IJID regions最新文献

{"title":"Extensively drug-resistant tuberculosis in Togo: first reported cases and implications for tuberculosis control","authors":"Maïssala Zoutené ,&nbsp;Akouvi Mawussé Edjodjinam Ako ,&nbsp;Koffi Atsu Aziagbe ,&nbsp;Narcisse Viani Gateu Tadjom ,&nbsp;Tété Amento Stéphane Adambounou ,&nbsp;Komi Séraphin Adjoh","doi":"10.1016/j.ijregi.2025.100825","DOIUrl":"10.1016/j.ijregi.2025.100825","url":null,"abstract":"<div><h3>Objectives</h3><div>The increasing burden of extensively drug-resistant tuberculosis (XDR-TB) undermines global TB control efforts.</div></div><div><h3>Methods</h3><div>This was a case series study conducted from January 1, 2007, to December 31, 2024, in the Department of Pulmonology at Sylvanus Olympio University Teaching Hospital.</div></div><div><h3>Results</h3><div>We report a series of three cases. Case 1: A 30-year-old man with a history of contact with an XDR-TB case was treated with a 20-month regimen. Culture conversion was achieved at the 3^rd month of treatment. A complication in the form of pyopneumothorax occurred during the 6^th month of therapy. Case 2: A 51-year-old patient with no significant medical history was diagnosed with XDR-TB after 4 months of treatment for multidrug-resistant TB (MDR-TB). Conversion of follow-up cultures was achieved 2 months after modification of the treatment regimen. Case 3: A 62-year-old woman living with human immunodeficiency virus (HIV), previously treated for MDR-TB, developed XDR-TB during the course of treatment. The patient died on the 29th day of XDR-TB treatment.</div></div><div><h3>Conclusions</h3><div>XDR-TB is a curable disease. Early and accurate diagnosis allows for better selection of the most appropriate treatment strategy.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100825"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care worker–reported barriers and potential facilitators of acute lower respiratory infection care deliver for children at Mchinji District Hospital in Malawi","authors":"Shubhada Hooli ,&nbsp;Beatwil Zadutsa ,&nbsp;Everlisto Phiri ,&nbsp;Karina Hofstee ,&nbsp;Nichole Davis ,&nbsp;Eric D. McCollum ,&nbsp;Charles Makwenda ,&nbsp;Carina King","doi":"10.1016/j.ijregi.2026.100848","DOIUrl":"10.1016/j.ijregi.2026.100848","url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to understand barriers to high-quality hospital-based child acute lower respiratory infection (ALRI) care at Mchinji District Hospital in Malawi.</div></div><div><h3>Methods</h3><div>In 2020, we conducted focus group discussions (FGDs) with clinical officers (COs) who provided direct clinical care after a half-day refresher course on pediatric ALRI case management. The underpinning research methodology of the FGDs was phenomenology, and they were analyzed using inductive and deductive thematic analysis.</div></div><div><h3>Results</h3><div>We recruited 16 COs to participate in three FGDs. Five themes emerged: lack of confidence in ALRI diagnosis and management, high clinical burden with understaffing, dysfunctional team dynamics, limited physical resources, and the recognition of the importance of vital sign measurements despite barriers to practice.</div></div><div><h3>Conclusions</h3><div>COs shared several barriers and potential interventions to improve child ALRI care delivery. Some solutions were locally implementable, with minimal to modest cost, such as a program for continuing education, standard operating procedures during electricity outages, and posting of job aides. However, many of their suggestions require investments and commitment from the Malawian Ministry of Health to increase staffing capacity and improve the physical infrastructure and are, therefore, of undetermined feasibility. Future research should examine the impact of hospital layout and infrastructure, continuing education programs, and informal vital sign assistants on clinical care delivery.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100848"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical ocular bartonellosis: A case report","authors":"Kamena Mwana-Yile HASSAN ,&nbsp;Fatima IHBIBANE ,&nbsp;Mathilde OTSASSO ,&nbsp;Latifa MARIH","doi":"10.1016/j.ijregi.2025.100830","DOIUrl":"10.1016/j.ijregi.2025.100830","url":null,"abstract":"<div><h3>Objectives</h3><div>To report a case of chorioretinitis without papilledema caused by <em>Bartonella henselae</em> in an immunocompetent patient.</div></div><div><h3>Observations</h3><div>A 27-year-old female patient with a history of multiple cat scratches presented on August 28, 2025, with a gradual decline in visual acuity in her right eye. This decline had been developing for 3 weeks following scratches from cats and was accompanied by a fever of 39°C. Optical coherence tomography revealed serous retinal detachment with associated epithelial detachment. Fluorescein angiography showed a hyperfluorescent perimacular focus in the superior temporal region, consistent with chorioretinitis characterized by star-shaped macular exudates, and there was no evidence of papilledema. HIV-1 and 2 serology was negative. Serum protein electrophoresis returned normal results, and the HbA1c level was 5.5%. Serology for <em>B. henselae</em> was positive (immunoglobulin [Ig]G and IgM) with titers greater than 1:1280 and 1:1200. The treatment plan included doxycycline (100 mg every 12 hours) for 6 weeks and rifampicin (300 mg every 12 hours) with corticosteroid therapy (1 mg/kg) for 4 weeks. Fluorescein angiography conducted 6 weeks after treatment showed a hypofluorescent area in the superior temporal region of the macula, indicating that the star-shaped macular exudates had disappeared. The patient reported improved visual acuity, although they experienced slight blurred vision in the right eye.</div></div><div><h3>Conclusions</h3><div>Ocular bartonellosis can lead to unusual eye damage, specifically chorioretinitis, even in the absence of papilledema.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100830"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on the HDV seroprevalence and genotype distribution among patients positive for HBsAg referred to a National Reference Laboratory in Cameroon between January 2019 and December 2020","authors":"Jacques Delors Toumansie Mfonkou ,&nbsp;Yacouba Foupouapouognigni ,&nbsp;Athenais Gerber ,&nbsp;Ségolène Brichler ,&nbsp;Frédéric Legal ,&nbsp;Abdou Fatawou Modiyinji ,&nbsp;Frederic Lissock ,&nbsp;Laure Ngono ,&nbsp;Boyomo Onana ,&nbsp;Emmanuel Gordien ,&nbsp;Richard Njouom","doi":"10.1016/j.ijregi.2025.100834","DOIUrl":"10.1016/j.ijregi.2025.100834","url":null,"abstract":"<div><h3>Objectives</h3><div>Cameroon is known to be endemic for hepatitis B virus infection, but available data on hepatitis delta virus (HDV) prevalence and genetic diversity are limited, inconsistent, and outdated. This study aimed to assess the current HDV prevalence and determine the HDV genotype distribution among patients positive for hepatitis B surface antigen (HBsAg) in Cameroon.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined patients positive for HBsAg from Cameroon’s 10 administrative regions. Anti-HDV antibodies and HDV viral load (VL) were tested using validated commercial enzyme-linked immunosorbent assay and HDV VL quantification assays. HDV genotypes were determined by the Sanger sequencing method, followed by phylogenetic analysis of the “HDV R0” genome region previously described.</div></div><div><h3>Results</h3><div>Of the 859 patients positive for HBsAg tested, 142 (16.5%) tested positive for anti-HDV, and HDV RNA was detected in 110 (77.5%) of them. The southern region of Cameroon had the highest infection rate. Notably, an undetectable hepatitis B virus VL was significantly associated with HDV infection (<em>P</em> &lt;0.001). Patients younger than 15 years were the least infected (10%). Five genotypes—HDV-1 (the more prevalent, 83.6%), HDV-5, HDV-6, HDV-7, and HDV-8—were found in the studied population.</div></div><div><h3>Conclusions</h3><div>Cameroon remains an endemic country for HDV, exhibiting high prevalence, remarkable regional distribution, and wide genetic diversity.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100834"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological investigation and public health response to a diphtheria outbreak in Jalalabad Union, Sylhet, December 2023","authors":"Md. Mainul Hassan,&nbsp;Sohel Rahman,&nbsp;Md Foyjul Islam,&nbsp;Sadia Sultana,&nbsp;Md. Ahashan Habib,&nbsp;Mohammad Rashedul Hassan,&nbsp;Md. Omar Qayum,&nbsp;Manjur Hossain Khan Jony,&nbsp;Zakir Hossain Habib,&nbsp;Ahmed Nawsher Alam,&nbsp;Mahbubur Rahman,&nbsp;Tahmina Shirin","doi":"10.1016/j.ijregi.2025.100805","DOIUrl":"10.1016/j.ijregi.2025.100805","url":null,"abstract":"<div><h3>Objectives</h3><div>Diphtheria incidence has significantly declined globally due to the Expanded Program on Immunization, yet breakthrough infections occur due to waning immunity in late childhood. Since 2010, Bangladesh has reported 148 cases. On December 10, 2023, a suspected diphtheria case was reported to the Institute of Epidemiology, Disease Control and Research, prompting an epidemiological investigation and public health response.</div></div><div><h3>Methods</h3><div>Following World Health Organization guidelines, the team identified suspected and confirmed cases, conducted interviews with the index case and contacts, and collected samples for polymerase chain reaction testing. Risk communication and active case searches were carried out in the affected area.</div></div><div><h3>Results</h3><div>The index case, a 10-year-old girl with classic diphtheria symptoms, was hospitalized for 15 days and recovered after receiving antibiotics and diphtheria antitoxin (DAT). Among 25 close contacts, 14 (56%) were suspected cases, and two (8%) were confirmed via polymerase chain reaction; these two positive cases were siblings of the index case and were previously vaccinated. Chemoprophylaxis, vaccination, isolation, and quarantine were implemented, although the two later confirmed cases did not receive DAT due to unavailability.</div></div><div><h3>Conclusions</h3><div>Despite a high average coverage rate of 95% (2018-2022) for Penta 3, the outbreak revealed potential waning immunity or vaccine failure. The outbreak was effectively contained through timely confirmation, contact tracing, prophylactic antibiotics, immunization, and quarantine. Booster doses, quantification of antibody titer, and DAT access remain critical.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100805"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serotype diversity and risk factors for pneumococcal carriage among healthy children in Klang Valley, Malaysia: A pre-vaccination cross-sectional study","authors":"Revathy Arushothy ,&nbsp;Cheng Ngee Tan ,&nbsp;Nur Asyura Nor Amdan ,&nbsp;Mohammad Ridhuan Mohd Ali ,&nbsp;Ratna Mohd Tap ,&nbsp;Prem Ananth Paliappan ,&nbsp;Yii Ling Liow ,&nbsp;Saraswathiy Maniam ,&nbsp;Salina Mohamed Sukur ,&nbsp;Rohaidah Hashim","doi":"10.1016/j.ijregi.2025.100814","DOIUrl":"10.1016/j.ijregi.2025.100814","url":null,"abstract":"<div><h3>Objectives</h3><div>Carriage of <em>Streptococcus pneumoniae</em> among children aged &lt;5 years facilitates transmission and invasive pneumococcal disease (IPD) progression, contributing to global childhood morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) can reduce disease and carriage prevalence, though their effectiveness varies by regional serotype distribution. Malaysia introduced PCVs into the National Immunization Program in late 2020, but data on pneumococcal carriage and risk factors in children before vaccine implementation remain limited. This study aims to identify pneumococcal carriage, diversity, and risk factors among the unvaccinated children in Klang Valley, Malaysia.</div></div><div><h3>Methods</h3><div>A cross-sectional study conducted from August 2018 to May 2019 involved 101 healthy children aged 2-5 years from 30 childcare centers in Klang Valley, Malaysia. Oropharyngeal swabs, which are more acceptable for young children although less sensitive than nasopharyngeal swabs for pneumococcal detection, were collected and enriched in Todd Hewitt Broth before DNA extraction. Carriage was identified using real-time polymerase chain reaction (PCR) targeting <em>lytA</em> gene, with positive samples serotyped using conventional multiplex PCR. Demographic and environmental data from structured questionnaires were analyzed for associations with pneumococcal carriage and multiple serotype colonization using logistic regression, chi-square, and Fisher exact test.</div></div><div><h3>Results</h3><div>Pneumococcal carriage was detected in 39.6% (n = 40) of children, with 33 distinct serotypes identified. Both vaccine serotypes (VTs) and non-VTs were detected, with 67.5% of carriers colonized by multiple serotypes. Household size &gt;5 members was significantly associated with carriage (adjusted odds ratio 4.62, 95% confidence interval 1.07-23.10, <em>P</em> = 0.047), while no demographic, behavioral, or environmental factors were significantly associated with multiple serotype colonization. VTs detected (19F, 6A/6B, 3, 1, and 5) were previously associated with IPD in Malaysia.</div></div><div><h3>Conclusions</h3><div>This study provides crucial pre-PCV baseline data on pneumococcal carriage, serotype diversity, and risk factors in children of Klang Valley, Malaysia. The high prevalence of NVTs and frequent co-colonization highlight the need for ongoing surveillance to detect serotype replacement and guide evaluation of higher-valency PCVs. These findings can inform national immunization policy and strengthen strategies for monitoring vaccine impact in Malaysia.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100814"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and control of hepatitis C virus infection in Brunei Darussalam: a retrospective cohort study","authors":"Kai Shing Koh ,&nbsp;Justin Wong ,&nbsp;Liling Chaw","doi":"10.1016/j.ijregi.2025.100818","DOIUrl":"10.1016/j.ijregi.2025.100818","url":null,"abstract":"<div><h3>Objectives</h3><div>We describe the epidemiology of hepatitis C virus (HCV) cases in Brunei Darussalam and evaluate factors associated with its treatment outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from two national databases between January 2013 and December 2022.</div></div><div><h3>Results</h3><div>We identified 801 anti-HCV-positive cases. Although incidence remained relatively stable, prevalence rates increased from 10.1 to 48.7 per 100,00 population. Among those with detectable HCV RNA, treatment was initiated in 52.3% (n = 239). Locals (adjusted odds ratio [aOR] = 2.42, 95% confidence interval [CI] 1.16, 5.36) and age (30-39 years [aOR = 2.41, 95% CI 1.17, 5.07], 40-44 years [aOR = 2.55, 95% CI 1.19, 5.58], and 50-54 years [aOR = 2.76, 95% CI 1.25, 6.24) were associated with treatment initiation. Among those who completed treatment (69.5%, n = 166), 64.5% (n = 107) achieved sustained virologic response. HCV-related complications at baseline were recorded in 7.4% (n = 59) of all cases, particularly among those aged ≥50 years (aOR = 3.32, 95% CI 1.93, 5.79). HCV-related deaths occurred in 36.4% (n = 47), among which 44.7% (n = 21) had HCV-related complications at baseline.</div></div><div><h3>Conclusions</h3><div>An increasing HCV prevalence (likely due to case management processes and patient-related factors) and the high proportion of deaths with baseline HCV-related complications suggest the need to strengthen HCV screening and management in Brunei.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100818"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and predictors of readmission among sepsis survivors in a tertiary emergency department in Ethiopia","authors":"Meron H. Biza ,&nbsp;Chernet T. Mengistie ,&nbsp;Biruk T. Mengistie ,&nbsp;Mikiyas G. Teferi ,&nbsp;Tsion K. Admas ,&nbsp;Nardos B. Feleke ,&nbsp;Gadissa B. Tafa ,&nbsp;Finot Debebe ,&nbsp;Tigist Worku","doi":"10.1016/j.ijregi.2025.100808","DOIUrl":"10.1016/j.ijregi.2025.100808","url":null,"abstract":"<div><h3>Objectives</h3><div>Sepsis is a leading cause of critical illness worldwide. Survivors often suffer long-term physical, cognitive, and psychological impairments. Post-sepsis rehospitalization is common but poorly characterized in low-resource settings. We aimed to determine 30/90/180-day readmission rates and predictors after emergency sepsis in Addis Ababa.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients meeting Sepsis-3 criteria (infection with ≥2-point rise in Sequential Organ Failure Assessment [SOFA]) admitted to a tertiary Ethiopian emergency department from 2019-2021. A modified SOFA score (five parameters) was used to define organ dysfunction, as has been validated for resource-limited settings. We recorded patient demographics, comorbidities (including cardiovascular disease and malignancy), acute severity (modified SOFA, septic shock, intensive care unit admission), microbiology, antibiotic duration, and outcomes. Survivors were followed for 180 days for hospital readmissions at any site of suspected infection. Multivariable logistic regression identified factors independently associated with 180-day readmission.</div></div><div><h3>Results</h3><div>Of 110 sepsis patients, 39 (35.5%) died during index admission. Among 71 survivors, 32 (45.1%) were readmitted within 180 days (78.1% within 30 days; 15.6% days 31-90; 6.3% days 91-180). Infectious diagnoses accounted for 71.9% of readmissions (often recurrent pneumonia or urinary tract infection). Median time to first readmission was 16 days (interquartile range 5-41). Multivariable analysis showed higher odds of 180-day readmission in younger patients (adjusted odds ratio [OR] 2.53 per decade decrease in age, 95% confidence interval 1.09-5.87, <em>P</em> = 0.029), and lower odds in those with non-metastatic malignancy (adjusted OR 0.15, 0.03-0.75, <em>P</em> = 0.027) or longer index hospitalization (adjusted OR 0.31 per 5-day increase, 0.11-0.89, <em>P</em> = 0.033).</div></div><div><h3>Conclusions</h3><div>Nearly half of emergency sepsis survivors were readmitted within 180 days, predominantly within 30 days, and most readmissions were for infection. Predictors included younger age, malignancy status, and length of stay. These findings highlight the need for targeted discharge planning, antimicrobial stewardship, and early follow-up for high-risk patients in low-resource settings.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100808"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global threats in local wards: Dissemination of high-risk clones resistant to last-generation cephalosporins and carbapenems in Iraqi hospitals","authors":"Ehsan Adnan Hashim ,&nbsp;Meriem Souguir ,&nbsp;Véronique Métayer ,&nbsp;Antoine Drapeau ,&nbsp;Sana Azaiez ,&nbsp;Hayder Ali Muhammed ,&nbsp;Jean-Yves Madec ,&nbsp;Marisa Haenni ,&nbsp;Wejdene Mansour","doi":"10.1016/j.ijregi.2026.100852","DOIUrl":"10.1016/j.ijregi.2026.100852","url":null,"abstract":"<div><h3>Objectives</h3><div>To conduct the first comprehensive molecular characterization of multidrug-resistant Gram-negative pathogens isolated from patients in six Iraqi hospitals.</div></div><div><h3>Methods</h3><div>Samples (n = 104) were collected from outpatients across six hospitals in Iraq between March and September 2022. Bacterial isolates were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed according to EUCAST guidelines. Genomic DNA was extracted and subjected to whole-genome sequencing (WGS).</div></div><div><h3>Results</h3><div>Over 104 samples, 42 resistant isolates were identified: <em>Escherichia coli</em> (n = 15), <em>Klebsiella pneumoniae</em> (n = 7), <em>Pseudomonas aeruginosa</em> (n = 15), and <em>Acinetobacter baumannii</em> (n = 5). WGS revealed genetic diversity, with the dominance of high-risk clones such as <em>E. coli</em> sequence type (ST131) (n = 6), <em>K. pneumoniae</em> ST14, ST15 or ST394 and <em>P. aeruginosa</em> ST308 or ST773. The extended-spectrum beta-lactamase phenotype in <em>E. coli</em> and <em>K. pneumoniae</em> was mainly conferred by the <em>bla</em>_CTX-M-15 gene. Carbapenem-resistance was predominantly mediated by the <em>bla</em>_NDM-1 gene, which was identified in <em>K. pneumoniae</em> ST15 and ST2943 isolates, and in <em>P. aeruginosa</em> ST308 and ST773. In <em>A. baumannii</em> ST2 isolates, carbapenem-resistance was due to the presence of the <em>bla</em>_OXA-23 gene.</div></div><div><h3>Conclusions</h3><div>These findings highlight the dissemination of high-risk clones resistant to expanded-spectrum cephalosporins and carbapenems in geographically diverse Iraqi hospitals, underscoring the urgent necessity to establish comprehensive national antimicrobial resistance surveillance and infection control strategies.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100852"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-travel health awareness and perceptions of voluntary airport PCR testing during COVID-19: A cross-sectional study in Okinawa, Japan","authors":"Masahiro Kozuka ,&nbsp;Yusuke Shimakawa ,&nbsp;Gerardo Chowell ,&nbsp;Tetsuharu Nagamoto ,&nbsp;Ryota Matsuyama ,&nbsp;Ryosuke Omori ,&nbsp;Yining S. Xu ,&nbsp;Yoshiro Shimoji ,&nbsp;Kaoru Ogawa ,&nbsp;Yoshihiro Takayama ,&nbsp;Kenji Mizumoto","doi":"10.1016/j.ijregi.2025.100817","DOIUrl":"10.1016/j.ijregi.2025.100817","url":null,"abstract":"<div><h3>Objectives</h3><div>During the COVID-19 pandemic, airport-based measures, such as fever screening and polymerase chain reaction (PCR) testing were implemented in Japan. Okinawa Prefecture introduced a voluntary airport PCR testing program for domestic travelers at Naha Airport (OKA). Their indirect behavioral effects on travelers remain underexplored. This study aims to describe self-reported pre-travel health awareness among participants in this program.</div></div><div><h3>Methods</h3><div>In February-March 2021, we conducted a cross-sectional questionnaire survey among Naha Airport PCR test Project (NAPP) participants (n = 4545; March subset n = 1859). The survey assessed demographics, travel purpose, awareness of airport screening (fever screening and PCR testing), pre-travel health awareness, COVID-19 history, and symptoms. Logistic regression evaluated factors associated with self-reported symptoms in the March subset.</div></div><div><h3>Results</h3><div>Among respondents aware of fever screening and PCR testing, 94.1% and 96.4%, respectively, reported increased attention to their physical condition before travel. Overall, 3.9% reported symptoms, mainly mild respiratory complaints. The proportion symptomatic varied by reason for testing; workplace-mandated testers reported fewer symptoms than family-motivated testers (adjusted odds ratio 0.36, 95% confidence interval 0.15-0.78).</div></div><div><h3>Conclusions</h3><div>Awareness of voluntary airport screening measures was associated with greater self-reported pre-travel health awareness among voluntary testers. These findings may inform context-specific behavioral strategies aimed at promoting health-conscious travel during infectious disease outbreaks.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100817"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}