Factors Influencing Mortality in COVID-19-Associated Mucormycosis - The International ID-IRI Study.

The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first three months post-COVID-19 diagnosis. Data collected through the IDI-IR included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29±13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis (ROCM). Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age [Hazard Ratio (HR)=1.06, (p<0.001)], rituximab use (HR=21.2, p=0.05), diabetic ketoacidosis (HR=3.58, p=0.009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR=8.81, p<0.001). The utilization of rituximab and diabetic ketoacidosis along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes.

Over a third of patients who developed mucormycosis after COVID-19 died. Older people, those on specific immunosuppressive treatments and those with diabetic ketoacidosis had a higher risk of death. However, undergoing surgery as part of treatment significantly improved survival.

Understanding clinical outcomes and factors influencing mortality in intensive care unit patients with COVID-19-associated candidemia.

BACKGROUND: During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection. OBJECTIVES: The aim of this international study was to evaluate the clinical outcomes and identify factors influencing mortality in patients who developed candidemia during their COVID infection. PATIENTS/METHODS: This study included adult patients (18 years of age or older) admitted to the intensive care unit (ICU) and diagnosed with COVID-associated candidemia (CAC). The research was conducted through ID-IRI network and in collaboration with 34 medical centres across 18 countries retrospectively, spanning from the beginning of the COVID pandemic until December 2021. RESULTS: A total of 293 patients diagnosed with CAC were included. The median age of the patients was 67, and 63% of them were male. The most common Candida species detected was C. albicans. The crude 30-day mortality rate was recorded at 62.4%. The logistic regression analysis identified several factors significantly impacting mortality, including age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07, p < .0005), SOFA score (OR 1.307, 95% CI 1.17-1.45, p < .0005), invasive mechanical ventilation (OR 7.95, 95% CI 1.44-43.83, p < .017) and duration of mechanical ventilation (OR 0.98, 95% CI 0.96-0.99, p < .020). CONCLUSIONS: By recognising these prognostic factors, medical professionals can customise their treatment approaches to offer more targeted care, leading to improved patient outcomes and higher survival rates for individuals with COVID-associated candidemia.

Clinicopathological profile of peritoneal tuberculosis and a new scoring model for predicting mortality: an international ID-IRI study.

Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data. In this study, 208 patients with TBP were included. Mean age of TBP cases was 41.4 ± 17.5 years. One hundred six patients (50.9%) were females. Nineteen patients (9.1%) had HIV infection, 45 (21.6%) had diabetes mellitus, 30 (14.4%) had chronic renal failure, 12 (5.7%) had cirrhosis, 7 (3.3%) had malignancy, and 21 (10.1%) had a history of immunosuppressive medication use. A total of 34 (16.3%) patients died and death was attributable to TBP in all cases. A pioneer mortality predicting model was established and HIV positivity, cirrhosis, abdominal pain, weakness, nausea and vomiting, ascites, isolation of Mycobacterium tuberculosis in peritoneal biopsy samples, TB relapse, advanced age, high serum creatinine and ALT levels, and decreased duration of isoniazid use were significantly related with mortality (p < 0.05). This is the first international study on TBP and is the largest case series to date. We suggest that using the mortality predicting model will allow early identification of high-risk patients likely to die of TBP.

A systematic review on green synthesis of silver nanoparticles using plants extract and their bio-medical applications.

Nanoparticles have recently become considered as a crucial player in contemporary medicine, with therapeutic uses ranging from contrast agents in imaging to carriers for the transport of drugs and genes into a specific target. Nanoparticles have the ability to have more precise molecular interactions with the human body in order to target specific cells and tissues with minimal adverse effects and maximal therapeutic outcomes. With the least number of side effects and the greatest possible therapeutic benefit, nanoparticles can target particular cells and tissues through more precise molecular interactions with the human body. The majority of global public health problems are now treated with green synthesized silver nanoparticles (AgNPs), which substantially affect the fundamental structure of DNA and proteins and thus display their antimicrobial action. AgNPs can inhibit the proliferation of tumor cells and induce oxidative stress. By inhibiting vascular endothelial growth factor (HIF)-1, pro-inflammatory mediators generated by silver nanoparticles are reduced, mucin hypersecretion is lessened, and gene activity is subsequently regulated to prevent infections. The biogenic synthesis of silver nanoparticles (AgNPs) using various plants and their applications in antibacterial, antifungal, antioxidant, anticancer, anti-inflammatory, and antidiabetic activities have been extensively discussed in this article. Also, because only natural substances are utilized in the manufacturing process, the particles that are created naturally are coated, stabilized, and play a vital role in these biomedical actions. The characterization of AgNPs, possibility of preparing AgNPSs with different shapes using biological method and their impact on functions and toxicities, impact of size, shape and other properties on AgNPs functions and toxicity profiles, limitations, and future prospects of green-mediated AgNPs have also been reported in this study. The major goal of this study is to provide readers with a comprehensive, informed, and up-to-date summary of the various AgNPs production and characterization methods and their under-investigational antioxidant, antibacterial, and anticancer, antidiabetic, antifungal and anti-inflammatory properties. This review provides instructions and suggestions for additional studies based on AgNPs. This evaluation also pushes researchers to look into natural resources like plant parts in order to create useful nanobiotechnology.

Assessment of biosecurity measures in commercial poultry farms of Rajshahi district in Bangladesh.

The application of biosecurity measures in the poultry sector are essential. Developing and implementing daily biosecurity activities are considered effective methods to prevent infectious diseases on poultry farms. Appropriate farm settings and management reduce the possibility of disease transmission between farms. This study aimed to assess the current biosecurity status of commercial poultry farms in the Rajshahi district of Bangladesh. A cross-sectional study was conducted from June to November 2021, involving 204 poultry farmers in the Rajshahi district, using a multistage sampling technique. Data were collected through face-to-face interviews using a semi-structured questionnaire. The statistically significant (p < 0.05) results found were: most farmers reported that the visitors could not access their farms (broiler vs. layer: 68.1%, 77.0%). A higher proportion of broilers compared to layer farms used company's supplied feed (81.2% vs. 66.7%). A higher proportion of layer (97.8%) farms cleaned the farm's litter within 24 h compared to broiler farms (72.5%). Broiler farms had better records animal mortality than layer farms (76.8% vs. 60.0%). More layer (96.3%) farms compared to broiler (87.0%) farms implemented a vaccination program. The findings of this study revealed that biosecurity measures are well-practiced and implemented in most broiler and layer farms in this region except in a small number of farms. Government authorities should strictly enforce and monitor biosecurity measures in farms that do not practice essential biosecurity measures.

A trend analysis of Black American women with cardiovascular disease and chronic medical conditions, sociodemographic factors from NHANES From 2011 to 2020.

BACKGROUND: Significant racial and gender differences exist in the prevalence of CVD in the United States. The goal of this study is to evaluate the prevalence of CVD among Black American women, the relationship between CVD and some medical conditions, and significant sociodemographic factors. METHODS: The researchers in this study used data from four cycles of the NHANES, carried out by the NCHS. 2011 to 2012, 2013 to 2014, 2015 to 2016, and 2017 to 2020 were the cycles that were chosen. The researchers used the survey package in the R programming language to examine the data. RESULTS: People with CVD problems 20 years of age and older were included in the analyses. Black American women experienced a considerable prevalence of CVD from 2011 to 2020. These women were more likely to report having completed no more schooling than the ninth grade, being widowed/divorced/separated, and having undergone a hysterectomy, as well as having a history of diabetes, asthma, obesity, arthritis, and depression. Black American women with CVD had a 3.8-fold increased risk of diabetes and a 5.6-fold increased risk of arthritis. CONCLUSION: This study shows that Black American women with CVD are more likely to have chronic illnesses such as hysterectomy, diabetes, asthma, obesity, arthritis, and depression. Black American women's cardiovascular risk profiles can be updated using the data from this study.

Exploring the prevalence of antibiotic resistance patterns and drivers of antibiotics resistance of Salmonella in livestock and poultry-derived foods: a systematic review and meta-analysis in Bangladesh from 2000 to 2022.

Background: Antimicrobial resistance (AMR) is a severe public health problem that Bangladeshis are dealing with nowadays. However, we wanted to investigate the pooled prevalence of Salmonella and AMR in Salmonella strains isolated from livestock- and poultry-derived foods between 1 January 2000 and 31 August 2022. Methods: The metafor and metareg packages in the R programming language were used to conduct all analyses. We used a random-effect or fixed-effect model for pooled prevalence of Salmonella and AMR to Salmonella, depending on the heterogeneity test for each antibiotic. The heterogeneity was examined using stratified analyses, the meta-regression approach and sensitivity analysis. Results: The combined prevalence of Salmonella in livestock and poultry-derived food in Bangladesh is 37%, according to the 12-research considered (95% CI: 23%-52%). According to subgroup analysis, neomycin had the lowest prevalence of resistance (4%, 95% CI: 1%-13%), whereas tetracycline had the highest prevalence of resistance (81%, 95% CI: 53%-98%). According to univariate meta-analysis and correlation analysis, the prevalence of Salmonella increased with the study period (ß = 0.0179; 95% CI: 0.0059-0.0298, P = 0.0034; R2 = 46.11%) and without this, none of aforementioned variables was significantly associated with the detected heterogeneity and there was a positive relationship (r = 0.692, P = 0.001) between the Salmonella prevalence and study period. Conclusions: AMR is rising alarmingly in Bangladesh by livestock-derived food consumption. However, monitoring and evaluating antibiotic sensitivity trends and developing effective antibiotic regimens may improve Salmonella infection inhibition and control in Bangladesh. Policymakers should be concerned about food handling practices. Doctors should be concerned when using prescribing antibiotics.

Prospective analysis of febrile neutropenia patients with bacteraemia: the results of an international ID-IRI study.

OBJECTIVES: Bacteraemia during the course of neutropenia is often fatal. We aimed to identify factors predicting mortality to have an insight into better clinical management. METHODS: The study has a prospective, observational design using pooled data from febrile neutropenia patients with bacteraemia in 41 centres in 16 countries. Polymicrobial bacteraemias were excluded. It was performed through the Infectious Diseases-International Research Initiative platform between 17 March 2021 and June 2021. Univariate analysis followed by a multivariate binary logistic regression model was used to determine independent predictors of 30-d in-hospital mortality (sensitivity, 81.2%; specificity, 65%). RESULTS: A total of 431 patients were enrolled, and 85 (19.7%) died. Haematological malignancies were detected in 361 (83.7%) patients. Escherichia coli (n = 117, 27.1%), Klebsiellae (n = 95, 22% %), Pseudomonadaceae (n = 63, 14.6%), Coagulase-negative Staphylococci (n = 57, 13.2%), Staphylococcus aureus (n = 30, 7%), and Enterococci (n = 21, 4.9%) were the common pathogens. Meropenem and piperacillin-tazobactam susceptibility, among the isolated pathogens, were only 66.1% and 53.6%, respectively. Pulse rate (odds ratio [OR], 1.018; 95% confidence interval [CI], 1.002-1.034), quick SOFA score (OR, 2.857; 95% CI, 2.120-3.851), inappropriate antimicrobial treatment (OR, 1.774; 95% CI, 1.011-3.851), Gram-negative bacteraemia (OR, 2.894; 95% CI, 1.437-5.825), bacteraemia of non-urinary origin (OR, 11.262; 95% CI, 1.368-92.720), and advancing age (OR, 1.017; 95% CI, 1.001-1.034) were independent predictors of mortality. Bacteraemia in our neutropenic patient population had distinctive characteristics. The severity of infection and the way to control it with appropriate antimicrobials, and local epidemiological data, came forward. CONCLUSIONS: Local antibiotic susceptibility profiles should be integrated into therapeutic recommendations, and infection control and prevention measures should be prioritised in this era of rapidly increasing antibiotic resistance.

A meta-analysis of COVID-19 vaccines acceptance among black/African American.

The COVID-19 pandemic had harmed Black/African Americans disproportionately. Mortality and morbidity can reduce by increasing vaccination acceptability and availability. We conducted a meta-analysis of 20 studies that show the prevalence of Black/African Americans who embrace COVID-19 vaccination between 2020 and September, 2022. Investigations conducted before and after the availability of COVID-19 vaccines found the vaccinations effective. The heterogeneity was examined using stratified analyses, the meta-regression approach, and sensitivity analysis in R programming language. This meta-analysis showed that the overall COVID-19 vaccine hesitancy among Black/African Americans is 35% (95% CI: 26%-45%). That means 65% of Black African Americans received vaccines without any hesitancy. According to correlation analysis, there was a negative relationship (r = -0.392, P = 0.021) between the prevalence of vaccine hesitancy and the survey year. Evidence suggests ethnic health disparities in Black/African Americans were for lower socioeconomic status. Some initiatives had to address health disparities, while ethnicity had not consistently been a focus. Only vaccines can prevent COVID-19 like infectious diseases. Policy makers and health educators should concern on vaccine acceptance or hesitancy related programs among Black/African American.

Factors associated with Facebook addiction among university students amid the COVID-19 pandemic: Findings from an online cross-sectional survey.

BACKGROUND: Facebook addiction (FA) has been suggested as a potential behavioral addiction. There is a severe lack of research evidence regarding the Facebook addiction behavior among university students during the ongoing COVID-19 pandemic. The aim of this study was to determine factors associated with Facebook addiction among Bangladeshi university students. METHODS: A cross-sectional online survey was conducted among 2,161 Bangladeshi university students during the COVID-19 pandemic from June 2021 to September 2021. A well fitted regression model in R programming language was used for this study. RESULTS: Female respondents and those whose family monthly income was <25,000 BDT were more addicted to Facebook than other respondents. Respondents who lost a family member or a relative to COVID-19, engaged in physical activities (exercise) during the pandemic, used Facebook for work purposes or used Facebook to relieve daily stress were more addicted to Facebook. CONCLUSION: Overuse of social media is problematic as it can trigger several mental health symptoms, especially among students. Adequate and effective interventions are required to educate students about the dangers of Facebook addiction and to provide an alternative, healthy options.

Analyzing central-line associated bloodstream infection prevention bundles in 22 countries: The results of ID-IRI survey.

BACKGROUND: Because central line-associated bloodstream infections (CLABSIs) are a significant complication of central venous access, it is critical to prevent CLABSIs through the use of central line bundles. The purpose of this study was to take a snapshot of central venous access bundles in various countries. METHODS: The participants in intensive care units (ICUs) completed a questionnaire that included information about the health center, infection control procedures, and central line maintenance. The countries were divided into 2 groups: those with a low or low-middle income and those with an upper-middle or high income. RESULTS: Forty-three participants from 22 countries (46 hospitals, 85 ICUs) responded to the survey. Eight (17.4%) hospitals had no surveillance system for CLABSI. Approximately 7.1 % (n = 6) ICUs had no CLABSI bundle. Twenty ICUs (23.5%) had no dedicated checklist. The percentage of using ultrasonography during catheter insertion, transparent semi-permeable dressings, needleless connectors and single-use sterile pre-filled ready to use 0.9% NaCl were significantly higher in countries with higher and middle-higher income (P < .05). CONCLUSIONS: Our study demonstrated that there are significant differences in the central line bundles between low/low-middle income countries and upper-middle/high-income countries. Additional measures should be taken to address inequity in the management of vascular access in resource-limited countries.

Vaccine hesitancy and refusal among parents: An international ID-IRI survey.

INTRODUCTION: Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. METHODOLOGY: In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children. RESULTS: Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). CONCLUSIONS: Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.