ESBL-producing Enterobacteriaceae, an Unnoticed Pandemic with Challenges in Clinical Practice, a mini-review.
Deving Arias Ramos1,2,*, Luis Eduardo Moreno Henao1,2, Omar Fernando Bolaños1,2, Álvaro José Roa Martínez1,2
1Universidad Santiago de Cali, Palmira city, Colombia.
2Semillero de investigación en patología, médica y medico quirúrgica, grupo de investigación en genética, fisiología y metabolismo (GEFIME), Universidad Santiago de Cali, Colombia.
Antimicrobial resistance in gram-negative bacilli is an ecological problem with a major impact on public health. Extended-spectrum β-lactamases (ESBLs) are enzymes that inactivate broad-spectrum antibiotics, penicillins, third and fourth generation cephalosporins. There are many factors associated with the global spread of ESBLs, such as the use of over-the-counter antibiotics, the food industry, travel abroad, and the lack of implementation of control strategies in hospitals and at the community level. Fecal carriers of ESBLs are increasingly commonly encountered in routine hospital settings as many hospitals have implemented rectal screening for ESBLs, however, the utility of this clinical practice and the routine isolation of patients carrying these bacteria has controversial benefits. There are challenges in selecting suitable patients for empirical therapy with carbapenems for the treatment of presumed severe ESBLs infections. Inappropriate empirical therapy is associated with high mortality in bloodstream infections. Carbapenems are the standard of care for severe invasive ESBL-E infections outside the urinary tract, however, overuse of carbapenems may lead to the emergence of carbapenem-resistant Enterobacterales. This mini review is intended to contribute to understanding about ESBLs as a global ecological problem, causing a considerable impact on health care services and posing enormous challenges in everyday antimicrobial therapy.
DOI: 10.29245/2689-9981/2024/3.1178 View / Download PdfAnti-SARS-CoV2 serological profile and associated factors in adults living with HIV followed at Departmental and Teaching Hospital of Borgou in 2022.
Attinsounon Cossi Angelo1,2,3*, Dovonou Comlan Albert2,3, Alidjinou Kazali4, Kanninkpo Fabius1,2, Alassani Adébayo2,3, Vodounou Amos1,2, Saké khadidjatou2,3, Serge Adé2,3
1Infectious Diseases and Tropical Medicine Unit, University of Parakou, R. Benin.
2Faculty of Medicine, University of Parakou, R. Benin.
3Departmental and Teaching Hospital of Borgou-Alibori (DTH-BA), Parakou, R. Benin.
4Laboratoire de virologie, Centre Hospitalier Universitaire de Lille, Faculté de médecine de Lille, France.
Introduction: Literature data suggest that people living with the human immunodeficiency virus (PLHIV) are at increased risk of severe forms of Coronavirus 2019 (COVID-19) infection and related mortality. The aim of this study was to investigate the anti-SARS-CoV-2 serological profile in adults living with HIV followed at the Departmental and Teaching Hospital of Borgou (DTH-B) in 2022 and to identify factors associated with anti-SARS-CoV-2 seropositivity in the latter.
Methods: This was a descriptive and analytical cross-sectional study conducted in the Internal Medicine Department at DTH-B, from June 27, 2022 to July 27, 2022. PLHIV were systematically recruited after informed consent. A survey form was used to collect epidemiological, clinical, paraclinical and therapeutic data. Anti-SARS-CoV-2 antibodies (IgG and IgM) were tested using the BIOSYNEX COVID-19 BSS rapid test (Biosynex SA, France). Data were analyzed using STATA/MP14.1 software. The significance level was 5%.
Results: A total of 135 adults living with HIV were included in the study. The sex ratio was 0.34 and the mean age 45 ± 11.03 years. Anti-SARS-CoV-2 seroprevalence was 50.37%. Only one respondent reported a confirmed COVID-19, while vaccination coverage was 37.78%. Anti-SARS-CoV-2 seroprevalence in unvaccinated patients was 40.48%. Factors significantly associated with anti-SARS-CoV-2 seropositivity in multivariate analysis were vaccination status (p=0.02) and viral load (p=0.001).
Conclusion: Anti-SARS-CoV-2 antibodies were detectable in more than half the PLHIV. Their presence was associated with the notion of vaccination and an undetectable viral load. This study therefore suggests the need to promote COVID-19 vaccination among PLHIV followed up at DTH-B, as well as the continuation of adequate management of HIV infection in order to reduce COVID-19-related morbidity and mortality in this so-called vulnerable population.
DOI: 10.29245/2689-9981/2023/2.1173 View / Download PdfInfluenza epidemics in Europe, nursing homes and vaccination of healthcare workers
Edward Goldstein Senior Biostatistician
Harvard Medical School, Boston, MA 02114, USA
During the 2022-2023 season, influenza circulation levels in the European Union (EU) have increased substantially compared to the 2021-2022 season but were still generally somewhat lower compared to pre-pandemic influenza seasons. Studies have shown that influenza epidemics in the EU countries were associated with a heavy toll of mortality for different principal causes of death including respiratory, cardiac and other causes. Mortality data also suggest that residents of long-term care facilities represent a sizeable share of all cases of death in the EU, and an even higher share among deaths stemming from infections with respiratory viruses, including influenza. Influenza vaccination coverage for healthcare workers in nursing homes in many EU countries is moderate to low, whereas evidence in the literature suggests that higher influenza vaccination coverage levels for healthcare workers result in a significant reduction in all-cause mortality during influenza seasons, both in nursing home residents as well as in hospital patients, though the magnitude of that effect varies with influenza season. Here, we review the above evidence, and as well as the effect of different strategies for boosting influenza vaccination coverage in healthcare workers, such as mandatory vaccination, educational initiatives/outreach activities and availability of on-sight vaccination.
DOI: 10.29245/2689-9981/2023/2.1172 View / Download PdfLinezolid-Associated Black Tongue: A Rare Adverse Drug Reaction
Dr. Gyanshankar P. Mishra
Associate Professor, Dept. of Respiratory Medicine, Indira Gandhi Government Medical College, C.A. Road, Nagpur, Maharashtra, India– 440018;
Linezolid is an effective second-line anti-tuberculosis drug. However, the use of linezolid has been associated with rare adverse drug reactions (ADRs), one of which is the linezolid-associated black hairy tongue (BHT). This reaction is characterized by a black or dark brown discoloration of the tongue, which may be accompanied by a metallic or bitter taste. In this case report, we present a 19-year-old male patient who developed linezolid-associated black tongue while receiving linezolid as part of an all-oral, longer-course treatment regime for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB). The patient's BHT was only cosmetic and resolved upon discontinuation of linezolid. This case report aims to raise awareness of this rare ADR and the importance of close monitoring and potential withdrawal of linezolid to optimize treatment outcomes.
DOI: 10.29245/2689-9981/2023/1.1170 View / Download Pdf