Journal Of Infection In Developing Countries[JOURNAL]
Sun
200 papers
Phage resistance profiles of AB-phages treated Acinetobacter baumannii: implications for phage therapy strategies.
Pasharawipas T, Woradulayapinij W, Pochairach R … +1 more , Yordpratum U
J Infect Dev Ctries · 2025 Oct · PMID 41187187 · Publisher ↗
INTRODUCTION: Phage therapy is a promising alternative for combating multidrug-resistant bacteria, including Acinetobacter baumannii (AB). However, the development of phage-resistant variants after treatment, particularl...
INTRODUCTION: Phage therapy is a promising alternative for combating multidrug-resistant bacteria, including Acinetobacter baumannii (AB). However, the development of phage-resistant variants after treatment, particularly when using phage cocktails, poses a significant challenge. This resistance can hinder the effectiveness of future phage-based treatments against pathogenic AB. METHODOLOGY: Three AB-specific phages-AB-phage 22, AB-phage 27, and AB-phage 32-susceptible to an AB isolate, designated ABU-3, were used as a model to study phage resistance development in AB following phage treatment. This study proposes a strategy to effectively eliminate pathogenic AB using an optimal multiplicity of infection (MOI), referred to as the MOI clearance value. RESULTS: The MOI clearance values required for complete elimination of ABU-3 were determined to be 10 for AB-phages 22 and 32 and 100 for AB-phage 27. Surviving ABU-3 colonies from lower MOI treatments were analyzed for phage resistance. ABU-3 treated with AB-phage 27 developed resistance to AB-phage 27 but remained susceptible to AB-phages 22 and 32. ABU-3 treated with AB-phage 22 developed resistance to AB-phage 22 but retained partial susceptibility to the other phages at reduced MOI. In contrast, ABU-3 treated with AB-phage 32 displayed complete resistance to all three phages. CONCLUSIONS: These findings highlight a key challenge in phage therapy: insufficient MOI ratio can promote phage resistance. The distinct resistance profiles observed emphasize the importance of optimizing phage combinations and dosages to prevent resistance development during treatment.
Development of multiplex immuno-PCR diagnostic platform using chicken IgY antibodies for COVID-19 diagnosis.
Altaha S, Al-Qaoud K, Al-Omari M … +1 more , Al-Shawaheen A
J Infect Dev Ctries · 2025 Oct · PMID 41187186 · Publisher ↗
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has significantly accelerated the development of diagnostic techniques. Real‑time quantitative polymerase chain reaction (RT‑qPCR) was the method of choice f...
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has significantly accelerated the development of diagnostic techniques. Real‑time quantitative polymerase chain reaction (RT‑qPCR) was the method of choice for diagnosis and was considered as the gold standard. However, limited specificity of RT-PCR was noticed during the pandemic. This research aimed to develop a combined highly specific immune-based and highly sensitive molecular-based diagnostic technique. METHODOLOGY: Groups of chicken were immunized with commercial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) N, S, and E antigens. The IgY antibodies were purified from eggs using a High-Trap IgY affinity column. Three unique DNA barcodes were designed, synthesized, and amplified using 5'-amine-labeled forward primers. DNA barcodes purified form PCR products were coupled to IgY antibodies using the (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide) - N-hydroxysuccinimide (EDC-NHS) coupling chemistry. ELISA; SDS-PAGEs; immunoblot (IB); and uniplex-, duplex- and multiplex immuno-PCR (IPCR) were used to confirm system validity. RESULTS: Amplification of single barcodes using RT-PCR showed a Ct value of 15, with no significant variation when amplified in duplex or multiplex formats. Chicken IgY-DNA barcode conjugation and reactivity were verified using IB and ELISA. IPCR resulted in efficient amplification of all three DNA barcodes in uniplex, duplex, and multiplex formats after binding to commercial N, S, and E antigens. CONCLUSIONS: The successful combination of the specific antibody-based techniques, low-cost chicken IgY antibodies, and RT-PCR sensitivity achieved in this study present a promising approach to meet the demand for sensitive and accurate diagnostics. This generic platform can be adopted in any analyte detection system.
Clonal dissemination of drug-resistant Acinetobacter baumannii in Thailand: insights from nationwide molecular typing.
Avzun T, Nitayanon P, Yungyuen T … +5 more , Kamolvit W, Wongsurawat T, Chewapreecha C, Kiratisin P, Thaipisuttikul I
J Infect Dev Ctries · 2025 Oct · PMID 41187185 · Publisher ↗
INTRODUCTION: Drug-resistant Acinetobacter baumannii poses a global health crisis, especially in Asia. It has a propensity to become clonally endemic in healthcare settings. However, its clonal distribution in a broad ge...
INTRODUCTION: Drug-resistant Acinetobacter baumannii poses a global health crisis, especially in Asia. It has a propensity to become clonally endemic in healthcare settings. However, its clonal distribution in a broad geographic area is unclear. METHODOLOGY: The clonality of A. baumannii was characterized nationwide by collecting 572 drug-resistant A. baumannii from 18 hospitals across Thailand regions between 2017-2018 and genotyping them by random amplified polymorphic DNA (RAPD) polymerase chain reaction (PCR) in association with carbapenemase genes data. RESULTS: The results depicted 12 types of RAPD banding. Strikingly, two types were predominant in all hospitals (79%). Of those, 96% harbored the blaOXA-23 gene. The banding pattern matched the preexisting strain in the institution, suggesting an ongoing nationwide circulation of the resistant clone. Interestingly, a unique banding type was identified in high proportion in two nearby hospitals in the northern region (21%, 53/252). Two isolates with the same banding pattern were also identified in a hospital in Bangkok, suggesting the possibility of transfer between regions. Most of the subset of isolates analyzed belonged to sequence type (ST) 2, the most prominent ST in the Asia-Pacific region. CONCLUSIONS: This study demonstrated continuous dissemination of predominating A. baumannii clones across the country, and the emergence of endemic hospital-specific clones, all with high burdens of blaOXA-23; suggesting a strong selection for these resistance determinants. In addition, genotyping with RAPD can be a simple and cost-effective epidemiological tool with efficient discriminatory power for A. baumannii in developing countries.
Erythrocyte morphology as a clinical disease indicator in hospitalized COVID-19 patients.
Hasanefendić B, Begović E, Šeherčehajić E … +9 more , Tihić-Kapidžić S, Halilović L, Fočo-Solak J, Hajro S, Pašić A, Fazlagić A, Velić A, Ibričević-Balić L, Zečević-Pašić L
J Infect Dev Ctries · 2025 Oct · PMID 41187184 · Publisher ↗
INTRODUCTION: Most COVID-19 cases are mild, but some require hospitalization due to pneumonia, with symptoms like hypoxia and dyspnea. This has led to speculation about erythrocyte involvement in the infection. This stud...
INTRODUCTION: Most COVID-19 cases are mild, but some require hospitalization due to pneumonia, with symptoms like hypoxia and dyspnea. This has led to speculation about erythrocyte involvement in the infection. This study aimed to examine the differences in the presence of dysmorphic erythrocytes in COVID-19 patients upon admission compared to healthy subjects, as well as to assess these differences in relation to the severity of the clinical presentation of COVID-19. METHODOLOGY: This study included 150 participants: 100 COVID-19 patients and 50 healthy subjects who formed the control group. The COVID-19 positive participants were divided into two groups based on the deterioration or improvement of their health conditions during hospitalization. Hematological parameters were analyzed, and peripheral blood smears were prepared to observe morphological changes in erythrocytes. RESULTS: The morphological changes observed in hospitalized COVID-19 patients included spiculated red blood cells (RBCs), spherocytes, stomatocytes, schistocytes, knizocytes, keratocytes, as well as mushroom- and cup-shaped RBCs. At admission, spiculated RBCs and spherocytes were more prevalent in patients showing improvement. Conversely, stomatocytes, knizocytes, keratocytes, and mushroom-shaped RBCs were more frequent in patients experiencing deterioration. Additionally, spiculated RBCs were more common in patients with improvement, while stomatocytes, schistocytes, knizocytes, keratocytes, mushroom-, and cup-shaped RBCs were more prevalent in deteriorating patients. CONCLUSIONS: The complete blood count and the examination of peripheral blood smears in hospitalized patients may serve as fundamental tools to assist clinicians in differentiating disease severity and improving treatment decision-making.
Characterization of urosepsis in a tertiary hospital: 5-year retrospective study on prevalence and risk factors in Palestine.
Bsharat I, Sadaqa D, Shoeibat A … +5 more , Rjoub H, Yaish M, Arafat H, Hindiyeh M, Sabateen A
J Infect Dev Ctries · 2025 Oct · PMID 41187183 · Publisher ↗
INTRODUCTION: The objective of this study was to characterize the occurrence of urosepsis in oncology patients and to explore the potential factors influencing its development and outcomes. Urosepsis is a serious systemi...
INTRODUCTION: The objective of this study was to characterize the occurrence of urosepsis in oncology patients and to explore the potential factors influencing its development and outcomes. Urosepsis is a serious systemic infection originating from a urinary tract infection. Its management is particularly challenging in immunocompromised oncology patients. METHODOLOGY: A retrospective review of 337 oncology patients diagnosed with urosepsis between 2019 and 2023 was conducted. Various clinical and demographic factors were examined, including patient gender, type of tumor (solid or liquid), nephrostomy, presence of a double J (DJ) stent, diabetes mellitus, length of hospital stay, and use of central lines. Statistical analysis was performed to assess associations between these variables and urosepsis. RESULTS: Males were found to be at higher risk to develop urosepsis (p: 0.039). Escherichia coli was the most commonly identified pathogen. However, none of the analyzed factors, including tumor type (p: 0.432), nephrostomy (p: 0.503), DJ stent (p: 0.325), diabetes mellitus (p: 0.637), length of hospital stay (p: 0.185), or presence of a central line (p: 0.122), showed a statistically significant association with the occurrence of urosepsis. CONCLUSIONS: This study is the first to examine urosepsis in oncology patients in Palestine. The findings highlight the increased risk for developing urosepsis in male gender; however, the other factors studied were not significant. The results cannot be generalized to all hospitalized patients as the studied population was in a tertiary hospital, and a bigger sample size is recommended for future studies to allow generalizability of the results.
A prediction model for lung involvement using circulating angiotensin converting enzyme-2 and renin levels in COVID-19 patients.
Akkan C, Daş M, Bardakci O … +5 more , Şehitoğlu MH, Akdur G, Akman C, Akdur O, Beyazit Y
J Infect Dev Ctries · 2025 Oct · PMID 41187182 · Publisher ↗
INTRODUCTION: The potential role of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of coronavirus disease 2019 (COVID-19) is controversial, with concerns mainly about the part RAAS peptides play in t...
INTRODUCTION: The potential role of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of coronavirus disease 2019 (COVID-19) is controversial, with concerns mainly about the part RAAS peptides play in the prediction of progression to more severe disease. Given the importance of COVID-19 prognostication at early disease stages, we established and validated a multivariable risk stratification tool for COVID-19 associated lung involvement by utilizing a combination of RAAS peptides. METHODOLOGY: In this prospective study, circulating renin and angiotensin converting enzyme-2 (ACE-2) levels were measured in 116 COVID-19 patients who were admitted to our hospital from March 30, 2021 to January 24, 2022 and underwent a lung computed tomography (CT) scan. Clinical severity was measured with a national early warning score (NEWS). Associations among RAAS peptides, inflammation-dependent biomarkers, demographic variables, and clinical outcomes were studied using logistic regression and Cox proportional-hazards models. RESULTS: We assessed 116 COVID-19 patients (mean age 45.1 ± 12.6 years; 51.7% male), of whom 66 (56.9%) had COVID-19 associated pneumonia. Baseline circulating ACE-2 (2.63 ± 0.12 ng/mL) and renin levels (85.04 ± 6.8 ng/L) were lower in patients with COVID-19 related pneumonia compared to patients without pneumonia (6.4 ± 0.7 ng/mL and 211.6 ± 21.9 ng/L, respectively) (p < 0.001 for both). Both RAAS components were found to be significantly related to adverse outcomes, including COVID-19 associated pneumonia and intensive care unit (ICU) admission, in both crude and adjusted multivariable logistic regression analyses. CONCLUSIONS: Circulating ACE-2 and renin levels can predict lung involvement in COVID-19 patients, and they display good correlation and agreement with NEWS.
Omadacycline treatment of severe Chlamydia psittaci pneumonia with septic shock diagnosed via metagenomic next-generation sequencing.
Xu P, Huang Z
J Infect Dev Ctries · 2025 Oct · PMID 41187181 · Publisher ↗
INTRODUCTION: Parrot fever, caused by Chlamydia psittaci, is a zoonotic disease typically treated with tetracyclines. Omadacycline, a novel aminomethyl tetracycline, has limited reports on its efficacy in severe Chlamydi...
INTRODUCTION: Parrot fever, caused by Chlamydia psittaci, is a zoonotic disease typically treated with tetracyclines. Omadacycline, a novel aminomethyl tetracycline, has limited reports on its efficacy in severe Chlamydia psittaci pneumonia in the literature. CASE PRESENTATION: We present a case of a patient with severe Chlamydia psittaci pneumonia showing symptoms of chills, high fever, shock, hepatic and renal insufficiency, and acute respiratory failure with copious yellow watery sputum. Chlamydia psittaci was confirmed by metagenomic next-generation sequencing (mNGS). Despite initial treatment with moxifloxacin and doxycycline, the patient did not improve and was subsequently discharged after receiving omadacycline. CONCLUSIONS: Our findings highlight the potential of mNGS for rapid diagnosis of Chlamydia psittaci pneumonia and suggest omadacycline as a potential therapeutic option for severe cases that do not respond to conventional treatment.
A rare case of intravesical and urethral cystic Echinococcosis with multi-organ involvement from Türkiye.
Tuna A, Topbaş E
J Infect Dev Ctries · 2025 Oct · PMID 41187180 · Publisher ↗
INTRODUCTION: Cystic echinococcosis is a parasitic disease recognized as a global public health problem in countries engaged in agriculture and animal husbandry. In natural life cycle, ungulates are intermediate hosts: c...
INTRODUCTION: Cystic echinococcosis is a parasitic disease recognized as a global public health problem in countries engaged in agriculture and animal husbandry. In natural life cycle, ungulates are intermediate hosts: canids are definitive hosts. It could be accidentally transmitted to humans by the fecal-oral route and migrate to the liver and other visceral organs to form cystic echinococcosis. It spreads hematogenously, lymphatically, and locally. The majority of initially asymptomatic patients develop liver and lung involvement. Involvement of other organs is rare. Cystic echinococcosis is a disease diagnosed by radiologic imaging and confirmed by histopathology, serologic, and molecular tests that can be used for diagnosis and follow-up primary and secondary infections. In this case report, the involvement of multiple and rare organs of cystic echinococcosis is presented. CASE PRESENTATION: An 82-year-old patient was admitted to the hospital with an inability to urinate. A glob vesicle was detected during examination, and urine output was achieved through urinary catheterization. Imaging techniques revealed multiple cysts in the abdomen, ureter, and bladder. Urine flow in ureter orifice was obstructed by cysts. Cystectomy was performed for the intraabdominal, intravesical, and ureteral cysts. Perioperative albendazole treatment was started as adjuvant and antiparasitic treatment was completed for one month. The case was confirmed histopathologically, and no secondary infection or complication was detected in one-year follow-up. CONCLUSIONS: By a multidisciplinary approach, the 82-year-old patient was diagnosed with Cystic echinococcosis, with a rare and multi-organ involvement, given the high risk of infection due to the environmental contamination in this country.
Interleukin-6 as a biomarker of sepsis and its clinical utility in predicting mortality: a prospective observational study.
Ameen SS, Hegde S, Parida A … +2 more , Kateel R, V M
J Infect Dev Ctries · 2025 Oct · PMID 41187179 · Publisher ↗
INTRODUCTION: Majority of patients admitted to intensive care units (ICUs) succumb to sepsis and its complications. However, currently available predictors fail to reliably gauge the severity of organ damage. There is a...
INTRODUCTION: Majority of patients admitted to intensive care units (ICUs) succumb to sepsis and its complications. However, currently available predictors fail to reliably gauge the severity of organ damage. There is a pressing need to identify biomarkers that can accurately forecast outcomes. Interleukin-6 (IL-6) has emerged as a potential biomarker, with some studies suggesting its utility as an early predictor of multi-organ failure in sepsis. This study evaluated the role of IL-6 in predicting mortality in an Indian ICU setting. METHODOLOGY: This prospective observational study included adult patients diagnosed with sepsis and a quick SOFA score ≥ 2. IL-6 levels, SOFA scores, and other clinical parameters were measured within 24 hours of admission. Univariate and multivariate analyses identified factors associated with mortality. RESULTS: The overall ICU mortality rate was 39%. Multivariate analyses indicated that IL-6 levels, total SOFA scores, and number of antibiotics used were independently associated with mortality. The IL-6 levels showed strong positive correlations with the total SOFA score (r = 0.77, p < 0.001) and individual organ dysfunction scores; particularly in cardiovascular (r = 0.61, p < 0.001), renal (r = 0.64, p < 0.001), and central nervous system (r = 0.6, p < 0.001). CONCLUSIONS: IL-6 levels, in combination with SOFA scores, provide a robust predictor of mortality in sepsis patients. The strong correlation between IL-6 levels and organ dysfunction scores suggests its potential as a biomarker for sepsis severity and progression.
Evaluation of bacterial pathogens and their antibiotic resistance on surfaces in the Mohammed V hospital, Al-Hoceima, Morocco.
Abourrich M, Mourabit N, El Barghmi R … +3 more , Boussa S, Ghalit M, El Ouarghi H
J Infect Dev Ctries · 2025 Oct · PMID 41187178 · Publisher ↗
INTRODUCTION: The hospital environment is an important source of nosocomial infections. Surfaces in the hospital facilities may be considered as microbial reservoirs that can cause patient contamination. This study aimed...
INTRODUCTION: The hospital environment is an important source of nosocomial infections. Surfaces in the hospital facilities may be considered as microbial reservoirs that can cause patient contamination. This study aimed to evaluate the microbiological quality of surfaces and equipment in the Mohammed V Hospital, located in Al-Hoceima, Morocco. METHODOLOGY: A total of 360 samples of surfaces were collected by swabbing from 5 service departments (intensive care unit (ICU), maternity, neonatology, operating room, and pediatric) over a period of 1 year (January-December 2021). The samples were analyzed at the provincial public health laboratory of Al-Hoceima. Isolation and identification of bacteria were performed according to conventional bacteriology methods. RESULTS: The results indicated that 34.4% (124/360) samples were contaminated. The ICU was the most contaminated service and the frequency of contaminated samples was 50%. The most contaminated sampling sites were soap for hand washing (27.4%), trolleys (25.8%), and sinks (22.6%). Gram-positive bacteria represented 51.6% of the contaminants. The most isolated bacteria were Staphylococcus aureus (50%), followed by Klebsiella pneumoniae (23.5%), and Pseudomonas aeruginosa (12.4%). Extended spectrum beta lactamase-producing Enterobacteriaceae represented 31.7% of the contaminants. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 17.6% of the contaminants. CONCLUSIONS: This study provided important data that can guide the nosocomial infection control committee to manage the risks related to contaminated hospital surfaces through the establishment of an adequate risk analysis strategy.
Low sensitivity of African Swine Fever active surveillance efforts in Serbia.
Milićević V, Dietze K, Glišić D … +4 more , Šolaja S, Veljović L, Maksimović Zorić J, Dačić M
J Infect Dev Ctries · 2025 Sep · PMID 41060742 · Publisher ↗
INTRODUCTION: African Swine Fever (ASF) poses a significant threat to swine populations and the global pork industry. Effective surveillance is critical for early detection and control of the disease. However, active sur...
INTRODUCTION: African Swine Fever (ASF) poses a significant threat to swine populations and the global pork industry. Effective surveillance is critical for early detection and control of the disease. However, active surveillance programs may face challenges in sensitivity, particularly in regions like Serbia, where ASF is an emerging concern. METHODOLOGY: This study evaluated the sensitivity of active surveillance efforts for ASF in Serbia, focusing on sampling strategies, diagnostic methods, and data analysis. Surveillance activities included field sampling in high-risk areas, testing of domestic pigs and wild boars, and assessment of diagnostic accuracy for early detection. RESULTS: The analysis revealed low sensitivity in the current active surveillance framework, attributed to suboptimal sampling density, limited diagnostic reliability, and logistical constraints in high-risk regions. These limitations potentially delay ASF detection, increasing the risk of disease spread and complicating control measures. CONCLUSIONS: Enhancing ASF surveillance in Serbia requires improving sampling strategies, deploying advanced diagnostic tools, and addressing logistical challenges to increase detection sensitivity and safeguard the swine industry.
Acute viral gastroenteritis following rotavirus vaccine implementation in Venezuela: Is rotavirus still a cause for concern?
Zerpa J, Maldonado AJ, Sulbaran MZ … +5 more , Jorquera A, Fernández R, Rosales RE, Gatto M, Vizzi E
J Infect Dev Ctries · 2025 Sep · PMID 41060741 · Publisher ↗
INTRODUCTION: Acute gastroenteritis (AGE) remains a major public health concern for the pediatric population. Diarrheal surveillance in Venezuela following the implementation of the rotavirus vaccines has been discontinu...
INTRODUCTION: Acute gastroenteritis (AGE) remains a major public health concern for the pediatric population. Diarrheal surveillance in Venezuela following the implementation of the rotavirus vaccines has been discontinuous, resulting in a lack of knowledge of the true epidemiological burden. This study investigated retrospectively the occurrence of enteropathogenic virus infections and potential changes in the etiological pattern of diarrheal disease in Venezuelan children during the post-vaccination period. METHODOLOGY: Stool samples from 150 children with AGE and 148 controls under five years old collected in 2012-2013, were analyzed using molecular assays by rotavirus, norovirus, human adenovirus, human astrovirus, and Aichi virus. Clinical and sociodemographic associations were assessed. RESULTS AND CONCLUSIONS: At least one virus was found in 66 (44%) of the children with AGE, and in 12 (8.1%) of the control group (p < 0.0001), mostly under 24 months old. Norovirus and rotavirus prevailed significantly in the AGE group (19.3% and 18%, respectively) compared to the control group (4.7% and 0%, respectively) (p < 0.001). Astrovirus, adenovirus, and Aichi virus were found in 5.3% or less of the children. Malnutrition, lack of breastfeeding, absence of rotavirus vaccination, and lower socioeconomic status were more frequent among AGE children than in controls (p = 0.014). This study suggests that rotavirus continued circulating widely even after vaccine introduction. It emphasizes the importance of norovirus and other viruses (adenovirus, astrovirus, and Aichi virus) as potentially emerging causes of pediatric diarrhea. Future strategies for precise health management and prevention of viral diarrhea should include surveillance using molecular methods alongside sanitation efforts and measures to reduce poverty and malnutrition.
Impact of drainage strategies on recovery in Stage III tuberculous empyema: a retrospective study.
Xu J, Chen Y, Gong C … +1 more , Liu H
J Infect Dev Ctries · 2025 Sep · PMID 41060740 · Publisher ↗
INTRODUCTION: Tuberculous empyema, a severe complication of pulmonary tuberculosis, often requires surgical intervention in stage III to remove fibrotic tissue and restore lung function. METHODOLOGY: This retrospective s...
INTRODUCTION: Tuberculous empyema, a severe complication of pulmonary tuberculosis, often requires surgical intervention in stage III to remove fibrotic tissue and restore lung function. METHODOLOGY: This retrospective study enrolled 224 stage III tuberculous empyema patients undergoing single-port thoracoscopic decortication and closed chest drainage. Patients were divided into three groups: Single-Tube group (n = 42), Double-Tube group (n = 51), and Double-Tube with Negative Pressure (Double-NP) group (n = 131, with -8 to -10 cm H₂O negative pressure applied from postoperative day 2). Primary outcomes included postoperative drainage volume, chest tube duration, hospital stay, complications, and Visual Analog Scale (VAS) pain scores. Data were analyzed using Analysis of Variance (ANOVA), chi-square tests, and multivariate regression. RESULTS: Baseline characteristics were comparable across groups. Postoperative drainage volumes were similar, but chest tube duration and hospital stay were significantly shorter in the Double-Tube and Double-NP groups compared to the Single-Tube group (p < 0.05). The Double-NP group exhibited lower rates of persistent air leak, pleural effusion, atelectasis, and reintubation (p < 0.05). VAS scores were significantly lower in the Single-Tube group than in the Double-Tube and Double-NP groups (p < 0.01). CONCLUSIONS: While the double-tube with delayed low-negative-pressure drainage strategy did not reduce postoperative pain, it significantly shortened chest tube duration and hospital stay while reducing complications, thereby improving overall prognosis in stage III tuberculous empyema patients.
Etiology of diarrhea among children under five years in Thai Binh, Vietnam: a prospective study.
Tran XD, Dao TL, Hoang VT … +9 more , Goumballa N, Vu TT, Tran TK, Pham HH, Nguyen DC, Nguyen TB, Parola P, Marty P, Gautret P
J Infect Dev Ctries · 2025 Sep · PMID 41060739 · Publisher ↗
INTRODUCTION: In developing countries like Vietnam, childhood diarrhea remains frequent and is often treated empirically without an etiological diagnosis. METHODOLOGY: Patients aged under five years, hospitalized at a ga...
INTRODUCTION: In developing countries like Vietnam, childhood diarrhea remains frequent and is often treated empirically without an etiological diagnosis. METHODOLOGY: Patients aged under five years, hospitalized at a gastroenterology department with acute diarrhea, were recruited at one hospital. Enteric pathogens were tested by real-time PCR. RESULTS: 451 children with diarrhea were included, 65.2% were male. 56.3% were aged under 12 months. Upon inclusion, 49.7% (224/451) had nausea and vomiting, and 17.5% had bloody diarrhea. 27.1% of children had a fever, and 37.7% and 4.2% had moderate and severe dehydration, respectively. Almost all patients (437/451, 96.9%) received empirical antimicrobial treatment. 76.5% of children were positive for at least one pathogen, with 37.9% positive for two to four pathogens. Adenovirus, norovirus, and enterovirus were the most frequent viruses detected, with a proportion of 35.7%, 25.7%, and 20.6%, respectively, while Campylobacter jejuni was the most frequent bacterium detected (14.2%), followed by Salmonella spp. and Escherichia coli pathotypes. Male gender, patients positive for at least one virus, and rotavirus were associated with an increased risk of severe disease (OR = 1.55, p = 0.04, OR = 2.23, p < 0.001, and OR = 1.86, p = 0.03, respectively). CONCLUSIONS: These findings underscore the complex interplay of viral and bacterial pathogens in pediatric diarrheal illness and highlight the need for targeted interventions focusing on appropriate diagnostic strategies, antimicrobial stewardship, and gender-specific considerations to mitigate the burden of childhood diarrhea in resource-limited settings like Vietnam.
Investigation of synergic activity of ceftazidime and colistin, and the effect of baicalin on biofilms.
Biyik İ, Tanriverdi Çayci Y, Birinci A
J Infect Dev Ctries · 2025 Sep · PMID 41060738 · Publisher ↗
INTRODUCTION: The objectives of this study were to determine the rates of biofilm formation by Pseudomonas aeruginosa (n: 136) isolates from different samples collected from intensive care patients; and to determine the...
INTRODUCTION: The objectives of this study were to determine the rates of biofilm formation by Pseudomonas aeruginosa (n: 136) isolates from different samples collected from intensive care patients; and to determine the synergistic effects of the combination of ceftazidime and colistin, and the inhibitory effect of baicalin on biofilm formation in strong biofilm-producing bacteria (3+). METHODOLOGY: Previous studies have performed biofilm grading based on microplate absorbance measurement to phenotype the biofilm formation rate. The in vitro synergistic efficacy of the combination of colistin and ceftazidime was evaluated using the checkerboard method for strains with 3+ biofilm test results. In addition, sub-minimum inhibitory concentration (sub-MIC; MIC/2, MIC/4, MIC/8) values of the biofilm inhibitory effect of baicalin were determined. RESULTS: The biofilm microplate method identified 5.15% of the isolates producing strong (3+) biofilms. Baicalin inhibited biofilm formation by 67.00-90.64% at sub-MIC concentration of 512 µg/mL, in 7 strong biofilm-producing isolates. These findings suggest that baicalin is a potential adjunctive therapy for disrupting biofilms, although the combination of ceftazidime and colistin may not be effective in this context. CONCLUSIONS: No synergistic effect of ceftazidime and colistin antibiotics was detected in high biofilm-producing P. aeruginosa isolates from an intensive care unit, and it was determined that certain concentrations of baicalin were effective in biofilm formation.
Routine hemoglobin-A1c screening is required before the next pandemic to reduce morbidity and in-hospital costs.
Saygideger Y, Candevir A, Curuk B … +7 more , Altunok E, Sancioglu Demir M, Güzel E, Ozyilmaz E, Baydar Toprak O, Kuscu F, Kuleci S
J Infect Dev Ctries · 2025 Sep · PMID 41060737 · Publisher ↗
INTRODUCTION: Glycosylated hemoglobin (HbA1c) levels are routinely used in secondary and tertiary care centers for monitoring diabetes patients. However, since it is an expensive test, it is not routinely tested in prima...
INTRODUCTION: Glycosylated hemoglobin (HbA1c) levels are routinely used in secondary and tertiary care centers for monitoring diabetes patients. However, since it is an expensive test, it is not routinely tested in primary care or used as a screening test. This study aimed to examine the relationship between HbA1c levels and in-hospital costs in hospitalized patients during the pandemic period to draw attention to the issue and to be prepared for future pandemics. METHODOLOGY: The design of the study was retrospective and cross-sectional. The study was conducted in a tertiary hospital between March and December 2020. Independent variables, including HbA1c levels, comorbidities, age, and gender; and dependent variables including in-hospital costs, prolonged hospital stay (≥ 14 days), and 30-day mortality; were statistically analyzed. RESULTS: Overall, 517 patients were included in the study, and 96 of them had high HbA1c levels (HbA1c ≥ 7). The in-hospital costs were significantly correlated with HbA1c ≥ 7 as continuous variables, and HbA1c ≥ 7 was a better indicator of in-hospital costs compared to the diagnosis of diabetes. Patients with HbA1c ≥ 7 also had prolonged hospital stays and higher mortality rates, in addition to high in-hospital costs. CONCLUSIONS: Routine testing of HbA1c levels might be cost-effective and should be performed at primary healthcare facilities.
A meta-analysis of the correlation between carbapenem antibiotic use and the incidence of carbapenem-resistant Pseudomonas aeruginosa.
Tang C, Mei Y, Fang H … +2 more , Wang W, Lv M
J Infect Dev Ctries · 2025 Sep · PMID 41060736 · Publisher ↗
INTRODUCTION: This meta-analysis evaluates the correlation between carbapenem antibiotic use and the incidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA). METHODOLOGY: A comprehensive literature search conduct...
INTRODUCTION: This meta-analysis evaluates the correlation between carbapenem antibiotic use and the incidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA). METHODOLOGY: A comprehensive literature search conducted across multiple databases yielded seven clinical experimental studies involving 4,417 patients. The primary outcomes assessed were the risk factors associated with CRPA infection, drug resistance rates, and the comparison of resistance rates between meropenem (MEM) and imipenem (IPM). The Newcastle-Ottawa Scale (NOS) was used to assess study quality, and Egger's test and funnel plots were used to assess publication bias. RESULTS: The NOS scores for the included studies ranged between 6 and 8, indicating their generally high quality. The analysis indicated that prior carbapenem use significantly increased the risk of CRPA infection (OR = 1.866, 95% confidence interval [CI]: 1.164-2.993, p = 0.010). The drug resistance rates of P. aeruginosa to carbapenems ranged between 21.07% and 37.90%. There was no significant difference in drug resistance rates between MEM and IPM (risk ratio = 1.09, 95% CI: 0.99-1.21, p = 0.517). CONCLUSIONS: With drug resistance rates between 21.07% and 37.90%, these findings suggest that carbapenem use is associated with an increased risk of CRPA infection, highlighting the need for the judicious use of these antibiotics in clinical practice.
Decreased albumin to INR ratio is a prognostic marker of 30-day mortality in neonatal sepsis: a retrospective study.
Tu X, Chen J, Liu W
J Infect Dev Ctries · 2025 Sep · PMID 41060735 · Publisher ↗
INTRODUCTION: Neonatal sepsis is a leading cause of neonatal mortality. This study aims to assess the clinical significance of the serum albumin (ALB) to international normalized ratio (INR) ratio (AIR) as a predictor fo...
INTRODUCTION: Neonatal sepsis is a leading cause of neonatal mortality. This study aims to assess the clinical significance of the serum albumin (ALB) to international normalized ratio (INR) ratio (AIR) as a predictor for 30-day mortality in neonates with sepsis. METHODOLOGY: Neonates diagnosed with sepsis between January 2019 and December 2022 were included. Admission data were collected, enabling the categorization of neonates into survival and non-survival groups. Logistic regression analyses and receiver operating characteristic (ROC) curves, were employed. RESULTS: A total of 195 neonates with sepsis were analyzed. The non-survival group exhibited significantly lower AIR compared to the survival group. Multivariate analysis identified low AIR as an independent risk factor (hazard ratio [HR]: 9.091, p < 0.001), achieving an area under the curve (AUC) of 0.746 for AIR. The sensitivity and specificity of AIR were 79.31% and 66.87%, respectively. CONCLUSIONS: AIR serves as a cost-effective and easily obtainable marker in neonatal sepsis research. It emerges as an independent predictor of adverse outcomes in neonatal sepsis, demonstrating good predictive capabilities.
Whole genome sequencing and analysis of the clinical implications of SARS-CoV-2 strains.
Soyak F, Sari T, Tokgun O … +2 more , Caliskan A, Turgut H
J Infect Dev Ctries · 2025 Sep · PMID 41060734 · Publisher ↗
INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that emerged shortly after the coronavirus disease 2019 (COVID-19) pandemic began have altered epidemiological and clinical findings...
INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that emerged shortly after the coronavirus disease 2019 (COVID-19) pandemic began have altered epidemiological and clinical findings; and these variants changed the course of this health crisis. METHODOLOGY: Whole-genome sequencing was performed on SARS-CoV-2 strains isolated from 21 patients with COVID-19. The frequency of structural changes in the virus and their effects on clinical findings of the disease were analyzed. RESULTS: The spike Q493R mutation was detected more frequently in patients who had received four or more doses of a COVID-19 vaccine (p = 0.043). The clinical effect of the spike R346K and A263T mutations (reported in Türkiye for the first time) detected in a patient who had received four doses of the vaccine in the 3 months prior to being infected with COVID-19 could be related to escape from the antibody response. The spike R21T mutation may increase the virus's entry into intestinal cells; and, as a result it may be responsible for severe clinical course and gastrointestinal symptoms. The patient infected with the Omicron BA.2 subvariant with the spike L452M mutation exhibited a significant increase in inflammatory parameters; suggesting that this mutation may trigger an excessive immune response and hyperinflammation. CONCLUSIONS: This is the first study based in Türkiye that evaluated the clinical impact of variations in the sequences of SARS-CoV-2 variants. There is a need for further investigation into the clinical impact of these results in a larger population spread over more centers, and more sequencing studies.
Comprehensive insights into pediatric infectious mononucleosis: a retrospective study.
Wang C, Saboor S, Zhang Y … +2 more , Li G, Jiang C
J Infect Dev Ctries · 2025 Sep · PMID 41060733 · Publisher ↗
INTRODUCTION: The objectives of this study were to identify clinical and laboratory markers of infectious mononucleosis (IM) in children, investigate the risk factors for liver damage and prolonged hospitalization, and e...
INTRODUCTION: The objectives of this study were to identify clinical and laboratory markers of infectious mononucleosis (IM) in children, investigate the risk factors for liver damage and prolonged hospitalization, and enhance Epstein-Barr virus (EBV) diagnostic precision. METHODOLOGY: This retrospective study analyzed 288 pediatric IM cases hospitalized from January 2023 to December 2024. Clinical features, laboratory parameters, and EBV-DNA loads were evaluated using statistical analyses to identify predictors of disease severity and outcomes. RESULTS: Among the 288 children (median age: 5 years; 48.3% male), fever, cervical lymphadenopathy, creatine kinase (CK), IgM, and CD4/CD8 ratios were significantly associated with high EBV-DNA load. Liver damage (35.1% of cases) correlated with age, splenomegaly, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH), ferritin, and immune markers (p < 0.05). Prolonged hospitalization was associated with hepatomegaly, ALT, AST, GGT, LDH, and ferritin levels (p < 0.05). Multivariate analysis identified fever as a predictor of high EBV-DNA load; while age, LDH, and ferritin were independent risk factors for liver damage. Hepatomegaly was a key predictor of extended hospitalization (p < 0.05). CONCLUSIONS: IM predominantly affected children aged 3-7 years in Hangzhou. Fever predicted high EBV-DNA load, while elevated LDH, ferritin, and hepatomegaly signaled increased risks of liver damage and prolonged hospitalization, informing more precise management strategies.
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