HPV Vaccine Knowledge and Hesitancy Among Health Colleges' Students at a Saudi University.

Introduction: Human papillomavirus (HPV) infection is a widespread sexually transmitted infection linked to various types of cancer. Although vaccination against HPV is available, global HPV vaccination rates remain low. Aim: This study aimed to evaluate the awareness and knowledge of the HPV vaccine and to identify predictors associated with vaccine hesitancy among health college students at King Saud University, Saudi Arabia. Methods: A cross-sectional survey was distributed during December 2022 to students enrolled in health colleges. The survey link was randomly distributed via social media platforms and in-person interactions. The number of participants was 405 including both males and females. The data was analyzed using the Statistical Package for Social Sciences (SPSS). The correct response rate for all knowledge items was calculated, and they were stratified by gender and college. The association of vaccine hesitancy with sociodemographic characteristics was examined using logistic regression analysis. Results: The study found that approximately half of the students (49.9%) were aware of the HPV vaccine. However, only a small percentage of students answered all to all HPV knowledge items correctly. Additionally, only a small proportion (5.2%) reported receiving the vaccine. The overall HPV vaccine hesitancy was 59.1% (43.9% for female and 75.9% for male). The most common reasons for vaccine hesitancy was not knowing enough about it. Males were two times more likely than females to believe that they did not need the HPV vaccine. The odds for HPV vaccine hesitancy were greater among males and younger age groups compared to females and older age groups. Conclusion: This study underscores the importance of implementing university-wide interventions and educational campaigns to enhance awareness and knowledge of the HPV vaccine.

A two-year retrospective study of multidrug-resistant Acinetobacter baumannii respiratory infections in critically Ill patients: Clinical and microbiological findings.

BACKGROUND: Acinetobacter baumannii infection is a serious public health problem because it is highly resistant to antimicrobial therapy and causes a high fatality rate in critically ill patients. The aim of the study is to examine the demographics, microbiological findings, clinical presentation, and outcomes of multi-drug-resistant Acinetobacter baumannii respiratory infections in adult ICU intubated patients during COVID-19 pandemic. METHODS: This study included 115 mechanically ventilated adult ICU patients who had multi-drug-resistant Acinetobacter baumannii retrieved from respiratory samples during the COVID-19 pandemic in Albaha, Saudi Arabia. The information was obtained from medical and laboratory files. Univariate analysis was used to compare gender, COVID-19 infection, and outcomes. RESULTS: The rate of Acinetobacter baumanni respiratory infections among adult ICU patients was 6.2 %. Almost 93 % developed ventilator-associated pneumonia, and five of them developed bacteremia. The isolates had significant antibiotic resistance patterns, of which 3 % were pandrug-resistant bacteria. The death rate was 74 %, with major risk factors including sepsis, septic shock, VAP, liver diseases, and the use of inappropriate antibiotic therapy that lacked both colistin and tigecycline. Patients with COVID-19 coinfection had worse outcomes compared to non-COVID-19 patients. CONCLUSIONS: The identification of MDR-AB as a threat highlights the importance of surveillance studies in this region.

Awareness of Human Papillomavirus among Male and Female University Students in Saudi Arabia.

BACKGROUND: Human papillomavirus (HPV) is a common sexually transmitted infection globally. Investigating HPV awareness can reduce the burden of HPV-related cancers. AIMS: (1) Assessing HPV awareness and knowledge among health college students at King Saud University, (2) comparing these outcomes across sociodemographic characteristics. METHODS: A cross-sectional survey study was conducted from November to December 2022 and included 403 health college students. Associations of HPV awareness and knowledge with sociodemographic characteristics were assessed using logistic regression analysis and linear regression analysis, respectively. RESULTS: Only 60% of students were aware of HPV, with awareness higher among females, although their knowledge scores were comparable to males. The odds of awareness of HPV were greater among medical students compared to other colleges and among students belonging to older age groups compared to the younger age group (18-20). The odds of HPV awareness among hepatitis B vaccinated students were 2.10 times that among unvaccinated students (AOR = 2.10; 95% CI = 1.21, 3.64). CONCLUSIONS: The low level of HPV awareness among college students warrants the need for HPV educational campaigns to improve HPV awareness and to promote HPV vaccination in the community.

The Effectiveness of an Educational Intervention on Helicobacter pylori for University Students: A Quasi-Experimental Study.

Introduction: Helicobacter pylori infection is widespread and harmful, rendering its eradication a serious public health problem. Undergraduate students' general understanding of H. pylori infection is relatively poor. This was a second-phase research study to evaluate the efficacy of an educational intervention in raising awareness among university students. Methods: A quasi-experimental approach was employed, with 108 undergraduate students at King Saud University as participants. First, during the October 2021 academic year, data were gathered using a validated survey. The survey was divided into sociodemographic characteristics and H. pylori knowledge. Second, we assessed the effectiveness of an educational intervention to increase university students' awareness of the topic. Results: Before the intervention, the percentage of students that had good (9.3%), fair (28.7%) and poor (62%) knowledge of H. pylori infection changed to 55.6%, 41.7%, and 2.8% respectively. There was a significant increase in overall and domain-wise mean knowledge score after the educational intervention (p = 0.001). The pretest knowledge was independent of all socio-demographic variables except "whether or not they had heard about H. pylori infection" (χ2= 8.666, p = 0.013). Conclusion: Educational intervention may help increase students' awareness of H. pylori infections.

Prevalence of Human Papillomavirus Infection and Cervical Abnormalities among Women Attending a Tertiary Care Center in Saudi Arabia over 2 Years.

Human papillomavirus (HPV) genotype distribution varies according to the assessment method and the population targeted. This study aimed to assess HPV infection prevalence in women aged 23 to 82 with abnormal cytology attending King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, using retrospective data collected from January 2021 to December 2022. Cytological distribution included 155 samples of atypical squamous cells of undetermined significance (ASCUS) (n = 83), low-grade squamous intraepithelial lesion (LSIL) (n = 46), high-grade squamous intraepithelial lesion (HSIL) (n = 14), atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H) (n = 10), and squamous cell carcinoma (SCC) (n = 2). All samples were submitted to HPV detection and genotyping using Xpert HPV assay specimens. The most prevalent epithelial abnormalities were ASCUS (53.50%). Positive HPV infection results were observed in 52.9% of the samples. The highest prevalence of HPV genotypes, accounting for 31%, was attributed to the other high-risk genotypes, including 31, 33, 35, 39, 51, 52, 56, 58, 59, 66, and 68, followed by high-risk genotype 16, which counted in 11.60% of cases. Individuals who tested positive for HPV 16 were at a high risk of ASC-H, HSIL, and LSIL. Those testing positive for HPV 18-45 exhibited an elevated risk of LSIL, and those with positive results for other high-risk HPV genotypes were at an increased risk of ASCUS and LSIL, suggesting a low oncogenic potential. The results suggest that the percentage of association between samples with abnormal cervical presentation and negative high-risk HPV diagnosis is noticeably increasing. This underscores the need for effective screening programs and an understanding of the impact of specific HPV genotypes on cervical abnormalities.

Effects of Repeated in-vitro Exposure to Saudi Honey on Bacterial Resistance to Antibiotics and Biofilm Formation.

Introduction: Although Sumra and Sidr Saudi honey is widely used in traditional medicine due to its potent activity, it is unknown whether its prolonged usage has impact upon bacterial virulence or leading to reduced antibiotic sensitivity. Thus, the study aims to investigate the effect of prolonged (repeated) in-vitro exposure to Saudi honey on the antibiotic susceptibility profiles and biofilm formation of pathogenic bacteria. Methods: Several bacteria, including Staphylococcus aureus, Escherichia coli, and Acinetobacter baumannii, were in-vitro exposed ten times [passaged (P10)]to Sumra and Sider honey individually to introduce adapted bacteria (P10). Antibiotic susceptibility profiles of untreated (P0) and adapted (P10) bacteria were assessed using disc diffusion and microdilution assays. The tendency regarding biofilm formation following in-vitro exposure to honey (P10) was assessed using the Crystal violet staining method. Results: Adapted (P10) bacteria to both Sumra and Sidr honey showed an increased sensitivity to gentamicin, ceftazidime, ampicillin, amoxycillin/clavulanic acid, and ceftriaxone, when compared with the parent strains (P0). In addition, A. baumannii (P10) that was adapted to Sidr honey displayed a 4-fold increase in the minimal inhibitory concentration of the same honey following in-vitro exposure. 3-fold reduction in the tendency toward biofilm formation was observed for the Sumra-adapted (P10) methicillin resistant S. aureus strain, although there was a lower rate of reduction (1.5-fold) in biofilm formation by both the Sumra- and Sidr-adapted A. baumannii (P10) strains. Conclusion: The data highlight the positive impact of prolonged in-vitro exposure to Saudi honey (Sumra and Sider) for wound-associated bacteria since they displayed a significant increase in their sensitivity profiles to the tested antibiotic and a reduction in their ability to form biofilm. The increased bacterial sensitivity to antibiotics and a limited tendency toward biofilm formation would suggest the great potential therapeutic use of this Saudi honey (Sumra and Sidr) to treat wound infections.

Regulation of Escherichia coli Group 2 Capsule Gene Expression: A Mini Review and Update.

The expression of a group 2 capsule (K antigen), such as the K1 or K5 antigen, is a key virulence factor of Escherichia coli responsible for extra-intestinal infections. Capsule expression confers resistance to innate host defenses and plays a critical role in invasive disease. Capsule expression is temperature-dependent being expressed at 37°C but not at 20°C when outside the host. Group 2 capsule gene expression involves two convergent promoters PR1 and PR3, the regulation of which is critical to capsule expression. Temperature-dependent expression is controlled at transcriptional level directly by the binding of H-NS to PR1 and PR3 and indirectly through BipA with additional input from IHF and SlyA. More recently, other regulatory proteins, FNR, Fur, IHF, MprA, and LrhA, have been implicated in regulating capsule gene expression in response to other environmental stimuli and there is merging data for the growth phase-dependent regulation of the PR1 and PR3 promoters. The aim of the present Mini Review is to provide a unified update on the latest data on how the expression of group 2 capsules is regulated in response to a number of stimuli and the growth phase something that has not to date been addressed.

Stenotrophomonas maltophilia Epidemiology, Resistance Characteristics, and Clinical Outcomes: Understanding of the Recent Three Years' Trends.

BACKGROUND: Stenotrophomonas maltophilia is an emerging pathogen classified as a public health concern, that infects critically ill patients and has expressed resistance against antimicrobial therapy. The aim of this study was to examine the epidemiological pattern, resistance characteristics and clinical outcomes of S. maltophilia infections in hospitalized patients. METHODS: The study included 393 S. maltophilia isolates from different clinical specimens as well as the clinical data of 209 Intensive Care Unit (ICU) patients. The patients' data were obtained from medical and laboratory files. Descriptive statistics and a univariate analysis were used to report and compare the demographics, clinical data, and outcomes. RESULTS: The S. maltophilia was mostly isolated from the respiratory specimens of ICU patients. The adult patients were more likely to develop serious infections and worse outcomes than were pediatric patients. The most common co-infecting pathogens were SARS-CoV2 and Pseudomonas aeruginosa. The death rate was 44.5% and increased to 47.1% in the case of a respiratory infection. Septic shock was the most significant predictor of mortality. Older age and mechanical ventilation were independent and significant risk factors that worsened the outcomes in patients with respiratory infections. CONCLUSIONS: The identification of S. maltophilia as a threat highlights the importance of surveillance studies in this region.

Three tandem promoters, together with IHF, regulate growth phase dependent expression of the Escherichia coli kps capsule gene cluster.

In this study we characterise three tandem promoters (PR1-1, PR1-2 and PR1-3) within the PR1 regulatory region of the Escherichia coli kps capsule gene cluster. Transcription from promoter PR1-2 was dependent on the activity of the upstream promoter PR1-1, which activated PR1-2 via transcription coupled DNA supercoiling. During growth at 37 °C a temporal pattern of transcription from all three promoters was observed with maximum transcriptional activity evident during mid-exponential phase followed by a sharp decrease in activity as the cells enter stationary phase. The growth phase dependent transcription was regulated by Integration Host Factor (IHF), which bound within the PR1 region to repress transcription from PR1-2 and PR1-3. This pattern of transcription was mirrored by growth phase dependent expression of the K1 capsule. Overall these data reveal a complex pattern of transcriptional regulation for an important virulence factor with IHF playing a role in regulating growth phase expression.