The Journal of Infection in Developing Countries

Distribution characteristics and genomic epidemiology of carbapenem-resistant Acinetobacter baumannii

Sun, 31 May 2026 00:00:00 +0100

Introduction: Carbapenem-resistant Acinetobacter baumannii poses significant challenges in clinical settings due to rapid emergence and limited treatment options. This study aimed to investigate the distribution characteristics and genomic epidemiology of carbapenem-resistant A. baumannii in a regional healthcare context to identify novel trends and genetic determinants.

Methodology: A total of 120 clinically isolated strains of carbapenem-resistant A. baumannii were collected in our hospital from July 2021 to June 2023. Distribution characteristics were assessed based on infection sites. Whole genome sequencing was performed to profile resistance genes.

Results: The resistance rates of carbapenem-resistant A. baumannii to 15 antibiotics, such as tobramycin and amikacin, increased yearly during the three years (p < 0.05). Respiratory tract and urinary tract infections were dominant. Whole genome sequencing revealed high prevalence rates of β-lactamase genes (AmpC: 82.5%, OXA-23: 70.83%, IMP-1: 54.17%) and efflux system genes (adeB: 78.33%, adeJ: 93.33%, adeG: 90.00%).

Conclusions: Our study provides novel insights by identifying significant increases in antibiotic resistance and revealing critical genomic co-occurrence patterns of resistance genes in carbapenem-resistant A. baumannii. These findings enhance the understanding of resistance mechanisms and support targeted strategies for improved prevention, control, and monitoring of nosocomial infections.

Lateral flow immunoassay for rapid detection of carbapenemase-producing E. coli and K. pneumoniae at Cho Ray Hospital, Vietnam

Ngoc B Tran, Phu T Truong, Van TH Tran, Dat Q Ngo — Sun, 31 May 2026 00:00:00 +0100

Introduction: Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae represent an escalating threat to global public health, particularly in Southeast Asia, where antimicrobial resistance (AMR) is highly prevalent. This study aimed to evaluate the diagnostic performance of the NG-Test Carba 5 lateral flow immunoassay for the rapid detection of carbapenemase-producing E. coli and K. pneumoniae.

Methodology: A cross-sectional study was conducted using 160 carbapenem-resistant E. coli and K. pneumoniae isolates collected from Cho Ray Hospital in Vietnam. The NG-Test Carba 5 was compared with a composite reference method comprising the modified carbapenem inactivation method (mCIM) and Multiplex Real-time PCR (Entero DR Assay). Diagnostic accuracy was assessed using positive percent agreement (PPA) and negative percent agreement (NPA) with 95% confidence intervals (CIs).

Results: The assay showed excellent diagnostic performance, with a PPA of 98.7% (95% CI: 96.24%–99.56%) and an NPA of 100.0% (95% CI: 99.33%–100.0%). No false positives were observed. Three false negatives were identified in isolates co-harboring blaNDM and blaOXA-48. Importantly, no isolates tested positive by mCIM but negative by either the NG-Test Carba 5 or the Entero DR Assay.

Conclusions: The lateral flow immunoassay demonstrated high diagnostic accuracy in detecting carbapenemase-producing E. coli and K. pneumoniae. Its operational simplicity and excellent performance support its use as a reliable frontline diagnostic tool, with minimal risk of missing rare or emerging carbapenemase genotypes in this setting.

Multidrug-resistant Escherichia coli and its role in stunting: evidence from a cross-sectional study in Indonesia

Sun, 31 May 2026 00:00:00 +0100

Introduction: This cross-sectional study aimed to investigate the relationship between environmental contamination and stunting among children under five years of age in Langkat, North Sumatra, Indonesia.

Methodology: This cross-sectional study was conducted from February to October 2024, involving 180 households with private drinking water sources. Stunting was assessed using height-for-age Z-scores (< -2 SD). Water samples were tested for E. coli and Coliforms using the membrane filtration method on Chromocult Coliform Agar, incubated at 37°C for 24 hours. E. coli was confirmed by IMViC biochemical tests, and antimicrobial resistance was assessed using the Kirby-Bauer disk diffusion method following CLSI guidelines.

Results: Water testing showed E. coli and Coliform bacteria in 75.4% and 80.7% of samples, indicating significant contamination. E. coli presence was significantly associated with stunting (p = 0.044), turbidity (p = 0.047), and diarrhea history (p = 0.004). Hierarchical regression identified E. coli, diarrhea, and turbidity as key stunting predictors, with E. coli showing a beta of -0.287 (p = 0.035). Multidrug resistance was high among E. coli isolates (n = 108), with 92.59% resistant to Tetracycline and Sulfamethoxazole, and 70.37% to Amoxicillin and Ampicillin, underscoring the need for targeted antimicrobial stewardship.

Conclusions: These findings highlight that environmental contamination, particularly from Escherichia coli, may represent a critical risk factor for stunting, emphasizing the need for improved water quality and hygiene practices in vulnerable communities.

Surveillance of multidrug-resistant bacterial isolates from bloodstream infections in Erbil, Iraq

Safaa TH Aka — Sun, 31 May 2026 00:00:00 +0100

Introduction: When bacteria enter the bloodstream and grow, they produce toxins that cause systemic sickness; and this leads to bloodstream infections (BSIs). BSIs are a major contributor to morbidity and mortality in hospitals. Since infections produced by multidrug-resistant (MDR) organisms are linked to greater mortality rates, the situation becomes even more complicated. This study evaluated the bacterial agents found in Erbil septicemia patients and investigated how resistant they were to antibiotics.

Methodology: Blood cultures were obtained from 81 patients at Maryamana Private Hospital who were suspected of having septicemia between March and October 2024. Automated laboratory equipment was used to identify the isolates and assess their susceptibility to antibiotics. Standard criteria were followed for classification into MDR, extensively drug-resistant (XDR), or pan-drug-resistant (PDR) categories.

Results: Around 57 (70.3%) of the 81 blood samples had bacterial growth. Around 32 (56.1%) were male and 25 (43.9%) were female. The majority were in the 30–59 years age group. More Gram-negative organisms (59.7%) than Gram-positive species (40.3%) were isolated. Staphylococcus aureus (16.1%) and Burkholderia cepacia (17.9%) were the most common bacteria. Methicillin-resistant S. aureus (MRSA) strains made for more than half of the total (55.5%). PDR was found among the Gram-negative isolates; 65.5% were MDR and 34.5% XDR.

Conclusions: The significant prevalence of resistant Gram-negative bacteria and MRSA highlights the critical need for quick diagnosis, careful antibiotic use, and improved infection control measures in healthcare environments.

Clinical and microbiological features of Streptococcus anginosus group infections: a 7-year retrospective study in Vietnam

Kim-Thu Le-Thai, Buu Chau Le, Hoang-Anh Vu, Quoc-Khanh Tran-Le, Quang Minh Ho — Sun, 31 May 2026 00:00:00 +0100

Introduction: The Streptococcus anginosus group (SAG) is emerging as a significant cause of invasive infections, yet data from Vietnam remain scarce. This study characterized the clinical features and outcomes of SAG infections in Ho Chi Minh City.

Methodology: We retrospectively reviewed patients with culture-confirmed SAG infections at the Hospital for Tropical Diseases (January 2017–August 2023). Demographics, clinical, and microbiological data were analyzed.

Results: A total of 82 patients (mean age 50.6 ± 16.8 years; 64.6% male) with culture-confirmed SAG infections were included. Comorbidities were present in 56.1% of patients, with diabetes mellitus being the most common (23.2%). S. anginosus was the most frequently isolated species (43.9%), followed by S. constellatus (34.1%) and S. intermedius (22.0%). Bacteremia (35.4%) and intra-abdominal infections (31.7%, mainly hepatic abscesses) were the predominant clinical presentations. Polymicrobial infections occurred in 14.6% of cases, primarily among patients with bacteremia and skin or soft tissue infections. All isolates remained susceptible to ceftriaxone and vancomycin, and 94.3% to ampicillin, but susceptibilities were lower to penicillin (84.3%), erythromycin (65.7%), clindamycin (54.3%), and tetracycline (54.3%). Despite a 92.7% cure rate, 19.5% required drainage procedures, and the 28-day mortality rate was 6.1%.

Conclusions: In this cohort, SAG infection most often present as occult bacteremia or hepatobiliary abscess, frequently in patients with comorbidities, but not restricted to immunocompromised hosts. Empirical β-lactam therapy (ampicillin or ceftriaxone) remains appropriate, although rising penicillin and macrolide resistance and the 15% polymicrobial rate, may warrant broader initial coverage when deep soft-tissue foci are suspected.

Direct MALDI-TOF MS identification from positive blood culture bottles: a time-saving approach to reduce diagnostic delays

Sun, 31 May 2026 00:00:00 +0100

Introduction: Bloodstream infections are a leading cause of mortality worldwide, necessitating prompt identification and treatment to improve patient outcomes. Conventional methods are time-consuming, often delaying appropriate antimicrobial therapy. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has emerged as a revolutionary tool for rapid microbial identification. This study aimed to evaluate the utility of direct microbial identification from positive blood cultures using MALDI-TOF MS in reducing diagnostic delays and improving pathogen detection for effective clinical management.

Methodology: This prospective study analyzed 416 monomicrobial positive blood cultures obtained between October 2022 and October 2024 from a tertiary care teaching hospital in North India. After Gram staining and initial processing, direct microbial identification was performed using MALDI-TOF MS. Conventional subculture-based methods were employed as the gold standard for comparison.

Results: Of the 416 isolates, 89% were correctly identified at the species level using the direct method. Among 204 Gram positive cocci, 91.6% were correctly identified, with species-specific rates of 100% for Staphylococcus aureus and Staphylococcus ureilyticus. Out of 160 Gram negative bacilli, 88.1% were accurately identified, with Acinetobacter baumannii showing 97.5% accuracy. Candida species showed a correct identification rate of 80.8%, with 100% identification for Candida albicans and Candida krusei.

Conclusions: Direct microbial identification using MALDI-TOF MS is a rapid, cost-effective alternative to conventional methods, enabling faster pathogen detection and supporting antimicrobial stewardship.

Molecular typing characteristics and drug resistance of Salmonella from food-borne diarrhea patients in Chifeng, China

Sun, 31 May 2026 00:00:00 +0100

Introduction: This study aimed to investigate the infection status, serotype distribution, drug resistance, and molecular typing characteristics of Salmonella in food-borne diarrhea patients in Chifeng, China, from 2022 to 2024.

Methodology: Fecal samples were collected from diarrhea patients for Salmonella isolation and molecular serotype identification. The isolates were tested using the microbroth dilution method and pulsed-field gel electrophoresis (PFGE) to assess drug susceptibility and perform molecular typing. Statistical analysis was conducted using the SPSS 25.0 software.

Results: Salmonella was detected in 52 of the 737 fecal samples, yielding a positive detection rate of 7.06% (52/737). A total of 52 Salmonella strains were isolated, predominantly Salmonella Typhimurium and Salmonella Enteritidis, which accounted for 40.38% (21/52) and 21.15% (11/52), respectively. Additionally, 5 other serotypes were identified: S. Kentucky, S. Dublin, S. Liverpool, S. Vilshaw, and S. Paratyphoid A. Notably, 48 strains (92.31%, 48/52) exhibited resistance to at least one antibiotic, with resistance rates exceeding 50% for ampicillin, streptomycin, tetracycline, and nalidixic acid. The rate of multiple drug resistance reached 86.54% (45/52). Cluster analysis of the 52 Salmonella strains revealed 39 band types with similarity indices ranging from 50.1% to 100%. Notably, a higher similarity coefficient indicated greater similarity in drug resistance phenotypes among the strains.

Conclusions: The detection rate of Salmonella among food-borne diarrhea patients in Chifeng from 2022 to 2024 was notably high. The predominant serotypes were S. Typhimurium and S. Enteritidis. The PFGE band types were relatively diverse, and the strains exhibited significant drug resistance, including multiple drug resistance.

Bacterial profile and antibiotic resistance in pediatric appendicitis: retrospective analysis and associated laboratory and clinical findings

Sun, 31 May 2026 00:00:00 +0100

Introduction: Identifying the bacterial profile in acute appendicitis, which is a common paediatric surgical emergency, can guide antibiotic therapy and improve outcomes. Therefore, the objective of this study is to evaluate the bacterial profile in paediatric appendicitis and its association with clinical and laboratory findings.

Methodology: A retrospective study was conducted on paediatric patients (≤ 14 years) who underwent appendectomy at King Fahad Hospital, Al-Baha, from 1 January 2019 to 1 October 2023. Data collected included demographics, clinical presentation, laboratory results, intraoperative findings, bacterial cultures, antibiotic regimens, and outcomes. Kruskal–Wallis and Mann–Whitney tests were performed. The normality of the data was evaluated using the Kolmogorov–Smirnov and Shapiro–Wilk tests. A p < 0.05 was considered statistically significant.

Results: In 170 patients (mean age of 10.02 years; 62.9% male), the prevalent symptoms were right lower quadrant pain (94.7%) and nausea or vomiting (80.6%). Preoperative antibiotics were administered in 91.8% of the patients. Peritoneal fluid cultures were positive in 28.8%, and Escherichia coli was the dominant isolate (60.2%). Antibiotic resistance was significantly associated with elevated white blood cell count (p = 0.003), high polymorphonuclear granulocytes (p = 0.032), abscess formation (p = 0.008), and perforation (p = 0.016). The mean hospital stay was 4.5 days, and postoperative complications occurred in 1.8% of patients.

Conclusions: E. coli is the predominant pathogen in paediatric appendicitis, with significant resistance in complicated cases. Tailored antibiotic therapy is crucial to reducing complications, but more studies are needed to refine empirical antibiotic selection.

Development and rapid identification of a self-constructed MALDI-TOF MS library for Mycoplasma pneumoniae clinical isolates

Ke Cen, Cong Qin, Jie Wang, Shenghai Wu — Sun, 31 May 2026 00:00:00 +0100

Introduction: To assess the diagnostic efficacy of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid and precise identification of Mycoplasma pneumoniae in clinical microbiology workflows.

Methodology: A reference-calibrated MALDI-TOF MS spectral database was generated through a standardized formic acid/acetonitrile extraction protocol from the M. pneumoniae reference strain (M129). Forty-nine prospectively collected M. pneumoniae clinical isolates were obtained from respiratory tract specimens at Hangzhou First People's Hospital during August-October 2023. These isolates optimized the in-house MALDI-TOF MS database for M. pneumoniae identification and validated the diagnostic feasibility of liquid pre-culture coupled with MALDI-TOF MS analysis.

Results: When we randomly selected 40 strains for database validation, we found that the first phase validation of the M129-derived spectral database indicated that 87.5% (35/40) of the clinical isolates were initially detected, among which 57.5% (23/40) reached the ≥ 2.0 log value (score) threshold required for species-level identification. Post-optimization through iterative spectral refinement, 100% detection rate (40/40) was attained, with 75% (30/40) meeting strict diagnostic criteria (log(score) ≥ 2.0). The integrated liquid culture-MALDI-TOF MS platform achieved a mean identification time of 9.6 ± 1.4 days, demonstrating a 19.3% reduction in turnaround time compared to traditional chromogenic detection methods (11.9 ± 1.6 days; Independent Samples t-test, p < 0.001).

Conclusions: This study establishes MALDI-TOF MS as a CLSI-compliant diagnostic method for M. pneumoniae with superior accuracy and operational efficiency. Optimized liquid culture-MALDI-TOF MS integration reduces diagnostic latency by 2.3 days, enhancing respiratory pathogen management in clinical laboratories.

Intravenous proton pump inhibitor uses for stress ulcer prophylaxis in the critically ill: a single-center study in Pakistan

Sun, 31 May 2026 00:00:00 +0100

Introduction: Irrational use of intravenous (IV) proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in critically ill patients increases the risk of adverse drug reactions (ADRs), and may lead to longer stays in the intensive care unit (ICU).

Methodology: A single-center, retrospective, observational study was conducted to assess the practices with prescribing IV SUP in critically ill adult patients treated at ICUs between January 2020–December 2022. Data was collected from electronic medical records, using a pre-designed checklist. Appropriateness of SUP administration was determined using the American Society of Health-System Pharmacists (ASHP) recommendations.

Results: Medical records of 1076 patients were analyzed; majority of patients (80.9%; n = 873) received IV SUP during their ICU stay, with the most commonly prescribed drug being omeprazole (99.2%). 75.5% of patients had no major or minor risk factors based on ASHP guidelines. The rationale of SUP was deemed appropriate in 51.7% of cases. Among patients treated at specific ICU wards, male patients were less likely (OR: 0.587 [95% CI: 0.345–0.998]; p = 0.048), while ventilated patients were more likely (OR: 2.525 [95% CI: 1.219–5.233]; p = 0.013) to receive SUP. Furthermore, ≥10 days of hospital stay corresponded to notable increase (OR: 4.076 [95% CI: 0.870–19.098]; p = 0.086) in the probability of receiving SUP.

Conclusions: The results may provide a basis for developing protocols related to acid-suppressive therapy in critically ill adults, calling for heightened awareness and tailored interventions to optimize pharmacological care in ICU settings.

Molecular detection of Rickettsia felis in ticks and fleas from the environment in Hanoi and Phu Tho province, Vietnam

Sun, 31 May 2026 00:00:00 +0100

Introduction: Surveillance for Rickettsia spp. is necessary given the recent emergence and re-emergence of various rickettsioses in Vietnam. However, data on their circulation in off-host arthropods from natural environments remain limited. This study aimed to investigate the presence and distribution of Rickettsia species in ticks and fleas collected from the environment in Hanoi and Phu Tho provinces, northern Vietnam, between September and December 2021.

Methodology: The ticks and fleas were collected using dragging, light traps, and carbon dioxide traps. Arthropods were identified morphologically and screened for Rickettsia species using real-time PCR targeting the 17kDa antigen gene. Positive samples were further analyzed using species-specific real-time PCR assays and multilocus sequence typing (MLST) for confirmation and phylogenetic analysis.

Results: A total of 758 arthropods were collected, including 748 ticks (747 larval ticks grouped into 101 pools and 1 adult tick) and 10 fleas. The minimum field infection rate (MFIR) of Rickettsia spp. in ticks was 2.94% (22/748), while the prevalence in fleas was 50% (5/10). Rickettsia felis was detected in 9 larval tick pools and 2 individual fleas by species-specific real-time PCR and MLST. No other Rickettsia species were identified.

Conclusions: This study provides the first evidence of Rickettsia spp. in off-host ticks and fleas from the natural environment in Vietnam. These findings indicate a potential risk of environmental exposure to Rickettsia and emphasize the need for integrated vector surveillance strategies.

A serological survey of hepatitis B among migrant workers at a construction site in Qingdao, China

Sun, 31 May 2026 00:00:00 +0100

Introduction: Migrant workers are a vulnerable population for hepatitis B virus (HBV) infection. The present study aimed to assess HBV prevalence and identify associated risk factors among migrant workers at a construction site in Qingdao, in order to inform prevention strategies.

Methodology: A random sampling method was used to select 169 migrant workers from a construction site in Qingdao in 2022. Data were collected through questionnaire surveys, and venous blood samples were obtained for serological testing. The electrochemiluminescence method was employed for serological testing to determine the positivity rate of Hepatitis B surface antigen (HBsAg), surface antibody (HBsAb), and core antibody (HBcAb), as well as the overall infection rate of HBV. Multivariate logistic regression analysis was conducted to identify factors associated with HBV infection.

Results: Among the 169 participants, the positivity rates of HBsAg, HBsAb, and HBcAb were 4.73%, 52.07%, and 43.20%, respectively, and the HBV infection rate was 46.75%. Multivariate logistic regression analysis revealed that being male, aged 41 years and above, having 2-5 years of working experience at construction sites, and residing in rural areas were risk factors for HBV infection, while a history of hepatitis B vaccination was a protective factor for HBV infection.

Conclusions: The positivity rate of HBsAg was higher among migrant workers at a construction site in Qingdao. Several risk factors were identified in relation to HBV infection. Strengthening health education and promoting hepatitis B vaccination are recommended to reduce the infection and prevalence of hepatitis B.

Correlation of hs-CRP and T lymphocyte subsets with severity and prognosis in elderly pulmonary infection

Yi Chen, Zhicong Liu, Yinan Chen, Jianfeng Zhong, Xiaoyong Li, Pengtao Song — Sun, 31 May 2026 00:00:00 +0100

Introduction: This study aimed to investigate the correlation between high-sensitivity (hs)-CRP, T lymphocyte subset profiles, disease severity, and treatment outcomes in elderly patients with pulmonary infection.

Methodology: The study included 85 elderly patients with respiratory infections (46 non-severe, 39 severe) and 79 healthy controls. The levels of hs-CRP, T lymphocyte subsets (CD4+/CD8+, CD4+, CD8+), and clinical pulmonary infection score (CPIS) were measured. Correlations with disease severity and CPIS were analyzed. Additionally, pre- and post-treatment levels of hs-CRP and T lymphocyte subsets were compared in patients with different treatment responses.

Results: Patients had lower CD4+ counts and CD4+/CD8+ ratios, but higher hs-CRP, CD8+, and CPIS levels (p < 0.05) compared to controls. Severe cases had lower CD4+ and CD4+/CD8+, but higher CD8+, hs-CRP, and CPIS, than non-severe cases (p < 0.05). CD4+ and CD4+/CD8+ were negatively correlated with disease severity and CPIS, while hs-CRP and CD8+ were positively correlated (p < 0.05). The patients who responded to treatment (responders) had higher increases in hs-CRP, CD4+, and CD4+/CD8+ after 7 days of treatment, compared to non-responders; while CD8+ levels were lower (p < 0.05). Receiver operating characteristic (ROC) analysis showed that an hs-CRP difference cutoff of 5.31 had the highest predictive value for treatment outcomes, with 86.67% sensitivity and 68.57% specificity.

Conclusions: hs-CRP and T lymphocyte subsets are closely associated with disease severity and treatment response in elderly patients with pulmonary infection, and their dynamic monitoring may aid in clinical prognosis evaluation.

Donning gloves before patient contact, with or without prior hand hygiene

Gülsüm Iclal Bayhan, Cansu Aydın Altuntaş, Nural Cevahir — Sun, 31 May 2026 00:00:00 +0100

Objective: Hand hygiene (HH) is a fundamental infection prevention measure in healthcare settings, playing a crucial role in reducing healthcare-associated infections (HAIs). Despite its importance, HH compliance remains suboptimal worldwide. A common error is omitting HH before donning gloves, specifically during WHO Moment 1 ("Before touching a patient"). This study investigates bacterial contamination associated with direct gloving and its potential implications for infection control.

Methods: A randomized controlled trial included nurses and doctors preparing to touch patients in the pediatric cardiovascular surgery intensive care unit. Participants were divided into two groups: (1) "HH prior to gloving" (HH performed before donning gloves) and (2) "direct gloving" (no HH before gloves). For each group, 129 samples were collected. Bacterial counts on gloved hands were compared between groups and against bare hands.

Results: The total bacterial colony counts on gloved hands were similar between the HH prior to gloving group and the direct gloving group (p = 0.559). However, bacterial colony counts on gloved hands in both groups were significantly lower compared to bare hands (p = 0.0001, p = 0.0001).

Conclusions: Direct gloving did not increase bacterial contamination on gloves relative to HH before gloving. However, given the established benefits of HH in broader infection control practices, further research is needed to assess the impact of both or separate HH and gloving techniques across different clinical settings.

Prevalence of Visceral Leishmaniasis among Wildlife Rangers in Dinder National Park, Sudan

Sun, 31 May 2026 00:00:00 +0100

Introduction: Visceral leishmaniasis (VL) is a significant public health concern in Sudan, particularly among populations exposed to vector-rich environments. This study aimed to determine the prevalence of VL and associated risk factors among Wildlife Rangers in Dinder National Park, Sudan.

Methodology: A descriptive, cross-sectional, community-based study was conducted among all 500 wildlife rangers in Dinder National Park using total population sampling. Data were collected using a pre-prepared and pre-tested questionnaire covering demographic information, risk factors, and clinical signs and symptoms of VL. Data analysis involved descriptive statistics, chi-square tests, and logistic regression to assess the association between VL prevalence and various risk factors.

Results: The prevalence of VL was 27.6%. Significant associations were observed between VL prevalence and educational level (p = 0.001), military rank (p = 0.004), with soldiers showing a reduced risk compared to officers (OR = 0.45, 95% CI: 0.27–0.75), and knowledge of (VL signs and symptoms (p = 0.000), with a substantially lower risk among the unaware group (OR = 0.20, 95% CI: 0.10–0.39)., transmission methods (p = 0.000), with lower odds in the unaware group (OR = 0.36, 95% CI: 0.21–0.61), and control measures (p = 0.012), with reduced odds for the unaware group (OR = 0.63, 95% CI: 0.34–1.18).), and sleeping under a mosquito net (p = 0.001), with higher odds in those not using a net (OR = 1.93, 95% CI: 1.28–2.92).

Conclusions: The high prevalence of VL among wildlife rangers in Dinder National Park underscores the need for targeted public health intervention. Strategies should include enhancing educational programs, improving awareness of VL prevention and control measures, and ensuring better access to protective measures, such as mosquito nets. Future research should focus on longitudinal studies, detailed environmental assessments, and intervention trials to further reduce the burden of VL in high-risk populations.

Mortality rates among adults with sepsis and septic shock in Indonesia: a systematic review and meta-analysis

Muhammad Ramadhan Ghifari, Lisa L Dewi, Alindina Anjani — Sun, 31 May 2026 00:00:00 +0100

Introduction: Sepsis and septic shock represent a critical global health challenge, accounting for a substantial proportion of patient fatalities worldwide. Despite this, Indonesia lacks a comprehensive, nationwide analysis of the mortality rates associated with these conditions. This study aimed to systematically evaluate the burden of sepsis and septic shock mortality across Indonesia, addressing a crucial gap in the existing healthcare data, which may aid clinical and policy considerations.

Methodology: We searched PubMed, Scopus, DOAJ, and citation lists for studies with sepsis and septic shock mortality rate , focusing on 28-day and in-hospital mortality. Study quality was assessed using the Newcastle-Ottawa Scale, and the protocol was registered with PROSPERO (CRD42025645312).

Results: Overall, 47 studies were included in this review , revealing a pooled 28-day mortality rate of 55.9% (95% CI, 48.7%–63.0%; I² = 79.5%) among patients with sepsis and septic shock, as determined by the Sepsis-3, Sepsis 2, and Not-Mentioned criteria. Additionally, the in-hospital mortality rates for the same cohort were higher at 67.4% (95% CI, 62.9%–72.0%; I² = 95.02%). Notably, among patients with septic shock specifically, in-hospital mortality reached 77.5% (95% CI, 67.3%–87.8%; I² = 91.18%).

Conclusions: Sepsis and septic shock mortality rates in Indonesian adults remain high. These findings underscore the need for enhanced sepsis management protocols, effective resource allocation, and targeted interventions for vulnerable patients.

Catheter-related bloodstream infections in hemodialysis: a systematic review and meta-analysis of prevalence and risk

Sun, 31 May 2026 00:00:00 +0100

Introduction: This study aims to identify and systematically assess the prevalence of Catheter-related bloodstream infections (CRBSI) and identify risk factors of CRBSI in hemodialysis (HD) patients.

Methodology: A comprehensive literature review was conducted to identify pertinent studies related to the prevalence of CRBSI and risk factors of CRBSI in HD patients. This involved searching widely recognized electronic databases with MeSH terms to retrieve relevant studies. Relevant articles were screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. Prevalence of CRBSI was pooled using a random effect model using Comprehensive Meta-Analysis (CMA) software.

Results: From the initial search across four electronic databases, a total of 1850 studies were identified. After eliminating 1615 duplicate studies, 235 remained for screening. Of these, 180 were excluded due to the lack of relevant terms. Of the 55 studies left, 43 were not included due to a lack of relevant data. Finally, the pooled combined prevalence across these 12 studies was 22.8% (95% CI of 0.117 to 0.397), whereas the I-squared value obtained is 99.38%. Regionally, prevalence in Asia was 17.5% (95% CI of 0.046 to 0.483), while in Africa it was 30.4% (95% CI of 0.240 to 0.376). The most common risk factors identified were immunocompromised status, along with comorbidities such as hypertension and diabetes mellitus, previous catheter insertion, and prolonged hospital stays.

Conclusions: The findings of this review indicate that CRBSI is a serious issue faced by HD patients, especially those with the commonly identified risk factors.

Prevalence of diarrhoeal cases and deaths associated with food-borne illnesses in India: a systematic review and meta-analysis

Sun, 31 May 2026 00:00:00 +0100

Introduction: Foodborne illnesses are infections or intoxications caused by consuming contaminated food or beverages. This study aims to find the prevalence of diarrheal cases and deaths associated with food-borne illnesses in India.

Methodology: A Search was performed on PubMed and other platforms from 2011 to 2022. Sensitivity and quality analyses were also performed. The pooled prevalence was reported with effect sizes, considering the random-effects and quality-effects models. A subgroup analysis was also performed based on the regions and age groups

Results: The prevalence of diarrheal cases due to foodborne illnesses in India was 18%. The prevalence was 22% in the North Eastern region, 20% in the Eastern region, 18% in the Southern region, 16% in the Western region, and 13% in the Northern region. Among the age groups, prevalence was 34% for 5-10 years, 22% for under 5, 13% for 20-60 years, 14% for 10-19 years, and 10% for more than 60 years.

Conclusions: The prevalence of diarrhea is still on the higher side in India. Although programs like Intensified Diarrhea Control Fortnight are running, interventions and awareness, ensuring intake of safe food and water are necessary.

Comparing COVID-19 vaccine effectiveness in Türkiye: heterologous, inactivated, and mRNA vaccines

Alpay Ari, Zeynep Altinay, Didem Demircan — Sun, 31 May 2026 00:00:00 +0100

Introduction: This study investigates the effectiveness of different coronavirus disease (COVID-19) vaccines in preventing hospitalization, ICU admissions, and mortality in Türkiye, upon comparing the responses to heterologous, inactivated, and mRNA vaccines.

Methodology: Data were gathered from 24,538 individuals, aged ≥ 18 years, whose COVID-19 status was confirmed through PCR testing. An analysis of the survival distributions for six vaccine types showed significant differences in severe disease outcomes, with distinct patterns observed for individuals older and younger than 65 years.

Results: Vaccines, including two-dose mRNA, both heterologous and homologous, showed the most protective and durable vaccine effectiveness. Homologous and heterologous inactivated vaccines demonstrated statistically significant reductions in severe COVID-19 outcomes for individuals aged > 65 years compared to unvaccinated individuals.

Conclusions: The results suggest that an early deployment of inactivated vaccines, despite being less advanced, may have played an important role in providing timely protection, mitigating severe outcomes, especially in countries with limited access to novel vaccine technologies. This study provides key insights for shaping future vaccine strategies and public health policies, particularly in regions with varying access to healthcare resources.

Mycetoma caused by Streptomyces sudanensis

Maria Alessandra Mattioli, Elisa Cinotti, Pietro Rubegni, Stefano Veraldi — Sun, 31 May 2026 00:00:00 +0100

Introduction: Mycetomas are deep, chronic skin infections caused by bacteria or fungi.

Case Presentation: We report the case of an adult male patient with mycetoma caused by Streptomyces sudanensis located on the foot. The patient was treated with i.m. gentamicin (80 mg/day) for six weeks, followed by three-week stop period. A total of eight courses six-week courses of gentamicin therapy, each followed by a three-week stop period, were completed. The patient is still undergoing treatment with the same regimen.

Conclusions: Pulsed therapy may be considered in the management of mycetoma in order to prevent the development of resistance.