Epidemiology,risk factors and antimicrobial profile of Vulvovaginal Candidiasis (VVC): A study among women in the central region of Saudi Arabia

BackgroundCandida spp. is a fungal resident of the normal microbiota of gastrointestinal tract, reproductive mucosa and oral cavity. Hence, a majority of the healthy population may be prone to the most common fungal infection such as candidiasis that can be caused by any species of Candida. In women, vaginitis or vulvovaginal candidiasis (VVC) forms a significant part of urogenital infections with a high recurrence rate thus posing a public health issue worldwide.ObjectivesThe aim of this study was to determine the prevalence of VVC, its possible risk factors and the antifungal susceptibility of the species isolated from women attending a hospital in the central region of Saudi Arabia.MethodsSamples of high vaginal swabs (HVS) were obtained from 208 women aged 15–64 years with signs and symptoms of VVC. The samples were cultured on Sabouraud agar plates (SDA) and incubated at 30 °C for 10 days. Candida spp. were initially identified using morphologic characteristics, wet mount, germ tube test and finally confirmed with Vitek 2.ResultsAmong the samples, 34% were culture positive. Out of the positive samples, 68% were Candida albicans, followed by C. tropicalis (27%) and C. glabrata (2.7%). Majority of the C. albicans (16%) were observed in women between ages of 21–30 years. All the isolates were sensitive to the antifungals tested. Also, the presence of Candida spp. did not correlate to risk factors such as pregnancy, diabetes and use of antibiotics.ConclusionsPrevalence of vulvovaginal candidiasis was observed in the central region of Saudi Arabia with the predominant organism as Candida albicans.     

Prevalence of group B streptococcal colonization in the healthy non-pregnant population: a systematic review and meta-analysis

BackgroundColonization and transmission precede invasive group B streptococcal (GBS) disease. Data on GBS colonization prevalence, detection methods and risk factors for carriage are relevant for vaccine development and to understand GBS pathogenesis.ObjectivesTo evaluate GBS colonization prevalence after the first week of life in the healthy non-pregnant population.Data sourcesPubmed/Medline, Embase, Latin American and Caribbean Health Sciences Literature, World Health Organization Library Information System, and Scopus. Search performed 12 January 2021 with search terms related to ‘GBS’ and ‘colonization, epidemiology, prevalence or screening’ without restrictions.Study eligibility criteriaAll studies that reported prevalence of GBS colonization (any site) in the healthy population.ParticipantsAll individuals (>6 days of age), with no indication of pregnancy, invasive disease or severe underlying immunological co-morbidities.MethodsLogit transformation and a random effects model (DerSimonian and Laird) were used to pool colonization estimates. Subgroup analysis and meta-regression on a priori determined subgroups were performed.ResultsWe included 98 studies with 43 112 participants. Our search identified 9309 studies of which 8831 were excluded based on title and abstract and 380 after reading the full text. Colonization rates varied considerably between studies (I² = 97%), which could be partly explained by differences in culture methods (R² = 27%), culture sites (R² = 24%), continent (R² = 10%) and participant's age (R² = 6%). Higher prevalence was found with selective culture methods (19%, 95% CI 16%–23% versus non-selective methods 8%, 95% CI 6%–9%; p < 0.0001). Colonization rates were highest in rectum (19%, 95% CI 15%–24%), vagina (14%, 95% CI 12%–17%) and urethra (9%, 95% CI 5%–18%). In participants with negative rectal cultures, 7% (95% CI 5%–9%) had GBS cultured from another niche. Colonization prevalence was lower in children (6 months to 16 years; 3%, 95% CI 2%–5%) compared with adults (16%, 95% CI 14%–20%; p < 0.0001). Using selective culture methods in adults resulted in a prevalence of 26% (95% CI 19%–33%) rectal, 21% (95% CI 17%–25%) vaginal and 9% (95% CI 6%–14%) urethral colonization.ConclusionThe rectum is the most common body site colonized by GBS. The best approach to screen for any GBS colonization is to screen multiple body sites using selective culture methods.     

Antifungal susceptibility,species distribution and risk factors associated with mortality of invasive candidiasis in children in Turkey: A six-year retrospective,single-centre study

Invasive candidiasis (IC) is a life-threatening fungal infection with high morbidity and mortality. In this study, we aimed to investigate the Candida species distribution and antifungal drug susceptibility and to identify the risk factors associated with IC mortality in children. We conducted a retrospective, single-centre study of paediatric IC in patients from a tertiary care hospital in Turkey between January 2013 and February 2019. A total of 56 Candida isolates underwent antifungal susceptibility testing performed by Sensititre YeastOne YO10 panel, and the demographic and clinical data of 65 patients were examined during the study period. The most commonly isolated species was Candida albicans in 30 patients (46%), followed by C. parapsilosis in 25 patients (38%) and C. tropicalis in three patients (5%). According to the antifungal drug susceptibility testing, C. albicans was fully susceptible to fluconazole and the other antifungal agents (100%). None of the isolates displayed resistance to anidulafungin, micafungin, flucytosine, posaconazole, voriconazole or itraconazole. There were low rates of resistance to fluconazole (1.8%), caspofungin (1.8%) and micafungin (1.8%). In addition, 5.3% of the Candida isolates were susceptible in a dose-dependent manner to itraconazole, 3.6% were susceptible to voriconazole and fluconazole and 1.8% were susceptible to anidulafungin. The mortality rate of IC was 15.4%. Thrombocytopenia after IC treatment was significantly associated with mortality in the multivariate analysis. These results, which help determine the species distribution, antifungal susceptibility patterns and risk factors for mortality, could make a significant contribution to the management of these challenging infections, including choosing appropriate empirical antifungal therapy.     

The importance of strain variation in virulence of Candida dubliniensis and Candida albicans: results of a blinded histopathological study of invasive candidiasis

The pathogenic yeast Candida dubliniensis is increasingly reported as a cause of systemic fungal infections. We compared the virulence of 9 clinical bloodstream isolates of C. dubliniensis with 3 C. albicans isolates in a murine model of invasive candidiasis. Quantification of organisms and inflammatory changes in kidneys of infected animals were evaluated in a blinded, systematic manner. Average 7-day mortality among animals infected with C. dubliniensis was 21.0% (33/157 animals; range for strains: 0–57.1%); and with C. albicans 23.2%, (23/99 animals; range for strains: 6.7–85.0%) (p 0.65). Greater strain variation was noted within species than between the two species. Both species comprised strains of either high or low virulence, and six of the nine C. dubliniensis strains showed negligible virulence. Colony counts determined on samples from liver and kidneys did not differ between species. According to histopathological analysis, C. dubliniensis produced significantly lower levels of hyphae than C. albicans (p <0.001). Candida albicans caused a greater inflammatory response in kidneys (p <0.001) and was more commonly associated with granulomatous inflammation (p 0.003) and greater mononuclear infiltrate (p <0.001). According to multivariate analysis, increasing tissue burden of both hyphal forms (p 0.032) and yeasts (p 0.016) was independently associated with death, whereas higher levels of mononuclear cells were protective (p <0.001). The results suggest a great overlap between the virulence properties of C. dubliniensis and C. albicans . Both yeast and hyphal forms are independently associated with mortality, suggesting similar virulence for both. The source of the fungal isolates may be a neglected confounding factor in virulence studies in animal models.     

Prevalence and associated factors of HIV-TB co-infection among HIV patients: a retrospective Study

BackgroundTB/HIV co-infection is a major public health problem in many parts of the world. But the prevalence of co-infection was varies among countries.This study was designed to assess prevalence of TB/HIV co-infection and to determine its factors.MethodsA retrospective study was done among HIV-positive patients at Hiwot Fana hospital from December, 2014 to 2018. The study participants were selected by simple random sampling. Patients with incomplete chart reviews were excluded and demographic, clinical and laboratory information were analyzed using SPSS and STATA. Uni-vitiate and bivariate logistic regressions were applied.ResultsFive hundred fourteen patients were enrolled in this study. Of these, 187(37.4%) had TB. Bivariate logistic analysis showed that HIV patients with regards to marital status[AOR = 2.6; 95%CI = 1.19–2.89], education status [AOR = 3.74; 95%CI = 2.47–5.66], weight less than 50kg [AOR = 2.54; 95% CI = 1.35 – 4.81], CD4 level < 200cells/mm³ [AOR = 4.57; 95%CI = 2.38– 6.86] and patient who were at WHO clinical stage III [AOR = 7.8; 95%CI = 5.15 – 8.55] were significantly associated with TB/HIV co-infection.ConclusionThe prevalence of TB among HIV patients was high and predicted by marital, education status, weight, CD4 cell count and WHO clinical stage III.     

Prevalence of disability and associated social and health-related factors among the elderly in Spain: a population-based study

Objectives: To estimate the prevalence of disability and its association with morbidity and other social and health-related factors among Spain’s non-institutionalized elderly population. Methods: Cross-sectional survey, by home-based personal interview, covering a sample of 4000 subjects representative of the non-institutionalized Spanish population aged 60 years and over. The relationship between disability and social and health-related study variables was studied using logistic regression. Results: A total of 72.9% of subjects reported some type of disability: 59.1% in agility, 51.6% in mobility, 40.1% in instrumental activities and 19.1% in activities of daily living. After adjusting for all relevant variables, disability showed to be significantly more frequent for: female gender (OR=1.83; 1.53–2.19); more advanced age (OR=4.54; 3.27–6.32); low/no educational level (OR=2.01; 1.67–2.42); deteriorated cognitive status (OR=1.67; 1.24–2.23); at least two chronic diseases (OR=2.54; 2.01–3.20); poor perceived health status (OR=3.02; 2.48–3.69); little physical activity (OR=2.57; 1.94–3.42); and greater use of hospital care (OR=1.34; 1.10–1.64). Conclusions: Prevalence of disability among Spain’s non-institutionalized elderly population is very high. This might be explained by a greater number of chronic diseases, a higher percentage of subjects with low educational level and a higher proportion of community-dwelling elderly persons than in Anglo-Saxon countries.     

Prevalence and clinical predictors of pulmonary tuberculosis among isolated inpatients: a prospective study

Guidelines help to prevent the transmission of Mycobacterium tuberculosis in healthcare settings, but may also result in the unnecessary isolation of many patients. We performed a prospective study to assess the prevalence and identify clinical predictors of culture-proven tuberculosis among inpatients isolated for suspected pulmonary tuberculosis (PTB) at our hospital. We also wished to validate a preexisting clinical decision rule to improve our isolation policy. From August 2005 to January 2007, 134 patients isolated on admission to the ward for suspicion of PTB were prospectively enrolled. The admitting team made the decision to isolate patients on the basis of clinical and radiological findings, without the use of the clinical decision rule, and graded the overall suspicion of PTB. Twenty-six of the 134 isolated patients had PTB (prevalence: 19.4%), as well as one patient not isolated at admission. Univariate analysis revealed that PTB was significantly associated with young age, lack of human immunodeficiency virus (HIV) infection, weight loss, night sweats, fever, upper lobe disease and, especially, cavitary lesions on chest X-ray (adjusted OR 25.4, p <0.0001). Low suspicion of PTB by the admitting team and low clinical decision rule score had negative predictive values of 98.5% and 95.8% for PTB, respectively. Use of the clinical decision rule in addition to the team assessment would have led to the isolation of the patient with PTB not isolated on admission, and avoided 16 (14.8%) unnecessary isolations. In conclusion, the prevalence of PTB among isolated inpatients was high, and the use of a clinical decision rule in addition to clinical impression might improve isolation decisions.     

Prevalence of complementary and alternative medicine (CAM) use by menopausal women: A systematic review of surveys

Large proportions of women have turned to complementary and alternative medicine (CAM) for relief from their menopausal symptoms. This highlights the need for more rigorous research into CAM. This article is aimed at critically reviewing surveys that examine the prevalence of CAM use by menopausal women worldwide. Eleven databases were searched for peer-reviewed surveys published in any language between 01 January 2000 and 27 October 2012. The bibliographies of the retrieved articles and relevant book chapters were also hand searched. Twenty-six surveys were identified, and they included a total of 32,465 menopausal women. The majority of these surveys were of poor methodological quality. Based on 6 surveys, 32.9% of women stated they were current/regular CAM users. Based on 9 surveys, 50.5% of women reported that they used CAM specifically for their menopausal symptoms. The average 12-month prevalence of CAM use was 47.7% (range: 33.1–56.2). Fifty-five percent of women did not disclose their use of CAM to their healthcare professional. The majority of women sought information about CAM from the media. The most popular CAM modality was herbal medicine, followed by soy/phytoestrogens, evening primrose oil, relaxation and yoga. There are a large number of predominantly low-quality surveys monitoring the prevalence of CAM use among menopausal women worldwide. The available evidence suggests that the prevalence of CAM use is high.     

Prevalence of menopausal symptoms in different ethnic groups of Asian women and responsiveness to therapy with three doses of conjugated estrogens/medroxyprogesterone acetate: the Pan-Asia Menopause (PAM) study

OBJECTIVE: To survey the prevalence of 18 menopausal symptoms in nine ethnic groups of Asian women. To evaluate responsiveness of symptoms to three estrogen/progestin doses in Asian women. DESIGN: A prospective, randomized, double-blind multinational clinical trial in 1028 healthy postmenopausal women from 11 Asian countries/regions. Following 2 weeks of baseline observations, the women received one of three conjugated estrogens (CE)/medroxyprogesterone acetate (MPA) doses (in mg) daily for 24 weeks: 0.625/2.5; 0.45/1.5; or 0.3/1.5. At baseline and throughout the study period, the women were asked to record each symptom daily on diary cards translated into 10 languages. RESULTS: The number of women in the different ethnic groups ranged from 24 (Malay) to 248 (Chinese). The overall prevalence of symptoms differed among the groups, with Vietnamese women generally reporting the highest rates. Within each ethnic group, the prevalence of individual symptoms varied substantially. Only 5% of Indonesian women, for example, reported hot flushes but 93% complained of body or joint aches/pains. Overall, body or joint aches/pains was the most prevalent symptom, ranging from 76% in Korean women to 96% in Vietnamese women. Therapy resulted in a significant decline in all symptoms. The decline was observed with all three doses after 4 weeks of treatment and continued throughout the 6-month study period. CONCLUSION: The prevalence of individual menopausal symptoms differed among ethnic groups of Asian women. Within each ethnic group the percentage of women reporting each symptom varied substantially. Symptoms declined after 4 weeks of hormone therapy and thereafter throughout the study. The effect of the lowest dose of CE/MPA (0.3/1.5 mg/day) was comparable to that of the higher doses.     

Vulvovaginal candidiasis among symptomatic women of childbearing age attended at a Medical Analysis Laboratory in Franceville,Gabon

BackgroundVulvovaginal candidiasis (VVC) is one of the most common lower genital tract infections in women; this unpleasant and extremely embarrassing pathology is one of the main reasons for gynaecological consultation. In Gabon, the prevalence of VVC remains poorly described even though VVC is known to be the leading gynaecological condition in several countries. This retrospective cross-sectional study sought to assess the prevalence of VVC among symptomatic women in southeastern Gabon.MethodsClinical samples were collected from patients suspected to have VVC during a 2-year period (from January 2016 to December 2017). Gram staining of vaginal smears provided indications of vaginal flora and confirmed the presence of yeast. Sabouraud-chloramphenicol and chromID Candida media were used to isolate yeast, and species identification was performed using morphological tests and the Vitek 2 Compact automated system.ResultsFor the 873 patients included in this study, the prevalence of VVC was 28.52%. Eleven Candida species were identified, with greater representation of Candida albicans (82.73%) than of Non C. albicans candida (NCAC) (17.27%), which were distributed as follows: Candida famata (4.02%), Candida spp. (3.61%), Candida rugosa (3.21%), Candida lipolytica (1.61%), Candida parapsilosis (1.61%), Candida glabrata (1.21%), Candida tropicalis (0.80%), Candida krusei (0.40%), Candida dubliniensis (0.40%), and Candida sphaerica (0.40%).ConclusionThis study offers the first estimation of VVC among Gabonese women in childbearing age with the symptoms. It showed that VVC is very common in Gabon. C. albicans as the most commonly represented species.     

Prevalence and genotype distribution of human papillomavirus infection among women: A population-based study in Dali Bai Autonomous Prefecture,Yunnan Province,China

Accumulating evidence indicates that persistent infection with high-risk oncogenic human papillomavirus (HPV) genotypes is the most important risk factor for cervical cancer, and that the distribution of HPV genotypes varies regionally. This study explored the prevalence and genotype distribution of HPV infection among Han, Yi, and Bai women in various regions of Dali Bai Autonomous Prefecture, Yunnan Province, China. This cross-sectional study included 2779 women (20–76 years old) who were referred for 21-HPV genotype array diagnostic from five regions of Dali Bai Autonomous Prefecture between February 2013 and May 2016. Statistical methods used included a the χ² test, Fisher's exact test, t test, and logistic regression. Overall HPV prevalence in the study population was 7.6%. HPV-52, HPV-58, HPV-18, HPV-81, and HPV-16 were the most prevalent genotypes in the study area, and notably, the prevalence of HPV-58 was significantly higher among women in Heqing County than that in other regions. Univariate analysis showed that husband's age, region, fertility status, and parity were potential factors associated with HPV infection. Multivariate logistic regression analysis revealed that Heqing County was an independent risk factor for HPV infection among women in the Dali area, moreover, Yi women showed the highest risk for HPV infections. Overall, our finding emphasizing the urgent need for an HPV screening and prevention program in Heqing County and Yi women. We also suggest that HPV-related health education should be provided not only to women, but also to men, to reduce the risk of infection in women.     

Prevalence, 1-year incidence and factors associated with urinary incontinence: a population based study of women 50–74 years of age in primary care

Objectives: To study prevalence, incidence, remissions and factors associated with urinary incontinence in women 50–74 years of age. Methods: Cross-sectional study of prevalence and associated factors and a 1-year prospective study of incidence and remissions. A random sample of 698 women were invited for a gynecological examination in general practice in three municipalities in Northern Norway in 1994–1995. Five hundred and seven (73%) met for the first consultation, 489 of them for the second one. Questionnaires were answered by women and doctors during consultations at inclusion and 1 year later. Prevalence was estimated at three levels of evidence. Results: Any leakage was reported by 47% and regularly by 31%. For 19%, leakage was objectively demonstrated and claimed to be a social or hygienic problem. Incontinence was associated with high body weight, with poor ability to contract pelvic floor muscles and with previous gynecological operations excluding hysterectomy. Three women (0.6%) developed regular incontinence during the year of investigation. There was no convincing case of spontaneous remission. Conclusion: Urinary incontinence is very frequent in women aged 50–74 years and about one in five are potential patients needing treatment. Urinary incontinence is an enduring condition with little tendency for remission without treatment.     

Epidemiology and persistence of cervical human papillomavirus infection among outpatient women in Heilongjiang province: A retrospective cohort study

As persistent carcinogenic human papillomavirus (HPV) infection is a prominent driver of cervical cancer, it is essential to explore HPV persistence and its associated factors for cancer screening and prevention. A retrospective cohort study was performed in outpatient women between March 2010 and 2019 in Heilongjiang, northeast China. HPV genotyping was performed by polymerase chain reaction-membrane hybridization. An unconditional logistic regression model was used to analyze the association of factors with persistence. The overall prevalence of HPV at baseline was 27.1%, with a downward trend from 2010 to 2019 (P < .0001). The most commonly observed high- and low-risk HPVs were HPV16 (N = 1094, 5.9%) and HPV11 (N = 596, 3.2%), respectively. The probabilities of 6-month persistence were high for women infected with HPV16 (P = .0001), HPV58 (P = .018), and HPV53 (P = .014), as well as for women with multiple infections (P = .009), and those who were 51 to 60 years old (P = .004) or more than 60 years old (P = .007). The probabilities of 12-month persistence were high for women infected with HPV53 (P = .017) and 51- to 60-year-old women (P = .044). HPV16 is the dominant HPV type in Heilongjiang. An age in the range of 51 to 60 years and infection with HPV53 is associated with HPV infection persistence in the Heilongjiang population.     

Moroccan women with a history of child sexual abuse and its long-term repercussions: A population-based epidemiological study

Summary. Childhood sexual abuse is defined as sexual contact imposed on a child whose development is still, from the emotional, cognitive and maturity point of view, lacking. The objective of this epidemiological study, conducted among a representative sample of the female population aged 20 and over in Casablanca, Morocco, is to determine the prevalence of the childhood sexual abuse and its long-term repercussions.The main results were that 9.2% (n=65) reported childhood sexual abuse. The mean age of this subgroup was 31.34±9.43 years (20–63); 66.1% were housewives; 40% were single and 10.8% were divorced. The prevalence of genital abuse with penetration was 33.8% (22 cases). The abuser was known in 56.2% and was a family member in 20.4% of the cases. Of the 728 women interviewed, 27 (43.5%) abused women and 83 (29.5%) non-abused women during childhood reported depressive symptoms with a positive association (p=0.03). There was also an association between the most severe types of abuse and vaginismus. Generally speaking, all those who were abused during their childhood suffered sexual disturbances during their adult life.     

Investigation of serotype distribution and resistance genes profile in group B Streptococcus isolated from pregnant women: a Chinese multicenter cohort study

We surveyed the group B Streptococcus (GBS) strains isolated from four teaching hospitals during 1‐year period to investigate the current serotypes and antimicrobial resistance status of these strains. A total of 231 non‐duplicate colonizing GBS isolates were collected from pregnant women. Antimicrobial susceptibility of these isolates was tested by the disk diffusion method. Serotype was performed by a multiplex polymerase chain reaction (PCR) method. Analysis of the resistance mechanisms was performed by PCR amplification and DNA sequencing. Seven serotypes (Ia, Ib, II, III, V, VI, and VIII) were identified, and the prevalence ranged from 0.9 to 35.9%. All isolates were susceptible to the penicillin, ceftriaxone, and vancomycin. The resistance of all the isolates to erythromycin, clindamycin, and levofloxacin was 61.5, 51.9, and 35.5%, respectively. The erythromycin resistance was mainly associated with the genes ermB and ermB‐mef(A/E) (69.8%). The most predominant phenotype was cMLSB (77.5%). Five gene panels, including gyrA, parC, parE, gyrA‐parC, and gyrA‐parC‐parE, were detected. The most predominant genotype was gyrA‐parC‐parE triple mutation (69.5%). The S81L in gyrA gene, S79Y mutation in parC gene, and H225Y mutation in parE gene were discovered. The isolates with serotype III, V, and Ia were the most important clone concerning the prevalence and resistance.     

Antiviral treatment with pegylated interferon and clinical outcomes in a cohort of immigrants patients affected by hepatitis delta: A retrospective analysis

Chronic hepatitis delta (CHD) is the most severe chronic hepatitis, with no satisfactory treatment options and severe clinical outcomes. This infection is frequent in the migrant subjects from endemic areas, especially from Africa and East-Europe. The pegylated (PEG)-interferon α (IFN) is limited by side effects and poor response. In this retrospective analysis, we reported our experience of treatment with PEG-IFN in a cohort of immigrant patients affected by CHD. We evaluated the virological responses are as follows: complete response (CR; clearance of hepatitis B surface antigen [HBsAg] and hepatitis D virus [HDV]-RNA), partial response (PR; HBsAg clearance with HDV-RNA+), and null response (NR; HBsAg and HDV-RNA+). Clinical outcomes were clinical stabilization, disease progression, hepatic decompensation, hepatocellular carcinoma (HCC), death, and liver transplantation. Forty-six patients were included. At the end of treatment (ET), 11 patients gained a CR (23.9%), 10 were PR (21.7%), and 16 were NR (34.8%). After 1 year, 10 remained with CR (21.7%), after 2 years, 9 (19.5%), and at 3 years, 8 (17.4%). Relapse rate was 2.2%, 4.4%, and 6.5% at year 1, 2, and 3, respectively. Favorable factors were CR at the ET (odds ratio [OR] = 4.559, 95% confidence interval [CI]: 2.219-7.116; P = 0.003), PEG-IFN course greater than 1 (OR = 1.240, 95% CI: 0.998-4.839; P = 0.012), prolonged treatment (OR = 1.276, 95% CI: 0.816-3.108; P = 0.018), quantitative hepatitis B surface antigen (qHBsAg) decline at 12 weeks greater than 0.5 log IU/mL (OR = 4.816, 95% CI: 2.190-8.194; P < 0.001). The unfavorable factors were cirrhosis (OR = 3.122, 95% CI: 1.466-4.190; P = 0.012), active hepatitis B virus (OR = 2.334, 95% CI: 1.788-3.992; P = 0.018), NR at ET (OR = 6.998, 95% CI: 5.987-11.404; P < 0001). Treatment of CHD is limited by poor virological response; is NR unfavorable outcomes were unavoidable. No other treatment options were available.     

Prevalence and trends in the antimicrobial susceptibility pattern of <Emphasis Type="Italic">Salmonella enterica</Emphasis> serovars Typhi and Paratyphi A among children in a pediatric tertiary care hospital in South India over a period of ten years: a retrospective study

The aim of this study was to determine the prevalence and trends in the antimicrobial resistance of typhoidal salmonellae in children and adolescents at a pediatric tertiary care hospital in South India. Typhoidal salmonellae were isolated from 483 of the 77,713 blood cultures received during the ten-year study period (2007–2016). Isolates were speciated by conventional biochemical reactions and serotyping. Antimicrobial susceptibility testing was performed and interpreted according to the British Society for Antimicrobial Chemotherapy (BSAC)/European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The overall blood culture isolation rates of Salmonella enterica serovars Typhi and Paratyphi A in children were 0.5% (408 cases) and 0.1% (73 cases), respectively, with the highest isolation rates in school [299 (61.9%)] and preschool children [113 (23.4%)]. A decreasing prevalence of enteric fever was seen from 2012 to 2015, with a sudden surge in 2016. From 2011 onwards, a high fluoroquinolone resistance (90–100%) was observed. Multidrug resistance was observed in only four (0.9%) S. Typhi isolates. 100% susceptibility to third-generation cephalosporins and azithromycin was noted. Enteric fever as seen in a pediatric tertiary care hospital in India affects children and adolescents of all age groups, with greater isolation rates in school children, followed by those in preschool years, calling for targeted interventions against these age groups. The study findings support the use of third-generation cephalosporins and azithromycin as first-line therapy and ampicillin and co-trimoxazole as step-down therapy in pediatric enteric fever. However, continued local surveillance should be done to detect antimicrobial resistance trends to optimize treatment.     

Prevalence of hepatitis B virus,hepatitis C virus,and human immunodeficiency virus among blood donors of Mekelle blood bank,Northern Ethiopia: A three‐year retrospective study

Blood transfusion services are a vital and integral part of modern healthcare services. However, the risk of transfusion transmittable infections (TTI) has been a major handicap. Therefore, this study was aimed at determining the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors. A retrospective study was conducted to collect data about the blood donors who consecutively donated blood from October 2011 to 2014. A three‐year retrospective study was conducted in Mekelle Blood Bank. A data abstraction format was used to collect the sociodemographic and clinical data, and the prevalence of HBV, HCV, and HIV was determined. Data were analyzed using STATA version 10 analytical software. P value less than 0.05 was considered significant in all the analyses. A total of 10 728 blood donors, median (interquartile range) of age 30 (23‐45) years and 3750 (34.9%) males were enrolled in this study. Of the participants 407(3.79%), 143(1.33%), and 111(1.03%) blood donors were positive for HBV, HCV, and HIV, respectively. HBV‐HIV coinfections were found 10 (1.93%) blood donors, followed by HBV‐HCV and HIV‐HCV. A significant association between sex and marital status with HBV and HIV infection was found. However, significant association of HCV was observed among sex ( X ² = 33.18, P < 0.001) and occupational ( X ² = 84.33, P < 0.001). A significant percentage of HBV, HCV, and HIV among blood donors was observed. To select a donor and collect safe blood risk factors exposing blood donor should be studied, and community‐based prevalence studies on TTI are also required.