BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
Multidrug-resistant(MDR)gram-negative bacteria(GNB)are responsible for high mortality and morbidity in health care settings world-wide.They have been declared as priority pathogens by the WHO for their continuously es...Multidrug-resistant(MDR)gram-negative bacteria(GNB)are responsible for high mortality and morbidity in health care settings world-wide.They have been declared as priority pathogens by the WHO for their continuously escalating antimicrobial resistance.Neverthe-less,data associated with MDR GNB in health care–associated infections are insufficient.Surgical site infections(SSIs)are among the most commonly occurring health care–associated infections.Such infections are particularly common when bacteria from a patient’s normal microflora are transferred to the surgical sites during surgical procedures.SSIs affect approximately 0.5%–3%of patients under-going surgery,resulting in prolonged hospital stays compared with patients without SSIs.SSIs result in severe problems and lead to a heavy economic burden.Most SSIs can be avoided if suitable preventive measures are employed.Novel findings support the dedicated usage of oral preoperative surgical antimicrobial prophylaxis for specific surgeries based on sites/organs.Immediate interventions are sought to control the transmission of MDR GNB typically found in hospital settings.The present narrative review aims to describe MDR GNB in SSIs in different sites.Antimicrobial resistance epidemiology and preventive measures for SSIs are also discussed.Differ-ent intrinsic and extrinsic factors and control measures are elaborated for curbing SSIs.展开更多
In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Boju...In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.展开更多
In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given t...In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.展开更多
BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve outcomes.Large language models(LLMs)can potentially provide medical information for patients.AIM To examine the...BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve outcomes.Large language models(LLMs)can potentially provide medical information for patients.AIM To examine the performance of three LLMs,ChatGPT-3.5,ChatGPT-4.0,and Google Gemini,in answering HBV-related questions.METHODS LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third reviewer.Each question was run three times using three LLMs.Readability was assessed via the Gunning Fog index and Flesch-Kincaid grade level.RESULTS Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatGPT-3.5:3.50;ChatGPT-4.0:3.69;Google Gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatGPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatGPT-3.5 and 73.1%for Google Gemini.Across the six domains,ChatGPT-4.0 performed better in terms of diagnosis,whereas Google Gemini demonstrated excellent clinical manifestations.Notably,in the readability analysis,the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal population.CONCLUSION Our results highlight the potential of LLMs,especially ChatGPT-4.0,for delivering responses to HBV-related questions.LLMs may be an adjunctive informational tool for patients and physicians to improve outcomes.Nevertheless,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.展开更多
In this editorial,we have commented on the article that has been published in the recent issue of World Journal of Clinical Cases.The authors have described a case of unilateral thyroid cyst and have opined that the a...In this editorial,we have commented on the article that has been published in the recent issue of World Journal of Clinical Cases.The authors have described a case of unilateral thyroid cyst and have opined that the acute onset of infection may be linked to diabetes mellitus(DM).We have focused on the role of nutrition in the association between DM and infection.Patients with DM are at a high risk of infection,which could also be attributed to nutrition-related factors.Nutritional interventions for patients with diabetes are mainly based on a low-calorie diet,which can be achieved by adhering to a low-carbohydrate diet.However,dietary fiber supplementation is recommended to maintain the diversity of the gut microbiota.Furthermore,high-quality protein can prevent the increased risk of infection due to malnutrition.Supplementation of vitamins C,vitamins A,vitamins D,and folic acid improves blood sugar control and facilitates immune regulation.Mineral deficiencies augment the risk of infection,but the relationship with diabetes is mostly U-shaped and a good intake should be maintained.展开更多
BACKGROUND Congenital cytomegalovirus(CMV)infection represents a significant public health concern as the most prevalent viral infection in newborns,potentially leading to severe neurological and developmental complic...BACKGROUND Congenital cytomegalovirus(CMV)infection represents a significant public health concern as the most prevalent viral infection in newborns,potentially leading to severe neurological and developmental complications.The majority of cases are asymptomatic and remain undetected during pregnancy due to the absence of effective screening methods.CASE SUMMARY A 27-year-old primigravida presented for early pregnancy ultrasound,which revealed an atypical finding:A normal anechoic thalamus appearing hyperechoic on the mid-sagittal view of the fetal head.Subsequent ultrasound examinations during mid and late gestation demonstrated classic intracranial features sug-gestive of congenital CMV infection.Chromosomal karyotyping and microarray analysis of the fetus yielded no significant abnormalities.Following compre-hensive prenatal counseling regarding potential adverse fetal outcomes,the patient elected to continue her pregnancy.She ultimately underwent cesarean delivery at 42 weeks gestation at another facility,resulting in the birth of a female neonate.At five months of age,the infant presented with epilepsy and significant growth and developmental delays.CONCLUSION Congenital CMV infection occurs during the first trimester may manifest as hyperechoic thalamus which can be revealed by ultrasound in the mid-saggital view of the fetal head.Future research should investigate the correlation between echogenic thalamus and developmental outcomes,as well as explore early sc-reening techniques for suspected congenital CMV infection cases.展开更多
BACKGROUND Transfusion transmissible infections(TTIs)are illnesses spread through contaminated blood or blood products.In India,screening for TTIs such as hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodefi...BACKGROUND Transfusion transmissible infections(TTIs)are illnesses spread through contaminated blood or blood products.In India,screening for TTIs such as hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency virus(HIV)-I/II,malaria,and syphilis is mandatory before blood transfusions.Worldwide,HCV,HBV,and HIV are the leading viruses causing mortality,affecting millions of people globally,including those with co-infections of HIV/HCV and HIV/HBV.Studies highlight the impact of TTIs on life expectancy and health risks,such as liver cirrhosis,cancer,and other diseases in individuals with chronic HBV.Globally,millions of blood donations take place annually,emphasizing the importance of maintaining blood safety.AIM To study the prevalence of TTIs,viz.,HBV,HCV,HIV I/II,syphilis,and malaria parasite(MP),among different blood donor groups.METHODS The study assessed the prevalence of TTIs among different blood donor groups in Delhi,India.Groups included total donors,in-house donors,total camp donors,institutional camp donors,and community camp donors.Tests for HIV,HBV,and HCV were done using enzyme-linked immunosorbent assay,while syphilis was tested with rapid plasma reagins and MP rapid card methods.The prevalence of HBV,HCV,HIV,and syphilis,expressed as percentages.Differences in infection rates between the groups were analyzed usingχ²tests and P-values(less than 0.05).RESULTS The study evaluated TTIs among 42158 blood donors in Delhi.The overall cumulative frequency of TTIs in total blood donors was 2.071%,and the frequencies of HBV,HCV,HIV-I/II,venereal disease research laboratory,and MP were 1.048%,0.425%,0.221%,0.377%,and 0.0024%,respectively.In-house donors,representing 37656 donors,had the highest transfusion transmissible infection(TTI)prevalence at 2.167%.Among total camp donors(4502 donors),TTIs were identified in 1.266%of donors,while community camp donors(2439 donors)exhibited a prevalence of 1.558%.Institutional camp donors(2063 donors)had the lowest TTI prevalence at 0.921%.Statistical analysis revealed significant differences in overall TTI prevalence,with total and in-house donors exhibiting higher rates compared to camp donors.CONCLUSION Ongoing monitoring and effective screening programs are essential for minimizing TTIs.Customizing blood safety measures for different donor groups and studying socio-economic-health factors is essential to improving blood safety.展开更多
BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the...BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the Cochrane Library databases were searched from inception to March 2024.Eligible articles included observational studies that reported on outcomes such as mortality,colectomy,hospitalization,intensive care unit(ICU)admission,complication rates,and length of hospital stay in IBD patients with and without CDI.Data were extracted,and a randomeffects model was used to calculate pooled odds ratios(ORs)and mean differences(MDs).RESULTS As shown in the data from 21 studies with 1249158 participants,CDI significantly increased the risk of mortality in IBD patients[pooled OR=4.569,95%confidence intervals(95%CI):2.584 to 8.079].Although the pooled OR for colectomy was 1.409(95%CI:0.922 to 2.155),it was not statistically significant.Similarly,CDI did not impact hospitalization(pooled OR=1.056,95%CI:0.512 to 2.179)and ICU admission outcomes(pooled OR=1.970,95%CI:0.420 to 9.246)of patients with IBD.The rate of complications was comparable in the two groups(pooled OR=0.658,95%CI:0.378 to 1.147).However,CDI was associated with a significantly more extended hospital stay(pooled MD=0.349 days,95%CI:0.002 to 0.696).CONCLUSION CDI is linked to increased mortality and prolonged hospitalization in IBD patients.These results emphasize the need for early detection and appropriate management.Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.展开更多
BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatm...BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.展开更多
Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP ...Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP remains challenging, particularly in patients with comorbidities or contraindications to standard therapies. Objectives: To evaluate the effectiveness of ozonated water as an adjunctive treatment for EP, delivered using a patented robotic therapy system designed for hygiene and infection prevention in non-self-sufficient patients. Methods: We report the case of a 90-year-old male patient with acute EP who received daily skin treatments with ozonated water in conjunction with supportive care, including rehydration and antibiotics. The intervention was facilitated by the robotic system “COPERNICO Surveillance & Prevention,” which ensured standardized hygiene practices and clinical documentation. Results: Within one week of treatment, the patient showed complete desquamation of necrotic skin, resolution of erythema, and significant metabolic recovery. Fever subsided, renal function improved, and the patient was discharged in stable condition. Follow-up confirmed sustained clinical improvement, and no adverse events were reported. Conclusions: Ozonated water demonstrated efficacy in alleviating the dermatological and systemic manifestations of EP in a high-risk elderly patient. This case highlights the potential of ozone therapy as a safe, cost-effective adjunctive treatment for EP and underscores the utility of robotic systems in managing complex dermatological conditions. Further research is warranted to validate these findings in larger cohorts.展开更多
BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pa...BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pain,rebound tenderness,and rapid onset.Its pathogenesis is complex and potentially linked to infection,environment,and genetics.Timely intervention is crucial to prevent complications.While surgery is the primary treatment,it carries risks,including postoperative infections that may necessitate re-operation.Gram-negative bacteria release endotoxin(ETX),which induces inflammation and is recognized by toll-like receptor 4(TLR4).This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections,aiding in prevention and treatment.AIM To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.METHODS A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024(n=153)were included in the study.Patients were categorized into infected(n=36)and uninfected(n=117)groups according to the development of postoperative incision infections.General characteristics and blood levels of ETX and TLR4 were compared,and the factors influencing postoperative infection were identified using multivariate logistic regression.ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.RESULTS No statistically significant differences were observed between the two groups in terms of sex,age,or other general characteristics(P>0.05).Compared to the uninfected group,the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis,longer surgical times,longer incision lengths,and elevated ETX and TLR4 levels(P<0.05).Multivariate logistic regression analysis identified pathological type,surgical method,surgical time,and incision length as factors influencing postoperative incision infection in acute appendicitis.Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection,with higher prediction efficiency when combined.CONCLUSION Pathological type,surgical method,surgical time,and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis.Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.展开更多
Acute respiratory tract infections(ARTIs)are among the leading causes of morbidity and mortality in children worldwide.Human adenovirus(HAdV)infections are estimated to account for at least 5%of pediatric ARTIs.The ci...Acute respiratory tract infections(ARTIs)are among the leading causes of morbidity and mortality in children worldwide.Human adenovirus(HAdV)infections are estimated to account for at least 5%of pediatric ARTIs.The circulated genotypes of HAdV and the correlation between genotype and clinical manifestations in Wuhan,China,before and after the complete relaxation of nonpharmaceutical interventions against severe acute respiratory syndrome coronavirus 2,remain unknown.Here,101 HAdV strains were isolated from throat swab samples collected from hospitalized children with ARTIs who tested positive for HAdV nucleic acid.Of these,sixty-six strains from 2022 to twenty-three strains from 2023 were successfully genotyped and subjected to phylogenetic analysis based on the hexon,penton base,and fiber genes.Six genotypes,B3,C1,C2,C5,C104,and C108 were identified.HAdV-B3(84.85%)was the most prevalent type in 2022,while HAdV-C(86.96%),including C1,C2,C108,and C104,was the most prevalent in 2023.These strains were phylogenetically related to strains from Japan,China,and the United States in recent years.When comparing clinical characteristics,pediatric patients infected with B3,C1,C2,C5,C104,or C108 exhibited similar clinical manifestations,primarily fever and cough,but varying interleukin(IL)-10 levels.In conclusion,from June 2022 to September 2023,the circulated genotypes of HAdV in Wuhan included B3,C1,C2,C108,C5,and C104.The endemic pattern of HAdV in Wuhan,China,shifted from species B as the dominant type in 2022 to species C in 2023.展开更多
Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of ...Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of sexually transmitted genital infections by traditional methods as culture remains extremely delicate, difficult or impossible (to find extremely fragile organisms that can be cultured). Thus, molecular techniques constitute an alternative to improve accurate diagnostic, personalized patient treatment, and public health. A total of 83 clinical samples including urethral discharge and urine samples from individual patients with symptoms of urethritis received were analyzed using traditional methods and a commercial real-time PCR (qPCR) method. Out of 83 urethritis patients, n = 55 (66.26%) were positive for at least one of the STI pathogens detected by qPCR. qPCR assay was more sensitive (50/83, positive cases) compared to culture (15/83, positive cases) and light microscopy (28/83, positive cases). The most prevalent NTD pathogen in the suspected patients was N. gonorrhoeae with 60.24% (50/83) based on real-time PCR diagnosis. Among the positive cases of STI pathogens, Neisseria gonorrhoeae had the highest frequency 49/55 (89.01%) followed by low frequencies of Trichomonas vaginalis 4/55 (7.27%) and Chlamydia trachomatis 1/55 (1.82%). This highlights the high prevalence of N. gonorrhoeae infection in male urethritis patients and a very important misdiagnosis using traditional routine methods in Burkina Faso by medical laboratories. Thus, this situation may negatively impact patients’ personalized treatment and care and public health with the possible rapid emergence of multidrug-resistant strains. This study also highlights the urgent need to optimize culture for the diagnosis of NTD pathogens in Burkina Faso and the usefulness and the need for the introduction of molecular diagnostic methods in routine diagnosis for the detection of NTD pathogens in the medical laboratories in Burkina Faso.展开更多
This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link betwee...This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.展开更多
Objective: With the increasing volume of trauma surgery, postoperative infections have garnered significant attention, as they not only affect patient outcomes but also raise healthcare costs and the risk of bacterial...Objective: With the increasing volume of trauma surgery, postoperative infections have garnered significant attention, as they not only affect patient outcomes but also raise healthcare costs and the risk of bacterial resistance. This study aims to analyze the microbial spectrum and antibiotic sensitivity of patients with postoperative infections in trauma surgery, providing a basis for clinical treatment and optimizing antibiotic usage strategies in this context. Methods: A retrospective analysis was conducted on patients with traumatic infections who were hospitalized in the departments of spine surgery, upper limb surgery, and lower limb surgery from January 2022 to December 2024. Bacterial culture-positive specimens were analyzed for bacterial species and antibiotic sensitivity. Results: A total of 804 traumatic infection specimens were submitted for testing, including 538 male patients (ages 2 - 95 years) and 266 female patients (ages 4 - 94 years). Among these, 267 cases showed positive culture results, with 172 males (ages 2 - 93 years) and 95 females (ages 4 - 94 years). A total of 153 strains of Gram-negative (G−) bacteria and 114 strains of Gram-positive (G+) bacteria were identified. Among G− bacteria, Escherichia coli was the most frequently isolated (40 strains), followed by Pseudomonas aeruginosa (28 strains) and Enterobacter cloacae (28 strains). Among G+ bacteria, Staphylococcus aureus was the most prevalent (75 strains), followed by Enterococcus faecalis (15 strains) and Streptococcus pyogenes (8 strains). Antibiotic sensitivity testing revealed that the resistance rate of Staphylococcus aureus to penicillin was as high as 93.33%, while the resistance rate of Escherichia coli to trimethoprim-sulfamethoxazole was 57.5%. Conclusion: The main pathogens responsible for postoperative infections in traumatology are Escherichia coli and Staphylococcus aureus, with significant antibiotic resistance. In clinical treatment, antibiotics should be selected rationally based on bacterial spectrum and resistance patterns to improve treatment efficacy.展开更多
This article discusses the findings presented by Zhang et al.They analyzed the risk factors and clinical characteristics associated with Klebsiella pneumoniae infection in patients with liver cirrhosis treated at a ho...This article discusses the findings presented by Zhang et al.They analyzed the risk factors and clinical characteristics associated with Klebsiella pneumoniae infection in patients with liver cirrhosis treated at a hospital in Beijing.In this article,we focus on the connection between chronic kidney disease and the intestinal microbiota,and propose microbiota transplantation as a potential treatment for this patient group.We also examine an intriguing phenomenon related to hepatic encephalopathy,and provide insights into the future research.展开更多
Background:Currently,there is a deficiency in a strong risk prediction framework for precisely evaluating the likelihood of severe postoperative complications in patients undergoing elective hepato-pancreatobiliary su...Background:Currently,there is a deficiency in a strong risk prediction framework for precisely evaluating the likelihood of severe postoperative complications in patients undergoing elective hepato-pancreatobiliary surgery subsequent to experiencing breakthrough infection of coronavirus disease 2019(COVID-19).This study aimed to find factors predicting postoperative complications and construct an innovative nomogram to pinpoint patients who were susceptible to developing severe complications following breakthrough infection of COVID-19 after undergoing elective hepato-pancreato-biliary surgery.Methods:This multicenter retrospective cohort study included consecutive patients who underwent elective hepato-pancreato-biliary surgeries between January 3 and April 1,2023 from four hospitals in China.All of these patients had experienced breakthrough infection of COVID-19 prior to their surgeries.Additionally,two groups of patients without preoperative COVID-19 infection were included as comparative controls.Surgical complications were meticulously documented and evaluated using the comprehensive complication index(CCI),which ranged from 0(uneventful course)to 100(death).A CCI value of 20.9 was identified as the threshold for defining severe complications.Results:Among 2636 patients who were included in this study,873 were included in the reference group I,941 in the reference group II,389 in the internal cohort,and 433 in the external validation cohort.Multivariate logistic regression analysis revealed that completing a full course of COVID-19 vaccination>6 months before surgery,undergoing surgery within 4 weeks of diagnosis of COVID-19 breakthrough infection,operation duration of 4 h or longer,cancer-related surgery,and major surgical procedures were significantly linked to a CCI>20.9.A nomogram model was constructed utilizing CCI>20.9 in the training cohort[area under the curve(AUC):0.919,95%confidence interval(CI):0.881–0.957],the internal validation cohort(AUC:0.910,95%CI:0.847–0.973),and the external validation cohort(AUC:0.841,95%CI:0.799–0.883).The calibration curve for the probability of CCI>20.9 demonstrated good agreement between the predictions made by the nomogram and the actual observations.Conclusions:The developed model holds significant potential in aiding clinicians with clinical decisionmaking and risk stratification for patients who have experienced breakthrough infection of COVID-19 prior to undergoing elective hepato-pancreato-biliary surgery.展开更多
BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause...BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.CASE SUMMARY A 20-year-old male developed persistent neck and back pain after consuming raw snail meat,followed by urinary retention and low fever.After admission,the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system.After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing,albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously.With effective antiparasitic treatment,the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.CONCLUSION This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.展开更多
Objective: This study aims to analyze the distribution of positive human papillomavirus (HPV) infections among women of appropriate age in Beiliu City during cervical cancer screening in 2024, providing data support f...Objective: This study aims to analyze the distribution of positive human papillomavirus (HPV) infections among women of appropriate age in Beiliu City during cervical cancer screening in 2024, providing data support for subsequent public health interventions. Methods: A retrospective analysis was conducted on the HPV test results from January 1, 2024, to November 30, 2024, at Beiliu Maternal and Child Health Hospital. We statistically analyzed the positive rates of different HPV genotypes and the co-infection status of multiple genotypes. Results: A total of 7558 individuals were tested, with 1103 positive cases identified, resulting in a positivity rate of 14.59%. Among these, HPV type 52 had the highest positive rate, accounting for 18.47%. The co-infection analysis showed that there were 788 cases with single genotype positivity, 236 with double genotype positivity, and 58 with triple genotype positivity, while cases with multiple genotypes simultaneously positive were relatively rare. Conclusion: The HPV infection rate among women of appropriate age in Beiliu City is relatively high, especially for high-risk HPV types. To reduce the future incidence of cervical cancer, it is recommended to enhance health education and vaccination efforts for this population.展开更多
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
文摘Multidrug-resistant(MDR)gram-negative bacteria(GNB)are responsible for high mortality and morbidity in health care settings world-wide.They have been declared as priority pathogens by the WHO for their continuously escalating antimicrobial resistance.Neverthe-less,data associated with MDR GNB in health care–associated infections are insufficient.Surgical site infections(SSIs)are among the most commonly occurring health care–associated infections.Such infections are particularly common when bacteria from a patient’s normal microflora are transferred to the surgical sites during surgical procedures.SSIs affect approximately 0.5%–3%of patients under-going surgery,resulting in prolonged hospital stays compared with patients without SSIs.SSIs result in severe problems and lead to a heavy economic burden.Most SSIs can be avoided if suitable preventive measures are employed.Novel findings support the dedicated usage of oral preoperative surgical antimicrobial prophylaxis for specific surgeries based on sites/organs.Immediate interventions are sought to control the transmission of MDR GNB typically found in hospital settings.The present narrative review aims to describe MDR GNB in SSIs in different sites.Antimicrobial resistance epidemiology and preventive measures for SSIs are also discussed.Differ-ent intrinsic and extrinsic factors and control measures are elaborated for curbing SSIs.
文摘In-utero exposure to Zika virus(ZIKV)could lead to miscarriage,preterm birth and congenital Zika syndrome.This study aimed at estimating the burden of ZIKV and Dengue virus(DENV)infections among pregnant women in Bojude,Nigeria.A total of 200 blood samples were collected from pregnant women between February and April 2022.Using the updated CDC guidelines for the diagnosis of ZIKV infections,including ELISA and microneutralization test(MNT),we found that 16.5%of participants were positive for ZIKV IgM,10%were positive for IgG,and 23%had nAb in their serum.Among the 46 ZIKV nAb-positive women,52.2%and 10.9%were recent and previous ZIKV infections,respectively,while 6.5%had previous DENV infections.Although no recent DENV infection was detected,recent and previous ZIKV/DENV co-infections were 13.0%and 17.4%,respectively.Two participants had recent secondary ZIKV infections,while 39.1%had prolonged lifelong immunity.Recent ZIKV infection rates were significantly higher among sexually active females aged 20–29 years than other age groups,with the highest risk observed in the first trimester of pregnancy.In addition,the grand-multiparous women are at higher risk of ZIKV infections than other categories.Monotypic recent,secondary and past ZIKV infections,as well as DENV and ZIKV co-infections,were detected in both the asymptomatic and symptomatic pregnant women.These findings highlight that ZIKV infection is prevalent among pregnant women in Nigeria and underscore the associated risk factors,providing evidence-based information on the burden of ZIKV infections in DENV-endemic region.
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038.
文摘In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.
基金Supported by National Natural Science Foundation of China,No.82260133the Key Laboratory Project of Digestive Diseases in Jiangxi Province,No.2024SSY06101Jiangxi Clinical Research Center for Gastroenterology,No.20223BCG74011.
文摘BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve outcomes.Large language models(LLMs)can potentially provide medical information for patients.AIM To examine the performance of three LLMs,ChatGPT-3.5,ChatGPT-4.0,and Google Gemini,in answering HBV-related questions.METHODS LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third reviewer.Each question was run three times using three LLMs.Readability was assessed via the Gunning Fog index and Flesch-Kincaid grade level.RESULTS Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatGPT-3.5:3.50;ChatGPT-4.0:3.69;Google Gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatGPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatGPT-3.5 and 73.1%for Google Gemini.Across the six domains,ChatGPT-4.0 performed better in terms of diagnosis,whereas Google Gemini demonstrated excellent clinical manifestations.Notably,in the readability analysis,the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal population.CONCLUSION Our results highlight the potential of LLMs,especially ChatGPT-4.0,for delivering responses to HBV-related questions.LLMs may be an adjunctive informational tool for patients and physicians to improve outcomes.Nevertheless,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038.
文摘In this editorial,we have commented on the article that has been published in the recent issue of World Journal of Clinical Cases.The authors have described a case of unilateral thyroid cyst and have opined that the acute onset of infection may be linked to diabetes mellitus(DM).We have focused on the role of nutrition in the association between DM and infection.Patients with DM are at a high risk of infection,which could also be attributed to nutrition-related factors.Nutritional interventions for patients with diabetes are mainly based on a low-calorie diet,which can be achieved by adhering to a low-carbohydrate diet.However,dietary fiber supplementation is recommended to maintain the diversity of the gut microbiota.Furthermore,high-quality protein can prevent the increased risk of infection due to malnutrition.Supplementation of vitamins C,vitamins A,vitamins D,and folic acid improves blood sugar control and facilitates immune regulation.Mineral deficiencies augment the risk of infection,but the relationship with diabetes is mostly U-shaped and a good intake should be maintained.
文摘BACKGROUND Congenital cytomegalovirus(CMV)infection represents a significant public health concern as the most prevalent viral infection in newborns,potentially leading to severe neurological and developmental complications.The majority of cases are asymptomatic and remain undetected during pregnancy due to the absence of effective screening methods.CASE SUMMARY A 27-year-old primigravida presented for early pregnancy ultrasound,which revealed an atypical finding:A normal anechoic thalamus appearing hyperechoic on the mid-sagittal view of the fetal head.Subsequent ultrasound examinations during mid and late gestation demonstrated classic intracranial features sug-gestive of congenital CMV infection.Chromosomal karyotyping and microarray analysis of the fetus yielded no significant abnormalities.Following compre-hensive prenatal counseling regarding potential adverse fetal outcomes,the patient elected to continue her pregnancy.She ultimately underwent cesarean delivery at 42 weeks gestation at another facility,resulting in the birth of a female neonate.At five months of age,the infant presented with epilepsy and significant growth and developmental delays.CONCLUSION Congenital CMV infection occurs during the first trimester may manifest as hyperechoic thalamus which can be revealed by ultrasound in the mid-saggital view of the fetal head.Future research should investigate the correlation between echogenic thalamus and developmental outcomes,as well as explore early sc-reening techniques for suspected congenital CMV infection cases.
文摘BACKGROUND Transfusion transmissible infections(TTIs)are illnesses spread through contaminated blood or blood products.In India,screening for TTIs such as hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency virus(HIV)-I/II,malaria,and syphilis is mandatory before blood transfusions.Worldwide,HCV,HBV,and HIV are the leading viruses causing mortality,affecting millions of people globally,including those with co-infections of HIV/HCV and HIV/HBV.Studies highlight the impact of TTIs on life expectancy and health risks,such as liver cirrhosis,cancer,and other diseases in individuals with chronic HBV.Globally,millions of blood donations take place annually,emphasizing the importance of maintaining blood safety.AIM To study the prevalence of TTIs,viz.,HBV,HCV,HIV I/II,syphilis,and malaria parasite(MP),among different blood donor groups.METHODS The study assessed the prevalence of TTIs among different blood donor groups in Delhi,India.Groups included total donors,in-house donors,total camp donors,institutional camp donors,and community camp donors.Tests for HIV,HBV,and HCV were done using enzyme-linked immunosorbent assay,while syphilis was tested with rapid plasma reagins and MP rapid card methods.The prevalence of HBV,HCV,HIV,and syphilis,expressed as percentages.Differences in infection rates between the groups were analyzed usingχ²tests and P-values(less than 0.05).RESULTS The study evaluated TTIs among 42158 blood donors in Delhi.The overall cumulative frequency of TTIs in total blood donors was 2.071%,and the frequencies of HBV,HCV,HIV-I/II,venereal disease research laboratory,and MP were 1.048%,0.425%,0.221%,0.377%,and 0.0024%,respectively.In-house donors,representing 37656 donors,had the highest transfusion transmissible infection(TTI)prevalence at 2.167%.Among total camp donors(4502 donors),TTIs were identified in 1.266%of donors,while community camp donors(2439 donors)exhibited a prevalence of 1.558%.Institutional camp donors(2063 donors)had the lowest TTI prevalence at 0.921%.Statistical analysis revealed significant differences in overall TTI prevalence,with total and in-house donors exhibiting higher rates compared to camp donors.CONCLUSION Ongoing monitoring and effective screening programs are essential for minimizing TTIs.Customizing blood safety measures for different donor groups and studying socio-economic-health factors is essential to improving blood safety.
文摘BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the Cochrane Library databases were searched from inception to March 2024.Eligible articles included observational studies that reported on outcomes such as mortality,colectomy,hospitalization,intensive care unit(ICU)admission,complication rates,and length of hospital stay in IBD patients with and without CDI.Data were extracted,and a randomeffects model was used to calculate pooled odds ratios(ORs)and mean differences(MDs).RESULTS As shown in the data from 21 studies with 1249158 participants,CDI significantly increased the risk of mortality in IBD patients[pooled OR=4.569,95%confidence intervals(95%CI):2.584 to 8.079].Although the pooled OR for colectomy was 1.409(95%CI:0.922 to 2.155),it was not statistically significant.Similarly,CDI did not impact hospitalization(pooled OR=1.056,95%CI:0.512 to 2.179)and ICU admission outcomes(pooled OR=1.970,95%CI:0.420 to 9.246)of patients with IBD.The rate of complications was comparable in the two groups(pooled OR=0.658,95%CI:0.378 to 1.147).However,CDI was associated with a significantly more extended hospital stay(pooled MD=0.349 days,95%CI:0.002 to 0.696).CONCLUSION CDI is linked to increased mortality and prolonged hospitalization in IBD patients.These results emphasize the need for early detection and appropriate management.Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.
文摘BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.
文摘Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP remains challenging, particularly in patients with comorbidities or contraindications to standard therapies. Objectives: To evaluate the effectiveness of ozonated water as an adjunctive treatment for EP, delivered using a patented robotic therapy system designed for hygiene and infection prevention in non-self-sufficient patients. Methods: We report the case of a 90-year-old male patient with acute EP who received daily skin treatments with ozonated water in conjunction with supportive care, including rehydration and antibiotics. The intervention was facilitated by the robotic system “COPERNICO Surveillance & Prevention,” which ensured standardized hygiene practices and clinical documentation. Results: Within one week of treatment, the patient showed complete desquamation of necrotic skin, resolution of erythema, and significant metabolic recovery. Fever subsided, renal function improved, and the patient was discharged in stable condition. Follow-up confirmed sustained clinical improvement, and no adverse events were reported. Conclusions: Ozonated water demonstrated efficacy in alleviating the dermatological and systemic manifestations of EP in a high-risk elderly patient. This case highlights the potential of ozone therapy as a safe, cost-effective adjunctive treatment for EP and underscores the utility of robotic systems in managing complex dermatological conditions. Further research is warranted to validate these findings in larger cohorts.
文摘BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pain,rebound tenderness,and rapid onset.Its pathogenesis is complex and potentially linked to infection,environment,and genetics.Timely intervention is crucial to prevent complications.While surgery is the primary treatment,it carries risks,including postoperative infections that may necessitate re-operation.Gram-negative bacteria release endotoxin(ETX),which induces inflammation and is recognized by toll-like receptor 4(TLR4).This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections,aiding in prevention and treatment.AIM To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.METHODS A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024(n=153)were included in the study.Patients were categorized into infected(n=36)and uninfected(n=117)groups according to the development of postoperative incision infections.General characteristics and blood levels of ETX and TLR4 were compared,and the factors influencing postoperative infection were identified using multivariate logistic regression.ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.RESULTS No statistically significant differences were observed between the two groups in terms of sex,age,or other general characteristics(P>0.05).Compared to the uninfected group,the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis,longer surgical times,longer incision lengths,and elevated ETX and TLR4 levels(P<0.05).Multivariate logistic regression analysis identified pathological type,surgical method,surgical time,and incision length as factors influencing postoperative incision infection in acute appendicitis.Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection,with higher prediction efficiency when combined.CONCLUSION Pathological type,surgical method,surgical time,and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis.Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.
基金supported by the projects of National Virus Resource Center(NVRC-PY-03,E1YZ020501)Natural Science Foundation of Hubei Province(2022CFB564)+4 种基金Foundation of Hubei Provincial Health Commission(WJ2023M108)National Basic Science Data Sharing Platform(no.2018ZX10101004)National Basic Science Data Sharing Service Platform(no.NBSDC-DB-13)the International Cooperation Base of Hubei Province for Infection and Immunitysupported by Outstanding Medical Young Scholars of Hubei Province and Wuhan Young and Middle-aged Medical Backbone Talent Program.
文摘Acute respiratory tract infections(ARTIs)are among the leading causes of morbidity and mortality in children worldwide.Human adenovirus(HAdV)infections are estimated to account for at least 5%of pediatric ARTIs.The circulated genotypes of HAdV and the correlation between genotype and clinical manifestations in Wuhan,China,before and after the complete relaxation of nonpharmaceutical interventions against severe acute respiratory syndrome coronavirus 2,remain unknown.Here,101 HAdV strains were isolated from throat swab samples collected from hospitalized children with ARTIs who tested positive for HAdV nucleic acid.Of these,sixty-six strains from 2022 to twenty-three strains from 2023 were successfully genotyped and subjected to phylogenetic analysis based on the hexon,penton base,and fiber genes.Six genotypes,B3,C1,C2,C5,C104,and C108 were identified.HAdV-B3(84.85%)was the most prevalent type in 2022,while HAdV-C(86.96%),including C1,C2,C108,and C104,was the most prevalent in 2023.These strains were phylogenetically related to strains from Japan,China,and the United States in recent years.When comparing clinical characteristics,pediatric patients infected with B3,C1,C2,C5,C104,or C108 exhibited similar clinical manifestations,primarily fever and cough,but varying interleukin(IL)-10 levels.In conclusion,from June 2022 to September 2023,the circulated genotypes of HAdV in Wuhan included B3,C1,C2,C108,C5,and C104.The endemic pattern of HAdV in Wuhan,China,shifted from species B as the dominant type in 2022 to species C in 2023.
文摘Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of sexually transmitted genital infections by traditional methods as culture remains extremely delicate, difficult or impossible (to find extremely fragile organisms that can be cultured). Thus, molecular techniques constitute an alternative to improve accurate diagnostic, personalized patient treatment, and public health. A total of 83 clinical samples including urethral discharge and urine samples from individual patients with symptoms of urethritis received were analyzed using traditional methods and a commercial real-time PCR (qPCR) method. Out of 83 urethritis patients, n = 55 (66.26%) were positive for at least one of the STI pathogens detected by qPCR. qPCR assay was more sensitive (50/83, positive cases) compared to culture (15/83, positive cases) and light microscopy (28/83, positive cases). The most prevalent NTD pathogen in the suspected patients was N. gonorrhoeae with 60.24% (50/83) based on real-time PCR diagnosis. Among the positive cases of STI pathogens, Neisseria gonorrhoeae had the highest frequency 49/55 (89.01%) followed by low frequencies of Trichomonas vaginalis 4/55 (7.27%) and Chlamydia trachomatis 1/55 (1.82%). This highlights the high prevalence of N. gonorrhoeae infection in male urethritis patients and a very important misdiagnosis using traditional routine methods in Burkina Faso by medical laboratories. Thus, this situation may negatively impact patients’ personalized treatment and care and public health with the possible rapid emergence of multidrug-resistant strains. This study also highlights the urgent need to optimize culture for the diagnosis of NTD pathogens in Burkina Faso and the usefulness and the need for the introduction of molecular diagnostic methods in routine diagnosis for the detection of NTD pathogens in the medical laboratories in Burkina Faso.
文摘This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.
文摘Objective: With the increasing volume of trauma surgery, postoperative infections have garnered significant attention, as they not only affect patient outcomes but also raise healthcare costs and the risk of bacterial resistance. This study aims to analyze the microbial spectrum and antibiotic sensitivity of patients with postoperative infections in trauma surgery, providing a basis for clinical treatment and optimizing antibiotic usage strategies in this context. Methods: A retrospective analysis was conducted on patients with traumatic infections who were hospitalized in the departments of spine surgery, upper limb surgery, and lower limb surgery from January 2022 to December 2024. Bacterial culture-positive specimens were analyzed for bacterial species and antibiotic sensitivity. Results: A total of 804 traumatic infection specimens were submitted for testing, including 538 male patients (ages 2 - 95 years) and 266 female patients (ages 4 - 94 years). Among these, 267 cases showed positive culture results, with 172 males (ages 2 - 93 years) and 95 females (ages 4 - 94 years). A total of 153 strains of Gram-negative (G−) bacteria and 114 strains of Gram-positive (G+) bacteria were identified. Among G− bacteria, Escherichia coli was the most frequently isolated (40 strains), followed by Pseudomonas aeruginosa (28 strains) and Enterobacter cloacae (28 strains). Among G+ bacteria, Staphylococcus aureus was the most prevalent (75 strains), followed by Enterococcus faecalis (15 strains) and Streptococcus pyogenes (8 strains). Antibiotic sensitivity testing revealed that the resistance rate of Staphylococcus aureus to penicillin was as high as 93.33%, while the resistance rate of Escherichia coli to trimethoprim-sulfamethoxazole was 57.5%. Conclusion: The main pathogens responsible for postoperative infections in traumatology are Escherichia coli and Staphylococcus aureus, with significant antibiotic resistance. In clinical treatment, antibiotics should be selected rationally based on bacterial spectrum and resistance patterns to improve treatment efficacy.
基金Supported by the Key Research and Development Project of the Science and Technology Department of Sichuan Province,China,No.2023YFS0280the High-level Research Initiation Fund Program of the First Affiliated Hospital of Chengdu Medical College,China,No.CYFY-GQ43.
文摘This article discusses the findings presented by Zhang et al.They analyzed the risk factors and clinical characteristics associated with Klebsiella pneumoniae infection in patients with liver cirrhosis treated at a hospital in Beijing.In this article,we focus on the connection between chronic kidney disease and the intestinal microbiota,and propose microbiota transplantation as a potential treatment for this patient group.We also examine an intriguing phenomenon related to hepatic encephalopathy,and provide insights into the future research.
基金supported by grants from the Science Fund for Creative Research Groups of the National Natural Science Founda-tion of China(81521091 and 82073031)the National Natural Sci-ence Foundation of China(92269204)Clinical Research Plan of SHDC(SHDC2020CR5007 and SHDC22020213)。
文摘Background:Currently,there is a deficiency in a strong risk prediction framework for precisely evaluating the likelihood of severe postoperative complications in patients undergoing elective hepato-pancreatobiliary surgery subsequent to experiencing breakthrough infection of coronavirus disease 2019(COVID-19).This study aimed to find factors predicting postoperative complications and construct an innovative nomogram to pinpoint patients who were susceptible to developing severe complications following breakthrough infection of COVID-19 after undergoing elective hepato-pancreato-biliary surgery.Methods:This multicenter retrospective cohort study included consecutive patients who underwent elective hepato-pancreato-biliary surgeries between January 3 and April 1,2023 from four hospitals in China.All of these patients had experienced breakthrough infection of COVID-19 prior to their surgeries.Additionally,two groups of patients without preoperative COVID-19 infection were included as comparative controls.Surgical complications were meticulously documented and evaluated using the comprehensive complication index(CCI),which ranged from 0(uneventful course)to 100(death).A CCI value of 20.9 was identified as the threshold for defining severe complications.Results:Among 2636 patients who were included in this study,873 were included in the reference group I,941 in the reference group II,389 in the internal cohort,and 433 in the external validation cohort.Multivariate logistic regression analysis revealed that completing a full course of COVID-19 vaccination>6 months before surgery,undergoing surgery within 4 weeks of diagnosis of COVID-19 breakthrough infection,operation duration of 4 h or longer,cancer-related surgery,and major surgical procedures were significantly linked to a CCI>20.9.A nomogram model was constructed utilizing CCI>20.9 in the training cohort[area under the curve(AUC):0.919,95%confidence interval(CI):0.881–0.957],the internal validation cohort(AUC:0.910,95%CI:0.847–0.973),and the external validation cohort(AUC:0.841,95%CI:0.799–0.883).The calibration curve for the probability of CCI>20.9 demonstrated good agreement between the predictions made by the nomogram and the actual observations.Conclusions:The developed model holds significant potential in aiding clinicians with clinical decisionmaking and risk stratification for patients who have experienced breakthrough infection of COVID-19 prior to undergoing elective hepato-pancreato-biliary surgery.
基金Supported by the Hainan Provincial Natural Science Foundation of China,No.824MS173 and No.823MS165the Project of Hainan Province Clinical Medical Center.
文摘BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.CASE SUMMARY A 20-year-old male developed persistent neck and back pain after consuming raw snail meat,followed by urinary retention and low fever.After admission,the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system.After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing,albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously.With effective antiparasitic treatment,the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.CONCLUSION This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.
文摘Objective: This study aims to analyze the distribution of positive human papillomavirus (HPV) infections among women of appropriate age in Beiliu City during cervical cancer screening in 2024, providing data support for subsequent public health interventions. Methods: A retrospective analysis was conducted on the HPV test results from January 1, 2024, to November 30, 2024, at Beiliu Maternal and Child Health Hospital. We statistically analyzed the positive rates of different HPV genotypes and the co-infection status of multiple genotypes. Results: A total of 7558 individuals were tested, with 1103 positive cases identified, resulting in a positivity rate of 14.59%. Among these, HPV type 52 had the highest positive rate, accounting for 18.47%. The co-infection analysis showed that there were 788 cases with single genotype positivity, 236 with double genotype positivity, and 58 with triple genotype positivity, while cases with multiple genotypes simultaneously positive were relatively rare. Conclusion: The HPV infection rate among women of appropriate age in Beiliu City is relatively high, especially for high-risk HPV types. To reduce the future incidence of cervical cancer, it is recommended to enhance health education and vaccination efforts for this population.
