Comparing mannose binding lectin genetic diversity in intracellular and extracellular pathogens

One of the important immunological factors in diseases is mannose binding lectin (MBL). The aim of present study is to determine the distribution of the alleles of mannose-binding lectin gene codon 52,54, 57 and promoter variants H/L, X/Y, P and Q in confirmed VL patients as an intracellular pathogen while compares with extracellular pathogens (in renal infection) and seek correlation between thesevariants and intracellular and extracellular infections. Fifty eight confirmed VL patients’ blood samples were compared with fifty eight blood samples of patients received renal in results of renal infections.MBL genotypes were investigated by polymerase chain reaction and restriction fragment length polymorphism. Frequency of defective allele B in extracellular pathogens was more than intracellular pathogens (P = 0.0001), and in contrary prevalence of wild type allele A in intracellular pathogens was more than extracellular pathogens (P = 0.0001), and in other alleles and variants there was not any significant difference. In conclusion, there was more prevalence of alleles with low mannose binding lectin serum level in extrallelular pathogens which can be consider as a risk factor for these infections. In other hand prevalence of high concentration alleles in intracellular pathogens indicate the role of mannose binding lectin level for susceptibility to intracellular pathogens

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA. © 2022, The Author(s).Funding text 1: S Afzal acknowledges support of the Pakistan Society of Medical Infectious Diseases and King Edward Medical University to access the relevant data of HIV from various sources. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia (FCT), I.P., in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences - UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy - i4HB; FCT/MCTES (Ministério da Ciência, Tecnologia e Ensino Superior) through the project UIDB/50006/2020. K Deribe acknowledges support by the Wellcome Trust [grant number 201900/Z/16/Z] as part of his International Intermediate Fellowship. C Herteliu and A Pana are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Claudiu Herteliu is partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. Y J Kim acknowledges support by the Research Management Centre, Xiamen University Malaysia [No. XMUMRF/2020-C6/ITCM/0004]. S L Koulmane Laxminarayana acknowledges institutional support by the Manipal Academy of Higher Education. K Krishan acknowledges non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India. M Kumar would like to acknowledge NIH/FIC K43 TW010716-04. I Landires is a member of the Sistema Nacional de Investigación (SNI), supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panama. V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya was supported by the Fogarty International Center of the National Institutes of Health under the Award Number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Z Quazi Syed acknowledges support from JNMC, Datta Meghe Institute of Medical Sciences. A I Ribeiro was supported by National Funds through FCT, under the ‘Stimulus of Scientific Employment – Individual Support’ program within the contract CEECIND/02386/2018. A M Samy acknowledges the support from a fellowship of the Egyptian Fulbright Mission program and Ain Shams University. R Shrestha acknowledges support from NIDA K01 Award: K01DA051346. N Taveira acknowledges support from FCT and Aga Khan Development Network (AKDN) - Portugal Collaborative Research Network in Portuguese speaking countries in Africa (project reference: 332821690), and by the European & Developing Countries Clinical Trials Partnership (EDCTP), UE (project reference: RIA2016MC-1615). B Unnikrishnan acknowledges support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. ; Funding text 2: LBD sub-Saharan Africa HIV Prevalence Collaborators S Afzal acknowledges support of the Pakistan Society of Medical Infectious Diseases and King Edward Medical University to access the relevant data of HIV from various sources. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia (FCT), I.P., in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences - UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy - i4HB; FCT/MCTES (Ministério da Ciência, Tecnologia e Ensino Superior) through the project UIDB/50006/2020. K Deribe acknowledges support by the Wellcome Trust [grant number 201900/Z/16/Z] as part of his International Intermediate Fellowship. C Herteliu and A Pana are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Claudiu Herteliu is partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. Y J Kim acknowledges support by the Research Management Centre, Xiamen University Malaysia [No. XMUMRF/2020-C6/ITCM/0004]. S L Koulmane Laxminarayana acknowledges institutional support by the Manipal Academy of Higher Education. K Krishan acknowledges non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India. M Kumar would like to acknowledge NIH/FIC K43 TW010716-04. I Landires is a member of the Sistema Nacional de Investigación (SNI), supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panama. V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya was supported by the Fogarty International Center of the National Institutes of Health under the Award Number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Z Quazi Syed acknowledges support from JNMC, Datta Meghe Institute of Medical Sciences. A I Ribeiro was supported by National Funds through FCT, under the ‘Stimulus of Scientific Employment – Individual Support’ program within the contract CEECIND/02386/2018. A M Samy acknowledges the support from a fellowship of the Egyptian Fulbright Mission program and Ain Shams University. R Shrestha acknowledges support from NIDA K01 Award: K01DA051346. N Taveira acknowledges support from FCT and Aga Khan Development Network (AKDN) - Portugal Collaborative Research Network in Portuguese speaking countries in Africa (project reference: 332821690), and by the European & Developing Countries Clinical Trials Partnership (EDCTP), UE (project reference: RIA2016MC-1615). B Unnikrishnan acknowledges support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal.; Funding text 3: This work was primarily supported by grant OPP1132415 from the Bill & Melinda Gates Foundation. The funder of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or decision to publish. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. ; Funding text 4: S Afzal reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, with the Pakistan society of Community Medicine & Public Health, the Pakistan Association of Medical Editors, and the Pakistan Society of Medical Infectious Diseases, all outside the submitted work. R Ancuceanu reports 5 payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Avvie, Sandoz, and B Braun, all outside the submitted work. T W Bärnighausen reports research grants from the European Union (Horizon 2020 and EIT Health), German Research Foundation (DFG), US National Institutes of Health, German Ministry of Education and Research, Alexander von Humboldt Foundation, Else-Kröner-Fresenius-Foundation, Wellcome Trust, Bill & Melinda Gates Foundation, KfW, UNAIDS, and WHO; consulting fees from KfW on the OSCAR initiative in Vietnam; participation on a Data Safety Monitoring Board or Advisory Board with the NIH-funded study “Healthy Options” (PIs: Smith Fawzi, Kaaya), Chair, Data Safety and Monitoring Board (DSMB), German National Committee on the “Future of Public Health Research and Education,” Chair of the scientific advisory board to the EDCTP Evaluation, Member of the UNAIDS Evaluation Expert Advisory Committee, National Institutes of Health Study Section Member on Population and Public Health Approaches to HIV/AIDS (PPAH), US National Academies of Sciences, Engineering, and Medicine’s Committee for the “Evaluation of Human Resources for Health in the Republic of Rwanda under the President’s Emergency Plan for AIDS Relief (PEPFAR),” University of Pennsylvania (UPenn) Population Aging Research Center (PARC) External Advisory Board Member; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as co-chair of the Global Health Hub Germany (which was initiated by the German Ministry of Health); all outside the submitted work. J das Neves reports grants or contracts from Ref. 13605 – Programa GÉNESE, Gilead Portugal (PGG/002/2016 – Programa GÉNESE, Gilead Portugal) outside the submitted work. L Dwyer-Lindgren reports support for the present manuscript from the Bill & Melinda Gates Foundation through grant OPP1132415. I Filip reports other financial or non-financial interests from Avicenna Medical and Clinical Research Institute, outside the submitted work. E Haeuser reports support for the present manuscript from the Bill & Melinda Gates Foundation through grant OPP1132415. C Herteliu reports grants from Romanian Ministry of Research Innovation and Digitalization, MCID, for project number ID-585-CTR-42-PFE-2021 (Jan 2022-Jun 2023) “Enhancing institutional performance through development of infrastructure and transdisciplinary research ecosystem within socio-economic domain – PERFECTIS,” from Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, for project number PN-III-P4-ID-PCCF-2016-0084 (Oct 2018-Sep 2022) “Understanding and modelling time-space patterns of psychology-related inequalities and polarization,” and project number PN-III-P2-2.1-SOL-2020-2-0351 (Jun 2020-Oct 2020) “Approaches within public health management in the context of COVID-19 pandemic,” and from the Ministry of Labour and Social Justice, Romania for project number “Agenda for skills Romania 2020-2025”; all outside the submitted work. J J Jozwiak reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Teva, Amgen, Synexus, Boehringer Ingelheim, Zentiva, and Sanofi as personal fees, all outside the submitted work. J Khubchandani reports other financial interests from Teva Pharmaceuticals, all outside the submitted work. K Krishnan reports other non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. H J Larson reports grants or contracts from the MacArthur Foundation and Merck to London School of Hygeine and Tropical Medicine, and from the Vaccine Confidence Fund to the University of Washington; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Center for Strategic and International Studies as payment to LSHTM for co-chairing HighLevel Panel and from GSK as personal payment for developing training sessions and lectures; leadership or fiduciary role in other board, society, committee or advocacy group, pair, with the ApiJect Advisory Board; all outside the submitted work. O O Odukoya reports support for the present manuscript from the Fogarty International Center of the National Institutes of Health under the Award Number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A Pans reports grants from Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, for project number PN-III-P4-ID-PCCF-2016-0084 (Oct 2018-Sep 2022) “Understanding and modelling time-space patterns of psychology-related inequalities and polarization,” and project number PN-III-P2-2.1-SOL-2020-2-0351 (Jun 2020-Oct 2020) “Approaches within public health management in the context of COVID-19 pandemic,” outside the submitted work. S R Pandi-Perumal reports royalties from Springer for editing services; stock or stock options in Somnogen Canada Inc as the President and Chief Executive Officer; all outside the submitted work. A Radfar reports other financial or non-financial interests from Avicenna Medical and Clinical Research Institute, outside the submitted work. A I Ribeiro reports grants or contracts from National Funds through FCT, under the ‘Stimulus of Scientific Employment – Individual Support’ program within the contract CEECIND/02386/2018, outside the submitted work. J M Ross reports support for the present manuscript from the Bill & Melinda Gates Foundation through grant OPP1132415; grants or contracts from National Institutes of Health and Firland Foundation as payments to their institution; consulting fees from United States Agency for International Development as personal payments, and from KNCV Tuberculosis Foundation as payments to their institution; all outside the submitted work. E Rubagotti reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the Greenwich China Office and Unviersity Prince Mohammad VI, Morocco, all outside the submitted work. B Sartorius reports grants or contracts from DHSC – GRAM Project; Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as a member of the GBD Scientific Council and a Member of WHO RGHS; all outside the submitted work. J A Singh reports consulting fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two labs Inc, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science LLC, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point communications, and the National Institutes of Health and the American College of Rheumatology; payment or honoraria for participating in the speakers bureau for Simply Speaking; support for attending meetings and/or travel from the steering committee of OMERACT, to attend their meeting every 2 years; participation on a Data Safety Monitoring Board or Advisory Board as an unpaid member of the FDA Arthritis Advisory Committee; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as a member of the steering committee of OMERACT, an international organization that develops measures for clinical trials and receives arm’s length funding from 12 pharmaceutical companies, with the Veterans Affairs Rheumatology Field Advisory Committee as Chair, and with the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis as a director and editor; stock or stock options in TPT Global Tech, Vaxart pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics Inc, Series Therapeutics, Tonix Pharmaceuticals, and Charlotte’s Web Holdings Inc. and previously owned stock options in Amarin, Viking, and Moderna pharmaceuticals; all outside the submitted work. N Taveira reports grants or contracts from FCT and Aga Khan Development Network (AKDN) – Portugal Collaborative Research Network in Portuguese speaking countries in Africa (Project reference: 332821690) and from European & Developing Countries Clinical Trials Partnership (EDCTP), UE (Project reference: RIA2016MC-1615), as payments made to their institution, all outside the submitted work

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding Bill & Melinda Gates Foundation

Quantitative Bestimmung von Staphylococcus aureus, Streptococcus pneumoniae und Haemophilus influenzae bei Patienten mit der neuen Virusgrippe (H1N1)/2009 und Virusgrippe A/2010

Introduction: Viral influenza is a seasonal infection associated with significant morbidity and mortality. In the United States more than 35,000 deaths and 200,000 hospitalizations are recorded annually due to influenza. Secondary bacterial infections or co-infections associated with cases of influenza are a leading cause of severe morbidity and mortality, especially among high-risk groups such as the elderly and young children. Aim: The aim of the present study was the quantitative detection of S. aureus, S. pneumoniae and H. influenzae in a group of patients with seasonal influenza A, influenza A (H1N1 ) pandemic 2009, and patients with symptoms of respiratory infection, but the negative for H1N1 serving as control group.Method: In total, 625 patients suspected respiratory infection from April 2009 to April 2010 were studied. There were 58 patients with influenza A H1N1 and 567 patients negative for influenza A H1N1 . From November 2010 to February 2011, 158 patients with respiratory symptoms were analyzed for seasonal influenza A. There were 25 patients with seasonal influenza A. To check the colonization status among the healthy individuals 62 healthy persons were further investigated. Individual were screened in parallel. The choices of special genes were amplified from clinical specimens using real-time PCR with a cutoff of 104 CFU/mL to differentiate colonization from infection in respiratory tract.Results: S. aureus, S. pneumoniae and H. influenzae were detected in 12%, 26% and 33% of patients with H1N1 , while the corresponding figures were 9%, 19%, and 31% for H1N1 negative patients. Among patients with seasonal influenza A 12% S. aureus, 24% S. pneumoniae , and 32% H. influenzae co-infections were detected, while influenza negative control group yielded 5% S. aureus , 11% S. pneumoniae , and 10% H. influenzae , respectively. Conclusion: The results of this study indicated that the serotype of pandemic H1N1 2009 did not increase incidence of secondary infection with S. aureus, S. pneumoniae and H. influenzae . Quantitative detection of secondary bacterial infection by QR-PCR can help us for distinguishing colonization from infection and controlling misuse of antibiotics and bacterial drug resistances.Einleitung: Die Virusgrippe ist eine saisonale Infektionskrankheit, die mit ausgeprägterer Morbidität und Mortalität einhergeht. In den USA werden jährlich mehr als 35.000 Todesfälle und 200.000 Krankenhausbehandlungen erfasst. Die mit der viralen Primärinfektion assoziierte bakterielle Superinfektion oder Ko-Infektion verursacht schwere Krankheitsverläufe speziell bei Hochrisikogruppen wie alten Menschen und Kleinkindern. Zielsetzung: Die Zielsetzung der Studie bestand in der quantitativen Bestimmung von S. aureus, S. pneumoniae and H. influenzae bei Patienten mit saisonaler Influenza A bzw. pandemischer Influenza A (H1N1 ) und Symptomen respiratorischer Infektionen, im Vergleich zu je einer Kontrollgruppe. Methode: Insgesamt wurden von April 2009 bis April 2010 625 Patienten mit Verdacht auf eine respiratorische Infektion untersucht, davon 58 Patienten mit Nachweis von Influenza A (H1N1 ). Vom November 2010 bis zum Februar 2011 wurden 158 Patienten mit respiratorischen Symptomen auf das Vorkommen der saisonalen Influenza A untersucht, davon erwiesen sich 25 als positiv. Zur Ermittlung der bakteriellen Kolonisation wurden parallel 62 gesunde Personen untersucht (Kontrollgruppe). Bei der verwendeten Real-time PCR wurde als Cutoff zur Unterscheidung von Koloniation und Infektion im Respirationstrakt 104 CFU/ml eingeführt. Ergebnisse: S. aureus, S. pneumoniae und H. influenzae wurden bei 12%, 26% bzw. 33% der Patienten mit Nachweis von Influenzavirus A (H1N1 ) gefunden; die Häufigkeit in der Kontrollgruppe betrug 9%, 19% bzw. 31%. Bei der saisonalen Influenza A waren bei 12%, 24% bzw. 32% die Erreger nachweisbar, in der parallelen Kontrollgruppe bei 5%, 11% bzw. 10%. Schlussfolgerung : Die Ergebnisse zeigen, dass der Serotyp der pandemischen Influenza A (H1N1 ) die Inzidenz der bakteriellen Superinfektion für die drei untersuchten Bakterienspecies nicht erhöht hat. Die quantitative Detektion einer sekundären bakteriellen Infektion mittels Real-time PCR ist geeignet, zwischen Kolonisation und Infektion zu unterscheiden und damit einer missbräuchlichen Anwendung von Antibiotika vorzubeugen

Akzeptanz und mangelnde Bereitschaft zur Covid-19-Impfung in der türkischen Erwachsenenbevölkerung

Objective: The aim of this study was to determine the acceptance of Covid-19 vaccine among the Turkish adult population. Methods: A total of 2023 persons participated in this cross-sectional study between October 2020 and January 2021. The questionnaire, which was delivered via social media, was filled out by the participants over "Google Forms".Results: Questionnaire results showed that 68.7% of the participants might agree to vaccinated against COVID-19. According to univariate analysis, the age group of 50-59, urban residents, healthcare workers, non-smokers, and those with chronic diseases, those who were vaccinated against influenza, pneumonia, and tetanus were all willing to be vaccinated against COVID-19.Conclusions: It is very important to determine a community's willingness to be vaccinated against COVID-19 so that interventions can be made to solve related problems. Risk of exposure and importance of Prevention play a critical role in vaccination acceptance.Zielsetzung: Ziel der Studie war es, die Akzeptanz der Covid-19 Impfung in der türkischen Erwachsenenbevölkerung zu ermitteln.Methode: An der Querschnittsstudie nahmen zwischen Oktober 2020 und Januar 2021 2023 Personen teil. Der Fragebogen, der über soziale Medien übermittelt wurde, wurde von den Teilnehmern über "Google Forms" ausgefüllt.Ergebnisse: 68,7% der Teilnehmer stimmen der Impfung gegen COVID-19 zu. Die univariate Analyse ergab, dass die Altersgruppe der 50- bis 59-Jährigen, Stadtbewohner, Beschäftigte im Gesundheitswesen, Nichtraucher und chronisch Kranke sowie diejenigen, die gegen Influenza, Lungenentzündung und Tetanus geimpft waren, alle bereit waren, sich gegen COVID-19 impfen zu lassen.Schlussfolgerung: Es ist wichtig, die Bereitschaft einer Gemeinschaft zu ermitteln, sich gegen COVID-19 impfen zu lassen, damit Maßnahmen zur Lösung der damit verbundenen Probleme ergriffen werden können. Das Expositionsrisiko und die Erkennung von Gefahren spielen eine entscheidende Rolle für die Akzeptanz der Impfung

Antibiotische Empfindlichkeit, molekulare Typisierung und Biofilmbildung klinischer Streptococcus agalactiae Isolate im Nordwestiran

Background: Group B Streptococcus (S. agalactiae ) is one of the colonizing bacteria in pregnant women which can be a causative agent of meningitis and neonatal sepsis. This organism has also been increasingly related to invasive infections in non-pregnant adults. Objective: In present study, we aimed to characterize the clonality of biofilm-producing S. agalactiae isolates from various sources from two different clinical laboratories in Tehran, Iran.Materials and Methods: S. agalactiae isolates were collected from community-acquired (CA) and hospital-acquired (HA) infections in pregnant and non-pregnant adults. The antimicrobial susceptibility patterns and biofilm formation ability were determined. In addition, pulse field gel electrophoresis (PFGE) was used to verify the clonal diversity of isolates.Results: Out of the 87 isolates, 15 (16.6%) formed biofilm. The antibiotic resistance rate was 98.85% for clindamycin, 98.85% for tetracycline, followed by 29.88% for erythromycin, 9.19% for moxifloxacin and 6.89% for levofloxacin. The PFGE patterns revealed a total of 16 different clusters consisting of 6 single types (STs). Conclusion: This study evaluated the biofilm formation of clinical S. agalactiae , which may be a step towards understanding its role in pathological processes. Biofilm formation was significant only in the hypervirulent ST-17 clone. Intraclonal spread of isolates indicates that a local lineage of isolates is responsible for infection by these bacteria.Hintergrund: Streptokokken der Gruppe B (S. agalactiae ) können bei schwangeren Frauen kolonisieren und Meningitis und Sepsis bei Neugeborenen verursachen. Der Erreger wird zunehmend auch mit invasiven Infektionen bei nicht schwangeren Erwachsenen in Verbindung gebracht.Zielsetzung: In der vorliegenden Studie sollte die Klonalität Biofilm-produzierender Isolate von S. agalactiae charakterisiert werden, die aus verschiedenen Quellen in zwei klinischen Laboratorien in Teheran, Iran, isoliert wurden. Material und Methode: Die Isolate von S. agalactiae wurden bei schwangeren und nicht schwangeren Frauen aus ambulant (CA) und stationär erworbenen (HA) Infektionen gewonnen. Bestimmt wurden die Resistenz und die Biofilmbildung. Die klonale Diversität der Isolate wurde mittels Pulsfeld-Gel-Elektrophorese (PFGE)-Technik bestätigt.Ergebnisse: Von 87 Isolaten bildeten 15 (16,6%) einen Biofilm. Die Resistenzrate betrug für Clindamycin 98,9%, für Tetracyclin 98,9%, für Erythromycin 29,9%, für Moxifloxacin 9,2% und für Levofloxacin 6,9%. Die PFGE-Muster zeigten 16 verschiedene Cluster, die aus 6 Einzeltypen (STs) bestanden.Schlussfolgerung: Diese Studie untersuchte die Biofilmbildung von klinischen S. agalactiae Isolaten, die ein Schritt zum Verständnis in der Pathogenese sein könnte. Die Biofilmbildung war nur bei einem hypervirulenten ST-17-Klon signifikant. Die intraklonale Ausbreitung der Isolate deutet darauf hin, dass eine lokale Linie von Isolaten für die Infektion durch diese Bakterien verantwortlich ist

Nasale Trägerrate Methicillin-resistenter Staphylokokken bei medizinischem Personal eines iranischen Universitätslehrkrankenhauses

Background : The opportunistic pathogens, methicillin-resistant-Stap hylococcus aureus (MRSA) and Staphylococcus epidermidis , are associated with severe nosocomial infections and high levels of mortality. Healthcare workers colonized with either MRSA or methicillin-resistant S. epidermidis (MRSE) in the nasal cavity are high risk groups for transmitting the agent to hospitalized patients. Objective: This study was carried out to investigate the prevalence of nasal carriage of MRSA and methicillin-resistant S. epidermidis among healthcare providers of Imam Reza University Teaching Hospital, Tabriz, Iran. Methods: A total of one hundred two nasal swabs were obtained from participants working on different wards of the hospitals. The antibiotic resistance pattern was investigated using disk diffusion methods, which were subsequently evaluated by polymerase chain reaction (PCR) for the mecA gene.Results: In the screened population, 22 isolates of S. aureus and 72 of S. epidermidis were detected. Of these, 7 isolates of S. aureus and 36 of S. epidermidis were cefoxitin resistant. Three isolates of S. aureus isolates and 35 of S. epidermidis were MRSE and positive for mecA amplification. Moreover, all isolates were penicillin G resistant but vancomycin and linezolid sensitive. High resistance was observed to clindamycin (74%). Conclusions: The present study indicates that healthcare workers are at high risk of acquisition and transmission of methicillin-resistant Staphylococci. Early screening and decolonization of hospital staff, as well as education on standard sanitation measures, especially hand hygiene practice, remain the most effective strategies for controlling transmission of infectious agents.Hintergrund: Die opportunistischen Erreger Methicillin-resistenter Staphylococcus aureus und Methicillin-resistenter Staphylococcus epidermidis (MRSE) können schwer verlaufende nosokomiale Infektionen mit hoher Mortalität verursachen. Medizinisches Personal, das entweder mit MRSA oder mit MRSE in der Nasenhöhle kolonisiert ist, kann die Erreger auf hospitalisierte Patienten übertragen.Zielsetzung: Die Studie wurde durchgeführt, um die Prävalenz der nasalen Vorkommens von MRSA und MRSE bei medizinischem Personal des Imam Reza-Universitätslehrkrankenhauses in Tabris, Iran, zu untersuchen.Methoden: Es wurden 102 Abstriche im Vestibulum nasi von medizinischem Personal auf verschiedenen Stationen der Krankenhäuser entnommen. Das Antibiotikaresistenzmuster wurde im Plättchendiffusionstest untersucht; anschließend wurde das mecA-Gen mittels Polymerase-Kettenreaktion (PCR) nachgewiesen. Ergebnisse: Bei 22 Personen (21,6%) wurde S. aureus , bei 72 Personen (70,6%) S. epidermidis nachgewiesen. Davon waren 7 S. aureus - und 36 S. epidermidis -Isolate Cefoxitin resistent. Drei S. aureus - und 35 S. e pidermidis -Isolate enthielten das mecA-Gen. Darüber hinaus waren alle Isolate resistent gegen Penicillin G, aber sensitiv gegen Vancomycin- und Linezolid. Es wurde eine hohe Resistenz gegenüber Clindamycin beobachtet (74%).Schlussfolgerungen: Die Studie weist darauf hin, dass Beschäftigte im Gesundheitswesen dem Risiko des Erwerbs und der Übertragung Methicillin resistenter Staphylokokken ausgesetzt sind. Früherkennung und Dekolonisierung des Krankenhauspersonals und die Aufklärung über die Einhaltung der Basishygienemaßnahmen, insbesondere der Händedesinfektion, sind nach wie vor die wichtigste Strategie zur Prävention nosokomialer Infektionen