Klebsiella pneumoniae infections after liver transplantation:Drug resistance and distribution of pathogens,risk factors,and influence on outcomes

BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

Urgent call for attention to diabetes-associated hospital infections

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.

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue.Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment.Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host,such as drug-resistant bacteria,biofilms,persister cells,intracellular bacteria,and small colony variants(SCVs).Moreover,microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process,leading to impaired bone defect repair.Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade,challenges remain in clinical management.The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections,but a comprehensive review of their research progress is lacking.This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration,and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections.It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.

Countermeasures to reduce the risk of infections at the 2024 Olympic and Paralympic Games—A balancing act

The Olympic and Paralympic Games are a global celebration of athletic dedication and achievement,bringing together athletes and spectators from around the world.However,such large gatherings present public health challenges for the Organizing Committees and local governments.As highlighted by the coronavirus disease 2019(COVID-19)pandemic,these events are associated with an increased risk of transmission of infections,which can significantly impact the health and well-being of athletes and attendees.Prioritizing the health and safety of athletes,officials and spectators is fundamental to ensure the successful hosting of the Games.Therefore,it is essential to design and implement comprehensive countermeasures to mitigate the risk of an infectious disease outbreak among participants but also to the residents of the host city.

The Place of Nursing Theory in the Management of Post-Operative Infections in a Hospital Environment: Case of Cibitoke District Hospital

Introduction: Post-operative infections, such as surgical site infections (SSIs), are a significant concern in healthcare settings. Nurses play a crucial role in the prevention and management of these infections. The use of nursing theory could contribute to the prevention of SSIs. The aim of this study was to evaluate the role of nursing theory in the management of surgical site infections (SSIs) in a hospital environment. Method: A cross-sectional study was conducted using descriptive and analytical methods to assess the role of nursing theory in the management of Post-operative infections (POI) in a hospital setting in October 2023. The study population consisted of nurses working in the Surgery, Emergency, and Maternity units at Cibitoke District Hospital. A sample size of 71 nurses working full or part time in the Surgery were invited to participate in this study. A questionnaire was used to collect the data, and SPSS version 21.0 software was used for analysis. Results: The study found that nursing theory did not have any statistically significant place in the management of POI (p-value = 0.523). However, the results showed that experience was the only significant factor influencing the management of POI (p-value = 0.004). This is explained by the analysis of the net effects of the explanatory variable where we noticed that those who had more experience were more likely to manage post-operative infections. The participants’ knowledge regarding nursing theory in the management was poor as they scored less than 30% in all the variables used to measure their knowledge. Conclusion: The study revealed that nurses’ knowledge of nursing theories and their applications in the management of SSIs was poor. Continuing professional development, curriculum review, and in-service training were highly recommended.

Ethnobotanical Study of Medicinal Plants Used for Treating Urinary Tract Infections in N’Djamena (Chad)

Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.

Risk Factors in Surgical Site Infections

Purpose of the Research: Our study aimed to determine and understand the risk factors of surgical site infections in patients operated on in general surgery wards. Method of Research: Between May 2008 and November 2008, 422 consecutive patients who underwent emergency and elective surgeries, excluding breast, goitre and laparoscopic surgeries, were included in the study to determine surgical site infections and risk factors. The patients’ risk factors were selected in the preoperative period, and postoperative 3rd, 7th, and 30th days were checked by the physician responsible for conducting the study regarding surgical site infection. Results and Conclusion: Surgical site infections were defined as incisional and organ/space based on NNIS data. Gender, diabetes mellitus, malignancy, degree of contamination, ASA score ≥ 3, preoperative skin cleansing, duration of intensive care unit stay, duration of hospital stay, growth in wound culture, duration of surgery and incision length were determined as risk factors increasing CAI rates. Especially the degree of contamination, duration of intensive care unit stay, hospitalisation, duration of operation, and growth in wound culture were decisive factors in the development of CAI. As a result of our study, in the light of these data, we concluded that to prevent the development of CAI can be modified, interventions to foreseeable factors can be assessed.

Beta-lactam antibiotic resistance among Escherichia coli isolates from patients with urinary tract infections in Vietnam:A systematic review and meta-analysis

Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to 2022.Methods:29 Descriptive studies published between 2010 and 2022 in English and Vietnamese were included in the analysis.Data on resistance rates to beta-lactam antibiotics,including cephalosporins and carbapenems,were extracted and analyzed.Weighted pooled resistance rates were calculated using random-effects models.Annual trends in resistance were assessed using linear regression analysis.Results:Among the beta-lactam antibiotics studied,Escherichia coli exhibited varying levels of resistance,with cephalosporins showing higher resistance rates compared to carbapenems.Weighted pooled resistance rates were 66%for cefotaxime,65%for ceftriaxone,54%for ceftazidime,and 56%for cefepime.In contrast,carbapenems demonstrated lower resistance rates,with weighted pooled resistance rates ranging from 3%to 4%for meropenem,ertapenem,and imipenem.Resistance rates were also observed for amoxicillin/clavulanate(35%),ticarcillin/clavulanate(26%),and piperacillin/tazobactam(12%).Significant annual increases in resistance were noted for imipenem(0.56%,P<0.001).Conclusions:This study highlights the critical issue of antimicrobial resistance in urinary tract infections in Vietnam and emphasizes the importance of prudent antibiotic use and the regular monitoring of resistance patterns.These insights are useful for guiding healthcare professionals in optimizing treatment strategies and for policymakers in formulating evidence-based clinical guidelines to combat antibiotic resistance effectively.

Epidemiologic Profile Urinary Tract Infections: Experience of the Microbiology Laboratory of the University Hospital Mohamed VI in Tangier

Urinary tract infection is one of the most common bacterial infections in humans. The urine cytobacteriological examination is the key test for its diagnosis. This work aims to Evaluate the prevalence of urinary tract infection at the Microbiology Laboratory of the University Hospital Mohamed VI in Tangier and to highlight its epidemiological and bacteriological characteristics. It was a descriptive study with retrospective data collection which took place from January 2021 to June 2022, at the Microbiology Laboratory of the university hospital Mohamed VI in Tangier. It covered all urine cytobacteriological examinations (ECBU) during the study period. We identified 77 cases of urinary tract infections out of 300 requests for (ECBU), that is a positivity rate of 25 %. The mean age was 55 years. The male gender was predominant. The epidemiological profile of the isolated strains was dominated by Enterobacteriaceae 81 %, followed by Gram-positive cocci 11 % and non-fermenting gram-negative bacteria 8 %. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli 42 %, Klebsiella pneumoniae 20 %, Enterobacter cloacae 9 %, Staphylococcus aureus 6 %, Pseudomonas aeruginosa 5 % and Acinetobacter baumannii 3%. Most of the analyzed organisms showed resistance, especially to the beta-lactam antibiotic;the enterobacteria strains isolated had revealed resistance to amoxicillin: 74%, to amoxicillin-clavulanic acid in 40% of cases, and to third-generation cephalosporins in 24%. In terms of resistance mechanisms, 11 % of the Enterobacteriaceae were extended-spectrum β-lactamase producers and 9 % of the specimens were identified as carbapenemase producers. Of the Staphylococcus aureus strains isolated, 75% were resistant to meticillin. The Glycopeptides and linezolid were the most active molecules on these isolated strains. 15% of Enterococcus species isolated in our laboratory were resistant to glycopeptides (vancomycin and teicoplanin).

Five-year analysis of isolated pathogens and antibiotic resistance of ocular infections from two large tertiary comprehensive hospitals in east China

AIM:To analyze the spectrum of isolated pathogens and antibiotic resistance for ocular infections within 5y at two tertiary hospitals in east China.METHODS:Ocular specimen data were collected from January 2019 to October 2023.The pathogen spectrum and positive culture rate for different infection location,such as keratitis,endophthalmitis,and periocular infections,along with antibiotic resistance were analyzed.RESULTS:We included 2727 specimens,including 827(30.33%)positive cultures.A total of 871 strains were isolated,530(60.85%)bacterial and 341(39.15%)fungal strains were isolated.Gram-positive cocci(GPC)were the most common ocular pathogens.The most common bacterial isolates were Staphylococcus epidermidis(25.03%),Staphylococcus aureus(7.46%),Streptococcus pneumoniae(4.59%),Corynebacterium macginleyi(3.44%),and Pseudomonas aeruginosa(3.33%).The most common fungal genera were Fusarium spp.(12.74%),Aspergillus spp.(6.54%),and Scedosporium spp.(5.74%).Staphylococcus epidermidis strains showed more than 50%resistance to fluoroquinolones.Streptococcus pneumoniae and Corynebacterium macginleyi showed more than 90%resistance to erythromycin.The percentage of bacteria showing multidrug resistance(MDR)significantly decreased(χ^(2)=17.44,P=0.002).CONCLUSION:GPC are the most common ocular pathogens.Corynebacterium macginleyi,as the fourth common bacterium,may currently be the local microbiological feature of east China.Fusarium spp.is the most common fungus.More than 50%of the GPC are resistant to fluoroquinolones,penicillins,and macrolides.However,the proportion of MDR strains has been reduced over time.

Clinical and Bacteriological Profile of Infections in Sickle Cell Children in Two Referral Hospitals in Niamey, Niger

Introduction: Infections are significant causes of mortality in sickle cell children in resource-limited countries. This study aimed to determine the clinical profile and bacterial ecology of infections in children with sickle-cell disease in two referral hospitals in Niamey. Patients and methods: A retrospective descriptive study was conducted from January 2018 to July 2020 in two referral hospitals in Niamey. All children aged one (1) to 15 years with sickle cell disease admitted for suspected infection, including at least one bacterial culture, were studied. Bacteriological analysis was performed using the appropriate culture media, using BactAlert (Reference 4700003 BTA3D60 BioMérieux). Results: Over 36-months, 350 children with a mean age of 10.9 months were admitted. The sex ratio was 1.2. The SS electrophoretic profile was the most common (93.4%). Immunization status was up to date in 66% of patients. Fever was the common reason for consultation (55.1%). Infection was confirmed in 62 patients (17.7%). The primary diagnoses were bacterial gastroenteritis (24.2%) and urinary tract infection (19.4%). Blood cultures were isolated from Salmonella typhi (13.0%) and Escherichia coli (8.7%). Klebsiella spp (7.1%) and Escherichia coli (5.0%) were detected in cytobacteriological examination of urine. Salmonella typhi (23.5%) and Escherichia coli (5.9%) were isolated on coproculture. Conclusion: Bacterial ecology appears not different from that usually observed in sickle-cell children. Salmonella and Escherichia coli were predominant.

Bacteriological Profile of Effusion Fluids Infections at Charles De Gaulle University Pediatric Hospital from 2017 to 2020

Introduction: Microbiology of effusion fluids in children in Burkina Faso is characterized by the scarcity of data. This work aimed to study the bacteriological and antibiotics susceptibility profile of bacteria involved in effusion fluid infections in paediatrics in order to improve the choice of probabilistic antibiotics therapy. Methods: A cross-sectional, descriptive study was used in children aged 0 to 15 years from 2017 to 2020 at the Charles De Gaulle Pediatric University Hospital Center (CHUP-CDG) in Ouagadougou. Classical bacteriology methods such as macroscopy, Gram staining, identification galleries and antibiotics susceptibility testing were used. Results: Of 231 samples, 64 bacteria were isolated. The most common bacterial strains of pleural fluid were Staphylococcus aureus (25%) and 40% for Enterobacteriaceae. Of the peritoneal fluid, 77% were Enterobacteriaceae with 57% Escherichia coli;and from joint fluid, 33% were S. aureus and 22% for P. aeruginosa. The overall susceptibility profile showed 29% extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), 10% methicillin-resistant S. aureus (MRSA), and 8% carbapenemases. Conclusion: Bacteriological profile is characterized by ESBL-producing Enterobacteriaceae and MRSA. The most active antibiotics were macrolides, aminoglycosides, and cefoxitin (methicillin) for Gram-positive cocci, carbapenems, and aminoglycosides for Gram-negative bacilli. Then, the monitoring of antibiotics resistance must be permanent.

Incidences and Risk Factors for Surgical Site Infections in Koutiala, Mali

Purpose: This paper aims to assess the incidences and risk factors for surgical site (ISO) infections in the general surgery department of the Koutiala District Hospital. Patients and Methods: This was a prospective and descriptive study from August 1, 2017 to October 31, 2020 involving all patients who underwent laparotomy in the general surgery department of the Koutiala District Hospital. Patients who were not operated on and who did not have a laparotomy were not included. Age, sex, frequency, patient history, National Nosocomial Infections Surveillance (NNIS) index, time to occur, bacteriological test results and course of infection were analyzed. Results: Fifty patients were registered. The average age was 34.2 ± 21.2 years old. Eleven patients were 60 years old or older. The hospital incidence rate was 4.3% and the community incidence rate was 6.1 cases per 100,000 population. The concept of smoking was noted in 15 patients. Patients were operated on in emergency 84% of cases. Peritonitis was the most common initial lesion with 32% of cases. Our patients had an NNIS index greater than 0 in 84% of cases. The time to develop infection from the surgical site was less than 3 days in 8 patients (16% of cases). Depending on the depth of the infection, it was superficial (cutaneous) in 39 patients (78%) and deep (subcutaneous and organic) in 11 patients (22%). Escherichia coli was the most common germ with 72% followed by staphylococcus aureus at 24%. We noted 22% morbidity. The median length of hospitalization was 9 ± 2.2 days. Conclusion: ISO is common in our service. Prevention and mastery require knowledge of risk factors.

Distribution of pathogenic bacteria and antimicrobial sensitivity of eye infections in Suzhou

AIM:To investigate the types of bacteria in patients with eye infections in Suzhou and their drug resistance to commonly used antibacterial drugs.METHODS:The clinical data of 155 patients were retrospectively collected in this study,and the pathogenic bacteria species and drug resistance of each pathogenic bacteria were analyzed.RESULTS:Among the 155 patients(age from 12 to 87 years old,with an average age of 57,99 males and 56 females)with eye infections(160 eyes:74 in the left eye,76 in the right eye and 5 in both eyes,all of which were exogenous),71(45.81%)strains were gram-positive bacteria,23(14.84%)strains were gram-negative bacteria and 61(39.35%)strains were fungi.Gram-positive bacteria were highly resistant to penicillin and erythromycin(78.87%and 46.48%respectively),but least resistant to vancomycin at 0.Gram-negative bacteria were highly resistant to cefoxitin and compound sulfamethoxazole(100%and 95.65%respectively),but least resistant to meropenem at 0.Comparison of the resistance of gram-positive and gram-negative bacteria to some drugs revealed statistically significant differences(P<0.05)in the resistance of both to cefoxitin,cotrimoxazole,levofloxacin,cefuroxime,ceftriaxone and ceftazidime,and both had higher rates of resistance to gram-negative bacteria than to gram-positive bacteria.The distribution of bacterial infection strains showed that Staphylococcus epidermidis was the most common strain in the conjunctiva,cornea,aqueous humor or vitreous body and other eye parts.Besides,Fusarium and Pseudomonas aeruginosa were also among the most common strains of conjunctival and corneal infections.CONCLUSION:Gram-positive bacteria are the dominant bacteria in eye infections,followed by gram-negative bacteria and fungi.Considering the resistance of gramnegative bacteria to multiple drugs,monitoring of bacteria should be strengthened in eye bacterial infections for effective prevention and control to reduce complications caused by eye infections.

Surgical Site Infections in Trauma and Orthopaedics at Bouaké Teaching Hospital (Côte d’Ivoire)

Background: Surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké Teaching Hospital. Method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. Multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. Surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

Skin and Soft Tissue Infections in the Surgical Area at the Kara Teaching Hospital

Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University Hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 women.The sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara University Hospital, with a high mortality rate due to delayed consultations.

Deep neck infections mortal complications:Intrathoracic complications and necrotising fasciitis

BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.

Improving treatment plan and mental health in children with abdominal infection for broad-spectrum bacterial infections

BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped.The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing,and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing;the control group only sent bacterial culture and drug sensitivity testing during the operation.RESULTS White blood cell count,C-reactive protein,procalcitonin,3 days after surgery,showed better postoperative index than the control group(P<0.05).The hospital stay in the observation group was significantly shorter than that in the control group.The hospitalization cost in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics,improving treatment outcomes and reducing medical costs to some extent.

Global Burden of Fungal Infections and Antifungal Resistance from 1961 to 2024: Findings and Future Implications

Background: Antifungal resistance (AFR) is a global public health problem with devastating effects, especially among immunocompromised individuals. Addressing AFR requires a One Health approach including Antifungal Stewardship (AFS). This study aimed to comprehensively review global studies published on fungal infections and AFR and to recommend solutions to address this growing problem. Materials and Methods: This was a narrative review that was conducted using published papers on fungal infections, AFR, and AFS between January 1961 and March 2024. The literature was searched using PubMed, Google Scholar, Web of Science, and EMBASE. Results: This found that there has been an increase in fungal infections globally, especially among immunocompromised patients. Due to this increase in fungal infections, there has been a proportionate increase in the use of antifungal agents to prevent and treat fungal infections. This increased use of antifungal agents has worsened the problem of AFR contributing to increased morbidity and mortality. Globally, fungal infections have contributed to 150 million infections annually and 1.7 million deaths per year. By the year 2023, over 3.8 million people died from fungal infections. Addressing AFR remains a challenge because the treatment of antifungal-resistant infections is difficult. Finally, the treatment of fungal infections is a global challenge exacerbated by the limited number of antifungal agents to treat invasive fungal infections. Conclusion: The results of this study indicated that fungal infections and AFR are prevalent across humans, animals, agriculture, and the environment. Addressing this problem requires the provision of solutions such as improving the awareness of AFR, conducting further research on the discovery of new antifungal agents, and implementing AFS programs. If this global problem is not addressed, the morbidity and mortality associated with AFR will continue to rise in the future.