"5354292"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Series Analysis of Atmospheric Pollution and <i>Mycoplasma pneumoniae</i> Infections in Children.","authors":"Haiyan Zhang, Meimei Lai, Hao Dong, Luoman Yan, Lei Zhang","doi":"10.1155/cjid/8860382","DOIUrl":"10.1155/cjid/8860382","url":null,"abstract":"<p><p><b>Objective:</b> Aimed to analyze the relationship between air pollution and <i>Mycoplasma pneumoniae</i> (MP) infection in children in Chengdu. <b>Method:</b> Data on outpatient and inpatient cases of MP infection among children at Chengdu Women and Children's Central Hospital from 2019 to 2023 were retrospectively collected. Air pollution and meteorological data from the same period were also obtained. A generalized additive model (GAM) was established using R statistical software to examine the impact of different air pollutant concentrations on MP infection incidence in children. The relationship between pollutant concentrations and MP infection rates was further analyzed by stratifying data by age, sex, and season. <b>Results:</b> From 2019 to 2023, a total of 21,075 outpatient and emergency cases and 6964 inpatient cases of MP infection were reported among children at Chengdu Women and Children's Central Hospital. A 10-μg/m³ increase in the daily concentration of particulate pollutants (PM_2.5, PM₁₀) had the most significant delayed effect on outpatient MP infection incidence at a 6-day lag (lag 06), although the cumulative lag effect was not statistically significant. When the average daily concentration of gaseous pollutants (SO₂) increased by 10 μg/m³, the strongest lag effects on outpatient and inpatient MP infections were observed at 7-day lags (lag 07 and lag 7, respectively). In the single air pollutant model, age-stratified analysis showed that SO₂ concentration had the most significant correlation with the incidence of outpatient and inpatient MP infections in children under 6 years of age, while nitrogen dioxide (NO₂) concentration had the most significant correlation in children over six. Sex-stratified analysis indicated that SO₂ levels were most significantly associated with MP infection in males, whereas NO₂ were most strongly correlated in females. Among outpatients, SO₂ had the most substantial effect on MP infection incidence across sexes. Seasonal stratification revealed that the impact of air pollution on MP infection was greater in autumn and winter than in spring and summer. <b>Conclusion:</b> Increased air pollution levels in Chengdu from 2019 to 2023 had a measurable impact on MP infection incidence in both inpatient and outpatient children, with notable lag and cumulative lag effects. These effects were more pronounced in autumn and winter, highlighting the need for targeted early warning systems to monitor air pollutant concentrations. Such efforts could play a crucial role in protecting vulnerable populations and reducing MP infection risks in children.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"8860382"},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sero-Molecular Markers and Genetic Diversity of Hepatitis B Virus Isolated From Hemodialysis Patients From Jenin District, West Bank, Palestine.","authors":"Kamal Dumaidi, Amer Al-Jawabreh, Areej Zraiqi, Jana Zaid, Suhair Ereqat, Nabeel Salami, Abedelmajeed Nasereddin","doi":"10.1155/cjid/6981644","DOIUrl":"10.1155/cjid/6981644","url":null,"abstract":"<p><p><b>Background:</b> Hepatitis B virus (HBV) infection remains a major global health challenge, especially among high-risk groups such as hemodialysis (HD) patients. <b>Aim:</b> This study investigated the prevalence of sero-molecular markers and the genetic diversity of HBV in 160 Palestinian HD patients. Blood samples were tested for HBV serological markers (HBsAg, anti-HBc, and anti-HBs) and screened using nested PCR. Whole genome sequencing was conducted on PCR-positive samples to identify HBV genotypes and subgenotypes. <b>Results:</b> The overall HBV prevalence among HD patients was 3.75%, comprising 1.9% with overt infection (HBsAg +ve) and 1.9% with occult HBV infection (OBI). HCV was detected in 1.9% of patients. Evidence of past exposure (anti-HBc positive) was observed in 20% of patients, and 45% showed serological immunity with anti-HBs levels ≥ 10 IU/mL. Although the values of the genetic diversity estimators such as K, S, <i>η</i>, and <i>π</i> were approximately as twice as those for the S-region, the S-region produced a more reasonable phylogenetic tree and haplotype networking but under the condition of accurate sequencing and adequate number of investigated sequences. Phylogenetic trees and haplotype networking of the WGS and S-region revealed a clustering pattern based on genotypes and subgenotypes with two Palestinian WGS clustering in Subgenotype D1, while the other two in Subgenotype D3. Genetic diversity analysis revealed high haplotype diversity (Hd) (0.98-1.00) with high h:n ratio (0.9-1.00) and low nucleotide diversity (<i>π</i>) (0.007-0.027) indicating slight variation between any two given sequences. This is explained by purifying selection, recent population expansion, or constrained evolution as neutrality test values such as Tajima's D were negative (-0.5 to -1.86). <b>Conclusion:</b> HBV infection remains prevalent among HD patients, including both overt and occult forms. Genotype <i>D</i>, specifically Subgenotypes D1 and D3, predominates in the study population. The HBV S-region is a sufficient surrogate for population genetics investigations.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"6981644"},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12473736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red Blood Cell Distribution Width Is Not a Predictor of Hospital Mortality in Elderly and Nonelderly COVID-19-Infected Patients: A Prospective Study at a Brazilian Quaternary University Hospital.","authors":"Helena Duani, Máderson Alvares de Souza Cabral, Carla Jorge Machado, Thalyta Nogueira Fonseca, Milena Soriano Marcolino, Vandack Alencar Nobre, Cecilia Gómez Ravetti, Paula Frizera Vassallo, Unaí Tupinambás","doi":"10.1155/cjid/2118702","DOIUrl":"10.1155/cjid/2118702","url":null,"abstract":"<p><p><b>Objective:</b> To investigate if red blood cell distribution width (RDW) is a risk factor for hospital mortality in patients admitted to a public university hospital in Belo Horizonte, Minas Gerais, Brazil. <b>Methods:</b> This observational prospective study included patients over 16 years who had been hospitalized for COVID-19 between May and October 2020. A descriptive and time-to-death analysis was performed using the Cox proportional hazards model. <b>Results:</b> Of the 161 patients included, 39 (24.2%) died during hospitalization. A total of 2227 blood counts were performed, an average of 13.8 tests per patient (standard deviation, SD 2.9). Upon admission, the RDW was normal (11.5% to 14.6%) in 115 patients (71.4%), elevated in 45 (28%), and low in 1 (0.6%). The mean RDW value at admission was 14.5 (SD 2.4), which falls within the normal reference range. Of the patients with normal RDW at admission, 82 (71.3%) maintained normal levels throughout their stay, while 33 (28.7%) showed increased RDW levels over time. Among those with elevated RDW at admission, 40 (88.9%) remained elevated, while 5 (11.1%) returned to normal levels. There was no significant difference in the mean RDW value at admission between survivors and nonsurvivors (14.4 [SD 2.4] for survivors vs. 14.9 [SD 2.4] for nonsurvivors; <i>p</i>=0.2081). The risk for mortality in the group with high RDW upon admission was higher than in the group with normal RDW, but without statistical significance (31.1% vs. 21.7%; RR = 1.43; <i>p</i>=0.413). When performing a multivariate analysis, the following continue to be risk factors for lower survival: age > 70 years, HR 4.8 (95% CI: 2.3; 10.3), <i>p</i> < 0.001; white race, HR 3.2 (95% CI: 1.2; 8.61), <i>p</i>=0.018; and need for invasive MV, HR 3.8 (1.7; 8.7), <i>p</i>=0.001. The presence of a chest X-ray suggestive of COVID-19, HR 3.5 (95% CI: 1.0; 11.5), <i>p</i>=0.044, also appears to be a risk factor in this analysis. <b>Conclusion:</b> Alterations on RDW values on admission were not associated with higher mortality, and further increases in RDW during hospitalization were not linked to a higher risk of mortality across all age groups. Our findings suggest that while RDW may indicate disease severity, it may not serve as a reliable independent predictor of mortality when other factors are accounted for in this cohort.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"2118702"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Healthcare Professionals' and Students' Perspectives and Intentions for Raising Public Awareness and Comprehension of Antimicrobial Resistance.","authors":"Malik Suliman Mohamed, Elkhanssa Abdelhameed Ahmed Elhag, Alnada Ibrahim, Mona Timan Idriss, Eyman Mohamed Eltayib, Tilal Elsaman, Magdi Awadalla Mohamed","doi":"10.1155/cjid/4106594","DOIUrl":"10.1155/cjid/4106594","url":null,"abstract":"<p><p><b>Background:</b> Limited public knowledge of antimicrobial agents contributes to their misuse and antimicrobial resistance (AMR). <b>Objective:</b> This study aimed to assess the intentions of healthcare students and professionals in promoting public awareness and understanding of AMR. <b>Methods:</b> A 31-item survey based on the theory of planned behavior (TPB) and the health belief model was developed, incorporating intention, attitudes, subjective norms, perceived behavioral control, and perceived benefits. The survey aligned with global and national AMR action plans and was distributed among healthcare professionals and students in Al-Jouf, Saudi Arabia, via Google Forms. Responses were analyzed using frequencies, percentages, correlations between constructs, and ordinal logistic regression to assess significant associations between intention and other variables. <b>Results:</b> A total of 572 participants completed the survey, comprising 59.4% males and 40.6% females. Over one-third were younger individuals, and about one-third were undergraduate students or had less than 5 years of experience. Most respondents (74%) expressed an intention to educate the public on AMR, with a median intention score of 24 (out of 30). Intention showed strong positive correlations with past behavior (<i>r</i> = 0.703), subjective norms (<i>r</i> = 0.695), perceived behavioral control (<i>r</i> = 0.690), and perceived benefits (<i>r</i> = 0.683), while attitudes had a weak correlation (<i>r</i> = 0.122). Attitudes also had low correlations with other constructs (<i>r</i> = 0.137-0.278). Among predictors, subjective norms significantly influenced intention (<i>p</i> < 0.001), while other factors showed no significant predictive relationship. <b>Conclusion:</b> Healthcare students and professionals exhibited a strong inclination toward educating the public on responsible antimicrobial use and AMR. The findings underscore the complex interplay of factors influencing this intention, with subjective norms playing a key role, highlighting the impact of social pressure. Identifying these contributing factors can inform targeted strategies for healthcare professionals and students, enabling broader educational outreach and strengthening AMR control efforts.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"4106594"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rickettsiosis Infections in Sarawak: Epidemiological Insights and Public Health Strategies.","authors":"Riz Anasthasia Alta Abang, Madinah Adrus","doi":"10.1155/cjid/5218808","DOIUrl":"10.1155/cjid/5218808","url":null,"abstract":"<p><p>Rickettsiosis infections pose a significant public health concern in Sarawak, Malaysia. Despite their importance, these infections remain poorly recognised, under-researched and inadequately documented within the context of the Sarawak region. This comprehensive evaluation seeks to address this knowledge gap by providing an in-depth analysis of Rickettsioses in Sarawak, focussing on four main aspects: the vectors and reservoirs of Rickettsioses, transmission dynamics and risk factors, existing challenges and public health implications and control strategies and future directions for raising awareness. Between 2013 and 2023, eleven Rickettsiosis cases were reported across seven districts in Sarawak. Three Rickettsial groups, namely, spotted fever group, typhus group and scrub typhus, have been identified in the region and linked to their respective arthropod vectors and vertebrate reservoirs. Although the overall number of confirmed Rickettsial infections in Sarawak remains relatively low, the detection of cases in both urban centres and smaller towns within rural areas raises concern regarding potential spread and under-recognition of these infections. This review underscores the urgent need to enhance regional awareness, strengthen disease surveillance and encourage focused research to bridge existing knowledge gaps. Developing evidence-based strategies for early detection, vector control and public health education will be crucial for preventing future outbreaks and safeguarding the health and well-being of communities throughout Sarawak.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"5218808"},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifungal Susceptibility Profile of <i>Candida</i> Species Isolated From Water Treatment Unit and Urine From Patients Undergoing Hemodialysis in General Hospital and University Teaching Hospital in Yaounde, Cameroon.","authors":"Tidding Ashley Ambock, Bitoungui Valentina Josiane Ngo, Guy Sedar Singor Njateng, Kamga Hortense Gonsu, Mbetyoumoun Heroine Mfouapon, Folefack Francois Jerome Kaze, Tomta Aristide Eric Nono, Kueti Flora Mafonang","doi":"10.1155/cjid/5583130","DOIUrl":"10.1155/cjid/5583130","url":null,"abstract":"<p><p><b>Background:</b> Improper maintenance of water used for hemodialysis poses a serious risk for patients by allowing the growth of biological contaminants like <i>Candida</i> species in the water system. These contaminants can be transmitted to patients through hemodialysis, exposing them to an increased risk of candidiasis. The objective of this study was to determine the antifungal susceptibility profile of <i>Candida</i> species isolated from water treatment units and urine from patients undergoing hemodialysis at GHY and UTHY in Yaounde, Cameroon. <b>Methods:</b> This cross-sectional descriptive study was conducted from February 2024 to May 2024. Urine samples were collected from 132 consenting hemodialysis patients using a questionnaire, cultured on Sabouraud plus chloramphenicol agar. Water samples were collected every two days from different sites in the hemodialysis circuits; input, pretreatment, reverse osmosis (RO), RO output of both hospitals, filtered through membranes deposited on SC, and incubated at 35°C-37°C. Positive samples were cultured on CHROMagarTM to identify <i>Candida</i> species, which were tested against antifungals. SPSS V29.0.1.0 and Excel 2019 were used for statistics. <b>Results:</b> Of the patients, 17 (12.88%) had candiduria with <i>C. auris</i> (35.30%) most prevalent. Of 180 water samples, <i>C. tropicalis</i> (44.4%) was isolated from input water, while <i>C. glabrata</i> (22.2%) and <i>C. parapsilosis</i> (22.2%) were found in input and pretreated water. <i>C. albicans</i> (11.1%) was isolated at the RO output. Antifungal susceptibility testing of 35 <i>Candida</i> isolates showed that water isolates of <i>C. glabrata</i>, <i>C. parapsilosis</i>, and <i>C. albicans</i> were 100% susceptible to fluconazole and ketoconazole. <i>C. tropicalis</i> from water exhibited resistance to fluconazole. <i>C. auris</i> from urine was resistant to all antifungals tested. None were susceptible to itraconazole or amphotericin B. <b>Conclusion:</b> This study emphasizes the critical need for rigorous maintenance and monitoring of water used in hemodialysis to prevent transmission of antifungal-resistant <i>Candida</i> to vulnerable patients.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"5583130"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Effects of Pulmonary Rehabilitation via Social Media Versus Brochures on General Health in Nonhospitalized COVID-19 Patients: A Randomized Controlled Trial.","authors":"Sheida Shojaei, Hamid Reza Farpour, Rezvan Ghaderpanah, Amin Sayyadi","doi":"10.1155/cjid/9676407","DOIUrl":"10.1155/cjid/9676407","url":null,"abstract":"<p><p><b>Background:</b> The global impact of COVID-19 has presented challenges to health systems, affecting both physical and psychological well-being. Nonhospitalized patients, constituting the majority, can benefit from pulmonary rehabilitation through breathing exercises. This study aims to evaluate the effect of breathing exercises delivered via social media on the general health of nonhospitalized individuals with mild COVID-19. <b>Methods:</b> In a randomized controlled trial conducted at university hospitals, ninety patients aged 18-65 without prior respiratory or other specified disorders were included. The intervention group learned breathing exercises from online videos on Instagram, while the control group received brochures. Both groups practiced 6 days a week for three sessions a day. Results were evaluated using General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-15), Barthel Index (BI), and Visual Analogue Scale (VAS). <b>Results:</b> Both groups improved significantly in terms of GHQ-28 and all of its subscales, PHQ-15, and VAS (<i>p</i>-value < 0.05), but none achieved significant improvements in BI (<i>p</i>-value > 0.05). The effect size was large in all criteria except for GHQ-28 depression symptoms in the Online group (Cohen's d = 0.347; 95% CI 0.103, 0.59), and GHQ-28 anxiety/insomnia (Cohen's d = 0.794; 95% CI 0.494, 1.095) and GHQ-28 depression symptoms (Cohen's d = 0.453; 95% CI 0.135, 0.771) in the Brochure group. The differences between the Online and Brochure groups were insignificant in all assessed criteria (<i>p</i>-value: GHQ-28 = 0.231; PHQ-15 = 0.166; VAS = 0.385; BI = 0.165). <b>Conclusions:</b> Breathing exercises through social media and brochures significantly improve physical and psychological aspects in mild COVID-19 patients. While comparison with face-to-face interventions was not possible, the results are promising, encouraging physicians to consider this intervention, especially for underdeveloped countries and patients facing access barriers. <b>Trial Registration:</b> Iranian Registry of Clinical Trials (IRCT): IRCT20201204049600N1.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"9676407"},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"β-Lactam Adjunctive Therapy Compared to Vancomycin or Daptomycin Monotherapy in Adult Patients With Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: An Update Systematic Review, Meta-Analysis, and Trial Sequential Analysis.","authors":"Changyun Zhao, Wenchao Mao, Difan Lu, Kailun Cai, Changqin Chen, Weihang Hu, Shanmei Lv, Qi Yang","doi":"10.1155/cjid/3972494","DOIUrl":"10.1155/cjid/3972494","url":null,"abstract":"<p><p><b>Background:</b> This study evaluated the efficacy and safety of vancomycin (VAN) or daptomycin (DAP) combined with β-lactams (BLs) versus monotherapy (STAN) for <i>methicillin-resistant Staphylococcus aureus</i> (MRSA) bacteremia. <b>Methods:</b> PubMed, Web of Science, Embase, and Cochrane Library were searched until September 30, 2024, for RCTs or cohort studies comparing combination therapy (COMBO) and STAN in adult MRSA bacteremia. Outcomes included all-cause mortality, 30-day mortality, clinical failure, and safety. Subgroup and trial sequential analyses were performed. <b>Results:</b> Among 22 studies (3214 patients), the COMBO group did not reduce all-cause mortality (RR = 1.16, 95% CI: 0.91-1.48, <i>p</i>=0.24) and 30-day mortality (RR = 1.18, 95% CI: 0.86-1.62, <i>p</i>=0.31). Subgroup analyses suggested increased all-cause mortality in high-quality studies (RR = 1.29, 95% CI: 1.00-1.67, <i>p</i>=0.05). Additionally, when VAN/DAP was administered randomly, COMBO was associated with higher all-cause mortality (RR = 1.37, 95% CI: 1.05-1.78, <i>p</i>=0.02) and 30-day mortality (RR = 1.41, 95% CI: 1.01-1.96, <i>p</i>=0.02). However, the COMBO reduced clinical failure rate (RR = 0.78, 95% CI: 0.65-0.93, <i>p</i>=0.006), persistent bacteremia (RR = 0.70, 95% CI: 0.54-0.92, <i>p</i>=0.01), and relapsed bacteremia (RR = 0.62, 95% CI: 0.48-0.80, <i>p</i>=0.0003). No differences were observed in the microbiological failure rate, duration of bacteremia, or length of hospital stay. Furthermore, the COMBO group showed no significant increase in the incidence of acute kidney injury (AKI). <b>Conclusions:</b> COMBO did not lower mortality in MRSA bacteremia and may increase risk in certain subgroups. However, it improved microbiological outcomes without raising AKI risk. However, these microbiological advantages must be weighed against two concerning findings: a nonsignificant trend toward increased Clostridium difficile infection (CDI) risk and elevated mortality signals in high-quality subgroup analyses. Given conflicting mortality signals, cautious clinical application and further RCTs are needed.</p>","PeriodicalId":50715,"journal":{"name":"Canadian Journal of Infectious Diseases & Medical Microbiology","volume":"2025 ","pages":"3972494"},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}