Journal Of Infection In Developing Countries[JOURNAL]
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200 papers
Cytomegalovirus and Epstein-Barr Virus reactivation in steroid-refractory immune checkpoint inhibitor colitis.
Sanyour J, Awada B, Mattar A … +5 more , Matar R, Yaqoub N, Al Haddabi I, Al-Baimani K, Qarshoubi I
J Infect Dev Ctries · 2025 Aug · PMID 40920724 · Publisher ↗
INTRODUCTION: Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivation are known complications in immunocompromised hosts, particularly transplant recipients. However, their occurrence and clinical implications in...
INTRODUCTION: Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivation are known complications in immunocompromised hosts, particularly transplant recipients. However, their occurrence and clinical implications in patients with solid tumors remain underexplored. The introduction of immune checkpoint inhibitors (ICIs) has transformed cancer therapy, but immune-related adverse events (irAEs), including colitis, are increasingly recognized. The potential role of viral reactivation in exacerbating these toxicities is not well established. CASES PRESENTATION: We report two cases of patients with solid tumors treated with ICIs who developed severe, refractory immune-related colitis. Extensive evaluation revealed markedly elevated CMV and EBV viral loads in colonic biopsies, confirmed by histopathology. Both patients showed significant clinical and endoscopic improvement following antiviral therapy with ganciclovir, highlighting the role of CMV and EBV in modulating the severity of ICI-induced colitis. CONCLUSIONS: CMV and EBV reactivation may contribute to the persistence or worsening of ICI-induced colitis. Early recognition and treatment of viral reactivation in patients with irAEs may improve outcomes. Clinical judgment and serial viral monitoring are essential for guiding management decisions.
The characteristics of the cases with brain abscess and the analysis of the predictive factors for poor outcome.
Bilgin E, Arslan Gulen T, Kızılpınar G … +4 more , Işıkber GG, Sezer C, Tas ZA, Oruc E
J Infect Dev Ctries · 2025 Aug · PMID 40920723 · Publisher ↗
INTRODUCTION: To evaluate the characteristics of patients who have undergone surgical operations due to brain abscess and to assess the risk factors for mortality and the outcomes. METHODOLOGY: Patients who have undergon...
INTRODUCTION: To evaluate the characteristics of patients who have undergone surgical operations due to brain abscess and to assess the risk factors for mortality and the outcomes. METHODOLOGY: Patients who have undergone surgical operations due to brain abscess between January 2014 and January 2024 in our hospital were evaluated retrospectively. Patients were divided into 2 groups to determine poor outcome predictive factors. RESULTS: A total of 57 patients with brain abscess were evaluated. Brain abscess was developed after a surgical procedure in 33% of the patients. Of these patients, 44 (77%) recovered without sequelae, 3 cases had epilepsy, and 2 had hemiplegia. Comparing the patients with poor outcome and the patients with good outcome in terms of symptom duration, time to hospital admission, and C-reactive protein, erythrocyte sedimentation rate and procalcitonin values, we detected statistically significant difference only in erythrocyte sedimentation rate (p = 0.018). Patients with poor outcome had higher C-reactive protein and procalcitonin values and shorter symptom duration and time to hospital admission than the patients with good outcome. Multivariate logistic regression analysis revealed that erythrocyte sedimentation rate is a predictive factor for poor outcome. CONCLUSIONS: Brain abscesses with high mortality and morbidity. Detailed questioning of symptom duration and time to hospital admission in patients presenting with headache who have or have not undergone surgical operation, precisely evaluating C-reactive protein, sedimentation, and procalcitonin values after performing necessary scanning procedures, and swiftly planning surgical and/or antibiotic treatment are associated with survival benefit.
Post COVID attitude, intent, awareness and preparedness of public to combat monkeypox infection in Odisha state, India.
Alanazi AS, Panda DS, Giri RK … +4 more , Padhy IP, Zafar A, Sahu PK, Magar SP
J Infect Dev Ctries · 2025 Aug · PMID 40920722 · Publisher ↗
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of public knowledge, vaccination, government preparedness, and a strong healthcare system in managing infectious diseases. Recentl...
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of public knowledge, vaccination, government preparedness, and a strong healthcare system in managing infectious diseases. Recently, monkeypox (mpox) cases have emerged globally. This study aimed to assess: (i) the public knowledge related to COVID-19 and its translation into preventive behavior, and (ii) the preparedness of the government and healthcare providers in addressing mpox. METHODOLOGY: An online survey was conducted among the adults in Odisha, India. Data were analyzed using SPSS version 26. RESULTS: Most participants recognized mpox as a viral infection transmitted between animals and humans. Awareness of its cause and symptoms was generally good. However, knowledge about vaccine availability and treatment was limited. The COVID-19 experience positively influenced attitudes toward vaccination, trust in the World Health Organization (WHO) guidance, preventive behavior, and digital health adoption. Despite this, participants felt that the government's response to mpox lacked sufficient preparedness. CONCLUSIONS: These findings highlight gaps in awareness and government readiness. They emphasize the need for stronger preventive strategies to avoid future epidemics or pandemics.
Metagenomic next-generation sequencing for diagnosis of severe pneumonia caused by Nocardia otitidiscaviarum.
Wang SK, Zhang XT, Liu YE … +1 more , Wang MT
J Infect Dev Ctries · 2025 Aug · PMID 40920721 · Publisher ↗
INTRODUCTION: Nocardia spp. are Gram-positive, aerobic actinomycetes, which can cause pulmonary, primary cutaneous, and lymphocutaneous infections. However, severe pneumonia caused by Nocardia otitidiscaviarum has rare r...
INTRODUCTION: Nocardia spp. are Gram-positive, aerobic actinomycetes, which can cause pulmonary, primary cutaneous, and lymphocutaneous infections. However, severe pneumonia caused by Nocardia otitidiscaviarum has rare reported. PATIENT CONCERNS: In this case report, a 73-year-old female presented with a 7-day history of fever, cough, followed by a 1-day history of dyspnea. Both lungs showed patchy shadows on a chest CT scan. Bronchoalveolar lavage and mNGS were performed for the rapid diagnosis of the Nocardia otitidiscaviarum induced infection. DIAGNOSIS: Community-acquired pneumonia was diagnosed following clinical assessment, including characteristic physical examination findings, abnormal laboratory results, and consolidations observed on CT imaging. And the evidence of pathogen was supplied by mNGS. INTERVENTIONS: The anti-infection therapy regimen was: trimethoprim-sulfamethoxazole (1.44 g q6h) for 3 months according to the detection of the Nocardia otitidiscaviarum. OUTCOMES: After 3 months of follow-up, the patient has a good outcome and chest CT suggested that the inflammation in the lungs had been almost absorbed. CONCLUSIONS: Rapid pathogen identification is pivotal for enhancing clinical outcomes and survival in severe pneumonia patients. This case report presents an exceptional case of severe pneumonia caused by Nocardia otitidiscaviarum and the uncommon potential occurrence of human-to-human transmission. mNGS could help avoid misdiagnosis and mistreatment in clinical practice.
Assessing the prevalence of antimicrobial resistance among pediatric patients at Kamuzu Central Hospital, Malawi.
Chitedze AC, Mzikamanda RR, Maida T … +4 more , McAtee CL, Mapahla L, Feasey N, Nyasulu PS
J Infect Dev Ctries · 2025 Aug · PMID 40920720 · Publisher ↗
INTRODUCTION: Severe bacterial infections cause significant disease burden in developing countries, including Malawi. The situation is compounded by the scarcity of resources, inconsistent availability of antibiotics, an...
INTRODUCTION: Severe bacterial infections cause significant disease burden in developing countries, including Malawi. The situation is compounded by the scarcity of resources, inconsistent availability of antibiotics, and increasing antimicrobial resistance (AMR). METHODOLOGY: This was a descriptive retrospective study where we analyzed blood culture results of pediatric patients admitted to Kamuzu Central Hospital (KCH), Lilongwe, Malawi. The data from January 2018 to January 2022 were compared with clinical metadata, and analyzed using the statistical software packages STATA version 16.1 and R version 4.2. RESULTS: The data of 272 isolates from blood culture were obtained; 47.8% (130/272) of participants presented with organisms resistant to first-line antibiotics; 13.4% (22/164) were resistant to second-line antibiotics which included resistance to piperacillin/tazobactam and meropenem. Gram-negative isolates constituted 54.3% (89/164) of the isolates, of which 32% (29/89) were Acinetobacter spp; while 45.7% (75/164) of the isolates were Gram-positive of which 42.7% (32/75) was Staphylococcus aureus. There were 12 Escherichia coli isolates, of which 50% (6/12) were highly resistant to piperacillin/tazobactam. The Fisher's exact test indicated that the antibiotic prescribed after a blood culture test result was significantly associated with the isolate observed (p = 0.016). CONCLUSIONS: This study highlights high rates of AMR to commonly used antibiotics in the pediatric ward at KCH, and calls for the need to revise treatment guidelines in the wake of empiric antibiotic choices for pediatric patients, including intensification of maximal use of blood culture tests as part of management of febrile illnesses and reinforcement of antimicrobial stewardship in pediatric patient care.
Age and sex distribution trends of SARS-CoV-2 infections: Insights from three epidemic waves in Puducherry, India.
Britto LJ, Rahul A, Sundaram D … +20 more , Vijayakumar B, Sankari T, Subramanian M, Dinesh RJ, Abraham PR, Devaraju P, Nazeer Y, Elango A, Ramalingam B, Mary KA, Tyagi S, Niranjan R, Rajaiah P, Muniaraj M, Kumar NP, Geetha I, Shriram AN, Srividya A, Kuttiatt VS, Kumar A
J Infect Dev Ctries · 2025 Aug · PMID 40920719 · Publisher ↗
INTRODUCTION: This study analyzed the age and sex distribution of COVID-19 patients during the initial three COVID-19 waves in Puducherry, India, from August 2020 to March 2022, to understand the distribution of infectio...
INTRODUCTION: This study analyzed the age and sex distribution of COVID-19 patients during the initial three COVID-19 waves in Puducherry, India, from August 2020 to March 2022, to understand the distribution of infection across different demographic groups. METHODS: The disease surveillance program conducted at ICMR-Vector Control Research Centre processed 79,705 Throat Swab/Nasal Swab (TSNS) samples received from various institutions in Puducherry through the Integrated Disease Surveillance Program (IDSP). Real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) was performed following approved protocols. RESULTS: Test positivity rates during the second (14.6%) and third waves (25.1%) were significantly higher than the first wave (11.4%). In the first wave, children (p < 0.001) and elderly individuals (p = 0.017) had a lower risk of testing positive than adults. However, in the second wave, elderly individuals had a 1.12 (95% CI: 1.03 - 1.23) times greater risk of contracting COVID-19 (p = 0.013). Children had a lower risk of testing positive across all waves (p < 0.001). A significant sex difference was noted only in the first wave, with males having a 1.27 (1.18-1.37) times greater chance of being COVID-19 positive. The mean age of female patients was significantly younger than male patients in the third wave (p = 0.008). The third wave showed an increasing trend of infection across all age groups and sexes, especially among younger individuals. CONCLUSIONS: The study highlights an increasing trend of infections across all age groups and sexes during the third wave. Micro-epidemiological analyses are crucial for developing targeted intervention strategies that address age and sex demographics effectively.
Pneumonia, a pulmonary abscess, and an empyema caused by Parvimonas micra.
Li Y, Wang X, Zhang L … +2 more , Huang Y, Liu Y
J Infect Dev Ctries · 2025 Aug · PMID 40920718 · Publisher ↗
BACKGROUND: Pneumonia with an empyema caused by anaerobic bacteria is rare but can be life-threatening, especially in immunocompromised patients. CASE PRESENTATION: A 67-year-old man with diabetes and hypertension who pr...
BACKGROUND: Pneumonia with an empyema caused by anaerobic bacteria is rare but can be life-threatening, especially in immunocompromised patients. CASE PRESENTATION: A 67-year-old man with diabetes and hypertension who presented with pneumonia and pleural effusion and was unresponsive to initial broad-spectrum antibiotics is presented. Next-generation sequencing identified Parvimonas micra and other pathogens. Therefore, targeted therapy with levornidazole was initiated. The patient's condition improved significantly after this treatment. CONCLUSIONS: This case highlights the importance of considering anaerobic bacteria in immunocompromised patients and the utility of next-generation sequencing in identifying atypical pathogens.
Investigation of the distribution and antifungal susceptibility of Candida species isolated from clinical specimens in central part of Turkey.
Ezer B, Ugrakli S, Kasapoglu E
J Infect Dev Ctries · 2025 Jul · PMID 40720471 · Publisher ↗
INTRODUCTION: This study aimed to examine the distribution and antifungal susceptibility of Candida species in a university hospital and investigate the association of Candida species with age, gender, and clinical speci...
INTRODUCTION: This study aimed to examine the distribution and antifungal susceptibility of Candida species in a university hospital and investigate the association of Candida species with age, gender, and clinical specimens. METHODOLOGY: A total of 939 samples isolated Candida spp. from various clinical samples between 01.01.2019-06.08.2024 were included in the study. Between 01.01.2019-29.04.2022, Candida species and antifungal susceptibilities were determined using Vitek2 automated system. Between 30.04.2022-06.08.2024, Candida species were detected using the Phoenix automated system and MALDITOF-MS, and antifungal susceptibilities were determined by the gold standard method of broth microdilution. RESULTS: Candida albicans was detected in 511 (54.4%) and non-albicans candida species (NAC) in 428 (45.6%) of the samples with Candida spp. growth. The most frequently detected species were C. albicans in 511 (54.4%) samples, C. parapsilosis in 215 (22.9%) samples, and C. glabrata in 85 (9.1%) samples. The MIC values of all antifungals were statistically significantly higher in NAC species than in C. albicans (p < 0.001). C. tropicalis was isolated most frequently in CSF, C. albicans was isolated most frequently in ocular corneal fluid, C. tropicalis was isolated most frequently in pleural fluid and C. albicans was isolated in all vaginal discharge samples. The higher MIC values of caspofungin, micafungin, and anidulafungin in C. parapsilosis isolates were statistically significant compared to C. albicans and C. glabrata (p < 0.001). CONCLUSIONS: Investigating the distribution and antifungal susceptibility of Candida species is vital to initiate appropriate and early empirical antifungal therapy. Each center should determine its species distribution and closely monitor antifungal resistance changes.
Intestinal parasites and sexually transmitted infections in a socially vulnerable rural community in southern Bahia, Brazil.
Barreto NM, Farias MM, Araújo WA … +8 more , De Souza JN, Oliveira CL, Sampaio LM, Souza ABDS, Gonçalves NL, Galvão-Castro B, Teixeira MC, Soares NM
J Infect Dev Ctries · 2025 Jul · PMID 40720470 · Publisher ↗
INTRODUCTION: Intestinal parasites and sexually transmitted infections (STI) are frequent among people living in conditions of social vulnerability. The aim of this study was to investigate the prevalence of parasitic in...
INTRODUCTION: Intestinal parasites and sexually transmitted infections (STI) are frequent among people living in conditions of social vulnerability. The aim of this study was to investigate the prevalence of parasitic infections, STIs (human T lymphotropic virus (HTLV), human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and T. pallidum/syphilis) in the residents of a rural community in southern Bahia, Brazil. METHODOLOGY: The study was conducted from March 2018 to September 2019, and 88.8% of residents of the rural community (n = 223/251) participated. Diagnosis was performed by parasitological examination and by detection of specific antibodies in sera. Data on socioeconomic and health conditions were obtained with a questionnaire. RESULTS: The prevalence of parasitic infection was 73.9%. Trichuris trichiura (26.9%) and Ascaris lumbricoides (25.6%) were the most frequent, with a higher occurrence in children and adolescents (p < 0.05%). The prevalence of anti-Strongyloides stercoralis antibodies (22.9%) was about 3 times higher than the presence of larvae in feces (7.2%; p < 0.05%). Seroprevalence for STI was 19.3%, mostly syphilis (11.7%) in the elderly participants (p < 0.05%), followed by HTLV-1 (8.1%; 18/223). The co-infection rate of S. stercoralis and HTLV-1 was 1.3% (3/223), based on parasitological diagnosis alone, but when the detection of IgG4 anti-S. stercoralis was considered, it increased to 6.7% (15/223). CONCLUSIONS: Illnesses associated with poverty, such as intestinal parasite infections and STI, trigger a vicious cycle of socioeconomic exclusion and persistent poverty. Therefore, it is essential to break the social determinants that perpetuate both poverty and diseases.
Application of the SARIMA-LSTM model to evaluate the effectiveness of interventions for Visceral Leishmaniasis.
Han M, Hao C, Zhao Z … +3 more , Zhang P, Wu B, Qiu L
J Infect Dev Ctries · 2025 Jul · PMID 40720469 · Publisher ↗
INTRODUCTION: This study proposes a combined Seasonal Autoregressive Integrated Moving Average and Long Short-Term Memory (SARIMA-LSTM) model to enhance the accuracy of evaluating the effectiveness of visceral leishmania...
INTRODUCTION: This study proposes a combined Seasonal Autoregressive Integrated Moving Average and Long Short-Term Memory (SARIMA-LSTM) model to enhance the accuracy of evaluating the effectiveness of visceral leishmaniasis prevention and control efforts in Yangquan, China. METHODOLOGY: Data were obtained from the Yangquan Centre for Disease Control and Prevention. The hybrid model integrates a SARIMA component with a residual-based LSTM neural network. RESULTS: In the SARIMA-LSTM model, the LSTM component included seven hidden layer nodes, a learning rate of 0.001, 500 training epochs, a batch size of 256, and utilized the Adam optimization algorithm. The SARIMA-LSTM model demonstrated superior performance (MSE = 2.824, MAE = 1.279, RMSE = 1.681). A paired samples t-test revealed a statistically significant difference between predicted and actual case counts (t = -4.058, p < 0.001), indicating that the actual number of cases was lower than predicted. CONCLUSIONS: The combined SARIMA-LSTM model outperformed the individual SARIMA and LSTM models, suggesting that the implemented interventions were generally effective.
Rapid bedside testing for septic arthritis: evaluating cost-effective diagnostic tools.
Rajasekharan P, Hegde A, Mane P … +2 more , Shetty C, Anand R
J Infect Dev Ctries · 2025 Jul · PMID 40720468 · Publisher ↗
INTRODUCTION: Diagnosing septic arthritis through synovial fluid culture and analysis can be time-consuming, and the limited accessibility of these tests in primary and secondary healthcare centers restricts their utilit...
INTRODUCTION: Diagnosing septic arthritis through synovial fluid culture and analysis can be time-consuming, and the limited accessibility of these tests in primary and secondary healthcare centers restricts their utility in emergency situations. Therefore, there is a pressing need for an alternative, rapid, and reliable test to significantly reduce morbidity. This study aimed to evaluate the efficacy of leucocyte esterase (LE) and glucose reagent strip tests for the early diagnosis of septic arthritis. METHODOLOGY: This cross-sectional study included 75 individuals presenting with atraumatic native joint effusion. Following arthrocentesis, bedside LE and glucose strip testing were performed, along with synovial fluid culture and analysis. RESULTS: Out of the 75 cases, 25 (33.3%) were diagnosed with septic arthritis based on standard diagnostic tests. The LE strip test showed a sensitivity of 92%, specificity of 70%, positive predictive value (PPV) of 60%, and negative predictive value (NPV) of 94%. The glucose strip test demonstrated a sensitivity of 88%, specificity of 76%, PPV of 67%, and NPV of 93%. Combining the two tests resulted in a sensitivity of 84%, specificity of 88%, PPV of 77.8%, and NPV of 91.7%. The overall diagnostic accuracy was 80% for the glucose strip test, 77.3% for the LE strip test, and 86.7% for the combined results. CONCLUSIONS: The LE and glucose strip tests are cost-effective bedside assessments for the rapid diagnosis of septic arthritis. Combining the results from both strip tests yielded greater diagnostic accuracy than each one alone.
Shifts in hospital-associated pathogens and prevalence trends of carbapenem-resistant Escherichia coli infections, 2021-2023.
Liu L, Liu S, Yang Z … +5 more , Wang F, Yuan H, Xu H, Chen J, Li X
J Infect Dev Ctries · 2025 Jul · PMID 40720467 · Publisher ↗
INTRODUCTION: Carbapenem-resistant Escherichia coli (CREC) have emerged as a significant global health threat, particularly in hospital settings, due to their high resistance to critical antibiotics. This study aimed to...
INTRODUCTION: Carbapenem-resistant Escherichia coli (CREC) have emerged as a significant global health threat, particularly in hospital settings, due to their high resistance to critical antibiotics. This study aimed to evaluate the dynamics of pathogenic bacterial isolates in clinical specimens, characterize patients with CREC infections, and identify risk factors for co-infection; in order to strengthen surveillance and infection control measures. METHODOLOGY: Clinical specimens were collected from patients at a tertiary hospital in southern Anhui Province between 2021 and 2023. Strain identification and antibiotic susceptibility testing were performed using a time-of-flight mass spectrometry analyzer and the VITEK-2 compact system. Demographic and clinical data were analyzed using rigorous statistical methods. RESULTS: The predominant bacterial species isolated included Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Notably, the prevalence of CREC increased from 10.10% in 2021 to 16.36% in 2023. The predominant carbapenem-resistant Enterobacteriaceae (CRE) species were Enterobacter cloacae, Klebsiella pneumoniae, and Escherichia coli; with the proportion of CREC increasing significantly from 10.10% in 2021 to 16.36% in 2023. Of the 81 patients with CREC, 65.43% were over 60 years old. The most common specimen types were urine and sputum, with the highest proportion of patients in the intensive care unit (ICU; 32.10%). Analysis of the co-infected population revealed that ICU patients with tracheal intubation were significant risk factors. Co-infection with carbapenem-resistant Acinetobacter baumannii (CRAB) showed a concerning annual rise. CONCLUSIONS: There is urgent need for enhanced surveillance and stringent infection control measures to mitigate the spread of CREC and associated nosocomial infections.
Molecular characterization and diversity of carbapenemases in Gram-negative bacteria in Libyan hospitals.
Slimene K, Almahjoub SK, Alkeskas AA … +9 more , Elbousify AI, Omar EO, El Salabi AA, Mohamed EA, Hameid MI, Alsanosi S, Miniaoui D, Rolain JM, Chouchani C
J Infect Dev Ctries · 2025 Jul · PMID 40720466 · Publisher ↗
INTRODUCTION: Antimicrobial resistance has become a major threat to public health, especially in developing countries, due to the uncontrolled consumption of antibiotics. This study aims to characterize antibiotic resist...
INTRODUCTION: Antimicrobial resistance has become a major threat to public health, especially in developing countries, due to the uncontrolled consumption of antibiotics. This study aims to characterize antibiotic resistance genes in different bacteria recovered in different healthcare facilities in Libya. METHODOLOGY: 379 samples were recovered from various sources from different sites. 210 samples were able to grow on culture media. 133 Gram-negative carbapenem-resistant strains were recovered from clinical specimens (n = 64), and hospital environments (n = 69). Antibiotic susceptibility tests were performed to select carbapenem-resistant strains. Colistin resistance was tested by the UMIC method to determine the minimum inhibitory concentration. RT-PCR was conducted to detect the incidence of carbapenemases-encoding genes. RESULTS: Gram-negative bacteria showed a low susceptibility to carbapenems. Molecular investigations indicated that NDM-1 was the most prevalent in Enterobacteriaceae isolated from patients and hospital environment (n = 26, n = 41), followed by blaOXA-48 (n = 16, n = 15) and blaVIM (n = 3) from patients and blaKPC (n = 1) from hospital environment. Concerning A. baumannii, blaOXA-23 was detected in strains isolated from patients (n = 8) and hospital environment (n = 6), followed by blaNDM (n = 9) from patients and one from hospital environment. Carbapenem resistance in P. aeruginosa was encoded by modification in OprD encoding gene, such as IS (ISpa26), polymorphism, and a premature stop codon. CONCLUSIONS: Several carbapenem resistant Gram-negative bacteria were identified by the expression of different carbapenemases and the alteration of OprD.
Prevalence of genetic variants in SERPINB2 and PKNOX1 genes in erythema nodosum leprosum patients from southern Brazil.
Perazzoli S, Fiuza MF, De Moraes PC … +3 more , Heck R, Vianna FS, Bonamigo RR
J Infect Dev Ctries · 2025 Jul · PMID 40720465 · Publisher ↗
INTRODUCTION: Erythema nodosum leprosum (ENL) is a humoral immune response to Mycobacterium leprae that is characterized by erythematous nodules, and may or may not be associated with systemic symptoms. Thalidomide is th...
INTRODUCTION: Erythema nodosum leprosum (ENL) is a humoral immune response to Mycobacterium leprae that is characterized by erythematous nodules, and may or may not be associated with systemic symptoms. Thalidomide is the primary treatment for ENL in Brazil, but peripheral neuropathy (PN) is a significant adverse effect. Genetic variants in SERPINB2 and PKNOX1 genes have been implicated in the predisposition to develop thalidomide-induced peripheral neuropathy (TiPN) in patients with multiple myeloma. This study evaluated the prevalence of the polymorphisms in SERPINB2 and PKNOX1 in ENL patients. METHODOLOGY: A cross-sectional study was conducted in a sample of ENL patients from southern Brazil to assess the presence of genetic variants of SERPINB2 and PKNOX1. RESULTS: Forty-seven patients with ENL were included. The prevalence of SERPINB2 (rs6103) was 66% for the C allele and 34% for the G allele, and the prevalence of PKNOX1 (rs2839629) was 75% for the A allele and 25% for the G allele. There was significantly relevant presence of the PKNOX1 (rs2839629) A allele in patients with ENL (p < 0.001). In the case of patients with PN, the presence of the C genotype for rs6103 (SERPINB2) was 85% in homozygosity and 77.3% in heterozygosity; and the presence of the A genotype for rs2839629 (PKNOX1) was 84% in homozygosity and 80% in heterozygosity. CONCLUSIONS: Polymorphisms in SERPINB2 and PKNOX1 were identified in patients with ENL, with emphasis on PKNOX1. If confirmed by more robust future studies, these findings may guide clinical decisions and treatment guidelines for ENL.
Clinical misconceptions and diagnostic delays in extrapulmonary tuberculosis: an evaluation on 89 cases.
Gürcüoglu E
J Infect Dev Ctries · 2025 Jul · PMID 40720464 · Publisher ↗
INTRODUCTION: Extrapulmonary tuberculosis (EPTB) has highly variable clinical findings, and has a more difficult diagnostic process than pulmonary tuberculosis (PTB). The aim of this study was to examine the difficulty o...
INTRODUCTION: Extrapulmonary tuberculosis (EPTB) has highly variable clinical findings, and has a more difficult diagnostic process than pulmonary tuberculosis (PTB). The aim of this study was to examine the difficulty of the diagnostic process in 89 cases that applied to different clinics in our hospital, with different complaints. METHODOLOGY: A total of 89 patients diagnosed with EPTB between March 2020 and March 2024 were included in the study. EPTB diagnosis was determined by excluding patients with primary PTB. RESULTS: The mean age of the cases was 47.84 ± 19.23 years, and 52 (58.4%) of the patients were women. There was a significant relationship between the affected area and gender (p < 0.001). The rate of peripheral lymphadenopathy (LAP) involvement was much higher in women than that in men (85.2% vs. 14.8%). Pleural involvement was 6.5-fold higher in men than in women (51.4% vs. 7.8%). There was also a significant relationship between the affected area and the time to diagnosis (p < 0.001). While peripheral LAP cases were diagnosed late, patients with pleural involvement were diagnosed more quickly (p < 0.001). The rate of smoking addiction was high in males with pleural involvement (79.9%). Quinolone use was 77.4% in the early-diagnosed group and 54.9% in the late-diagnosed group (p = 0.110). CONCLUSIONS: Due to the difficulty of diagnosis, EPTB should be included in the differential diagnoses of all relevant medical specialties, and insistence should be made for the diagnosis in the presence of clinical suspicion.
Silent spread of pathogens in hospital settings: a one-week molecular epidemiologic study.
Tanriverdi ES, Yakupogullari Y, Ceylan D … +2 more , Duman Y, Otlu B
J Infect Dev Ctries · 2025 Jul · PMID 40720463 · Publisher ↗
INTRODUCTION: Molecular fingerprinting analyses of the pathogens isolated from healthcare-associated infections (HAIs) in an off-outbreak period can provide important data which cannot be obtained by prospective surveill...
INTRODUCTION: Molecular fingerprinting analyses of the pathogens isolated from healthcare-associated infections (HAIs) in an off-outbreak period can provide important data which cannot be obtained by prospective surveillance. Such data may indicate unnoticed breaks in infection control measures and guide in determining targeted interventions or reinforcements. The study aimed to analyze the clonal relatedness of pathogens isolated from HAIs during a period when the facility}'s HAI rate remained stable. METHODOLOGY: A prospective cross-sectional study was conducted in a university hospital. A total of 105 bacterial pathogens isolated from HAIs in a one-week period were genotyped using pulsed-field gel electrophoresis. RESULTS: All 12 enterococci isolates belonged to one of the genotypes that infected more than one patient. There was an epidemic clone in Staphylococcus aureus responsible for 7 out of 12 HAIs caused by this species. Among the Gram-negative bacteria, Acinetobacter baumannii showed the highest clonality, with 3 genotypes responsible for 13 out of 16 HAIs caused by this species. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa showed the lowest clonality, and their spreads involved a pair of patients in a total of 7 events. CONCLUSIONS: This study showed that almost half of HAIs were due to clonal spread that was not detected by active surveillance. Enterococci, S. aureus, and A. baumannii had the highest clonality, suggesting that a significant proportion of HAIs could be prevented in healthcare facilities where these pathogens predominate. Repeating comprehensive studies in hospitals at regular intervals will be useful to identify unnoticed breaks in infection control measures.
Prevalence of multidrug-resistant biofilm-forming pathogens in diabetic foot ulcers and antimicrobial activity of nanoparticles.
Kainat S, Sohail M, Rafique S … +2 more , Mustafa M, Ejaz U
J Infect Dev Ctries · 2025 Jul · PMID 40720462 · Publisher ↗
INTRODUCTION: Diabetic foot ulcers (DFU) are the main devastating complications for diabetic patients. The involvement of multidrug-resistant microorganisms with the ability to produce biofilms in DFUs renders them diffi...
INTRODUCTION: Diabetic foot ulcers (DFU) are the main devastating complications for diabetic patients. The involvement of multidrug-resistant microorganisms with the ability to produce biofilms in DFUs renders them difficult to treat. Nanotechnology has emerged as an innovative and promising technology in the therapy of diabetic foot lesions. Therefore, this study was designed to assess the prevalence of drug resistance and biofilm-forming pathogens in DFU and the antimicrobial activity of nanoparticles against these pathogens. METHODOLOGY: A total of 111 adults with diabetic foot ulcers were randomly included. The clinical parameters and data of the classification and grading of the wound, along with microbiological factors, were analyzed. RESULTS: Nanoparticles were synthesized from Withania coagulans and Fagonia cretica. The results showed that the majority of patients were male (76%), with an average age of 54 years. The majority of ulcers were polymicrobial (56%), while Staphylococcus aureus (21.2%) was the predominant pathogen. A significant increase in methicillin-resistant Staphylococcus aureus (76.5%), extended-spectrum β-lactamase (ESBL) producers (55.8%), carbapenem-resistant Pseudomonas aeruginosa (46%), and vancomycin-resistant Enterococci (18.1%) was observed. Gram-negative isolates (31%), particularly Pseudomonas aeruginosa, exhibited strong biofilm formation activity compared to gram-positive (6%) and fungal isolates (24%). CONCLUSIONS: The tested nanoparticles showed significant antimicrobial activity against strong biofilm forming bacterial and fungal isolates. Controlling certain extrinsic and metabolic parameters and comprehensively evaluating nanoparticle-based therapeutics can serve as powerful tools in curing chronic diabetic wounds.
Tigecycline therapy for multidrug-resistant bacteria: is it the right choice for pediatric patients.
Avcu G, Arslan SY, Arslan A … +7 more , Karadas N, Celtik U, Barut D, Turanli E, Cilli F, Kurugol Z, Sahbudak Bal Z
J Infect Dev Ctries · 2025 Jul · PMID 40720461 · Publisher ↗
INTRODUCTION: The incidence of infections caused by multidrug-resistant pathogens is increasing worldwide, resulting in significant morbidity and mortality. Tigecycline has become a good option because it has a broad spe...
INTRODUCTION: The incidence of infections caused by multidrug-resistant pathogens is increasing worldwide, resulting in significant morbidity and mortality. Tigecycline has become a good option because it has a broad spectrum of antibacterial activity. This study aimed to reveal the clinical, microbiological, and laboratory outcomes of hospitalized children treated with tigecycline. METHODOLOGY: We retrospectively collected the medical records of the hospitalized pediatric patients treated with tigecycline from April 1, 2018, to Apr 30, 2023, at Ege University Children's Hospital. Demographic features and clinical and laboratory findings were evaluated to determine the efficacy and safety of tigecycline therapy. RESULTS: Sixty-seven patients (65.7% male) with a median age of 6 years (2.5 months-17.5 years) were included. There was an underlying condition in 83.5% of the patients, and 55.2% were immunosuppressed. The most common infections were; lower respiratory tract infections (29.8%), intra-abdominal infections (20.9%), bloodstream infections (17.9%), and soft tissue infections (13.4%), respectively. Acinetobacter spp. (28.4%) was the most isolated microorganism, followed by Klebsiella spp. (19.4%) and Enterococcus spp. (14.9%). Tigecycline was used as a targeted treatment in 76.1% of the patients and was often used as a combination therapy (80.6%) with a median duration of 12 days (range, 2-60 days). Clinical response was achieved in 65.6% of patients, microbiologic response in 62.6%, and treatment failure in 34.3%. No major adverse events were noted during the therapy. CONCLUSIONS: Tigecycline, which was mostly preferred in combination therapy, had high clinical response and microbiologic eradication rates, but these rates varied according to infection sites and microorganism species.
Infection dynamics and management in patients undergoing extracorporeal membrane oxygenation: a retrospective analysis.
Yuan Z, Zhong S, Tang Q … +3 more , Liu Y, Wang Z, Xiao H
J Infect Dev Ctries · 2025 Jul · PMID 40720460 · Publisher ↗
INTRODUCTION: The aim of this study was to summarize the infection situation of patients during extracorporeal membrane oxygenation (ECMO) treatment, and analyze the relevant infectious indexes before and after ECMO trea...
INTRODUCTION: The aim of this study was to summarize the infection situation of patients during extracorporeal membrane oxygenation (ECMO) treatment, and analyze the relevant infectious indexes before and after ECMO treatment; so as to provide clinical evidence for the control of infection after ECMO treatment. METHODOLOGY: A retrospective analysis was conducted from May 2014 to January 2024 on 66 patients treated with ECMO at the Department of Intensive Care Medicine, Daping Hospital, Army Medical University. The patients' general clinical data were collected, focusing on infection types, pathogenic bacteria, anti-infective regimens, infection markers, and coagulation function. Additionally, risk factors for infection in intensive care unit (ICU) patients undergoing ECMO treatment were analyzed. RESULTS: Pulmonary infections were the most common among the patients in this study, and Gram-negative bacilli were the predominant pathogens. Significant reductions were observed in white blood cell count (p < 0.05, n = 57), platelet count (p < 0.05, n = 56), and fibrinogen levels (p < 0.05, n = 57) 48 hours after ECMO treatment. Of the 66 ECMO patients, 30 survived. The length of stay in the ICU was identified as an independent risk factor for adverse events following ECMO treatment. CONCLUSIONS: Controlling infection during ECMO is the cornerstone of survival and prognosis of patients. Mechanical ventilation time, continuous renal replacement therapy, central venous catheterization time, and antibiotic treatment time may be related to infection after ECMO. Early bacterial culture; and prophylactic, empirical, and targeted antimicrobials contribute to infection control.
Could serum intestinal fatty acid-binding protein and citrulline levels be predictive markers of mortality in critically ill COVID-19 patients?
Onuk S, Ozer NT, Sahin Ergul S … +5 more , Eryilmaz Eren E, Karakukcu C, Sipahioglu H, Karayol Akin A, Gundogan K
J Infect Dev Ctries · 2025 Jul · PMID 40720459 · Publisher ↗
INTRODUCTION: The global Coronavirus Disease 2019 (COVID-19) pandemic has been demonstrated to cause severe acute respiratory syndrome and is frequently associated with gastrointestinal (GI) manifestations. Intestinal fa...
INTRODUCTION: The global Coronavirus Disease 2019 (COVID-19) pandemic has been demonstrated to cause severe acute respiratory syndrome and is frequently associated with gastrointestinal (GI) manifestations. Intestinal fatty acid binding protein (IFABP) and citrulline have been identified as potential biomarkers of intestinal (dys)function. The present study was undertaken to ascertain the relationship between serum IFABP and citrulline concentrations and mortality in patients with COVID-19. METHODOLOGY: This observational study was conducted in the medical intensive care unit (ICU) and included adult patients diagnosed with PCR-confirmed cases of severe acute respiratory syndrome (SARS-CoV-2). Serum citrulline and IFABp concentrations were quantitatively analyzed using an enzyme-linked immunosorbent assay (ELISA) within the initial 24 hours following ICU admission. RESULTS: A total of 85 critically ill patients (mean age: 70.0 12.4 years) were recruited for this study. The mean Acute Physiology and Chronic Health Evaluation (APACHE II) score was 20.0 7.1. In comparison with survivors (n = 48 patients), non-survivors (n = 37 patients) exhibited significantly elevated serum IFABp concentrations (median (interquartile range, IQR): 13.27 [6.41-17.87] vs. 7.23 [3.26-12.25] ng/mL, p = 0.007) and diminished citrulline levels (median (IQR): 7.61 [4.37-8.52] vs. [4.67 (3.34-8.90] nmol/L, p = 0.043). Receiver operating characteristic (ROC) analysis revealed that the cut off value of serum IFABp and citrulline concentrations to predict ICU mortality was 8.15 ng/mL (AUC: 0.722, 95% Cl: 0.611-0.833, p = 0.001) and 5.99 nmol/L (AUC: 0.671, 95% Cl: 0.551-0.791, p = 0.009), respectively. CONCLUSIONS: The findings of this study indicate that serum IFABP and citrulline concentrations possess the potential to function as biomarkers for predicting mortality in critically ill patients with confirmed cases of SARS-CoV-2.
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