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Oman Medical Journal Mar 2023Eye infections can be caused by several microorganisms and the most common causative bacterial agents are staphylococci, streptococci, and This study aimed to estimate... (Review)
Review
OBJECTIVES
Eye infections can be caused by several microorganisms and the most common causative bacterial agents are staphylococci, streptococci, and This study aimed to estimate the prevalence of viridans group streptococci, and as the cause of ocular infections in Iran.
METHODS
We conducted a systematic search on the studies published by Iranian authors from January 2000 to December 2020 in Web of Science, PubMed, Scopus, and Embase. Eligible studies were selected according to the defined inclusion/exclusion criteria. Statistical heterogeneity between and within groups was estimated by the Q-statistic and I index. The funnel plots, Duval and Tweedie trim, and fill methods were obtained to evaluate the evidence of publication bias.
RESULTS
Twenty-seven studies were included in this review. According to the meta-analysis results, the prevalence of was 19.1% (95% CI: 12.5-28.1). It was estimated 6.9% (95% CI: 4.4-10.6), 6.7% (95% CI: 4.6-9.6), and 3.3% (95% CI: 1.8-5.8) for and viridans streptococci, respectively.
CONCLUSIONS
. is the prevalent bacterial agents responsible for eye-associated infections in Iran.
PubMed: 37132006
DOI: 10.5001/omj.2023.22 -
Pharmaceuticals (Basel, Switzerland) Jul 2023Approved for acute bacterial skin and skin structure infections, dalbavancin (DBV) has gradually acquired over the years a role as an off-label treatment for several... (Review)
Review
BACKGROUND
Approved for acute bacterial skin and skin structure infections, dalbavancin (DBV) has gradually acquired over the years a role as an off-label treatment for several infections caused by Gram-positive bacteria even in other anatomical sites. Osteoarticular (OA) infections are one of the most difficult-to-treat infections and, since the absence of recommendations, clinicians use different and heterogenic DBV dosing schedule regimens for the off-label treatment of osteomyelitis, spondylodiscitis, and septic arthritis. Our aim is to systematically review the current literature to describe DBV administration schedules and their outcome in OA infections.
METHODS
According to the 2020 updated PRISMA guidelines, all peer-reviewed articles regarding the use of DBV in OA infections were included. We conducted a literature search on PubMed and Cochrane Controlled Trials.
RESULTS
A total of 23 studies and 450 patients were included, prevalently male (144/195, 73.8%) and diabetic (53/163, 32.5%). Overall, 280 (280/388, 72.2%) osteomyelitis, 79 (79/388, 20.4%) spondylodiscitis, and 29 (29/388, 7.5%) septic arthritis were considered. (164/243, 67.5%) was the most common pathogen isolated. A previous treatment failure (45/96, 46.9%) was the main reason for a switch to a long-acting antibiotic. Most patients were successfully cured with DBV (318/401, 79.3%). A source control was performed in most patients with a favourable outcome (80.4%), while MRSA was prevalently isolated in people with an unfavourable outcome (57%). While a higher percentage of success was found in people who received three doses of DBV 1 week apart (92.3%), a higher rate of treatment failure was recorded in cases of when the DBV cycle was composed of less than two or more than four doses (27.8%).
CONCLUSIONS
DBV has shown to be effective as a treatment for OA infections. The most favourable outcome was found in patients receiving three doses of DBV and with an adequate surgical management prior to antibiotic treatment. Although a rigorous administration schedule does not exist, DBV is a viable treatment option in the management of OA infections.
PubMed: 37513919
DOI: 10.3390/ph16071005 -
International Journal of Infectious... Sep 2022Staphylococcus aureus bacteremia (SAB) is a common infection worldwide. We compared SAB mortality in low- and middle-income countries (LMIC) versus high-income countries... (Review)
Review
OBJECTIVES
Staphylococcus aureus bacteremia (SAB) is a common infection worldwide. We compared SAB mortality in low- and middle-income countries (LMIC) versus high-income countries (HIC) in a meta-analysis.
METHODS
We searched MEDLINE, Embase, and Cochrane Database of Systematic Reviews from 1991-2021 and included observational, single-country studies on patients with positive blood cultures for S. aureus. The main outcome was the proportion of patients with SAB who died in the hospital. A generalized linear mixed random-effects model was used to pool estimates, and a meta-regression was used to adjust for study-level characteristics.
RESULTS
A total of 332 studies involving 517,671 patients in 39 countries were included. No study was conducted in a low-income country. Only 33 (10%) studies were performed in middle-income countries (MIC), which described 6,216 patients. The pooled in-hospital mortality was 32.4% (95% confidence interval [CI] 27.2%-38.2%, T = 0.3063) in MIC and 22.3% (95% CI 20.1%-24.6%, T = 0.3257) in HIC. In a meta-regression model, MIC had higher in-hospital mortality (adjusted odds ratio 1.37, 95% CI 1.11-1.71; P = 0.0042) than HIC.
CONCLUSION
In SAB studies, LMIC are poorly represented. In-hospital mortality was significantly higher in MIC than in HIC. Research should be conducted in LMIC to characterize differences in care processes driving the mortality gap.
Topics: Humans; Bacteremia; Odds Ratio; Staphylococcal Infections; Staphylococcus aureus
PubMed: 35728748
DOI: 10.1016/j.ijid.2022.06.026 -
Patient Safety in Surgery 2020Surgical site infection is a common complication in patients who underwent surgery. The prevalence is higher in low-income countries. In Ethiopia, prevalence and... (Review)
Review
BACKGROUND
Surgical site infection is a common complication in patients who underwent surgery. The prevalence is higher in low-income countries. In Ethiopia, prevalence and pathogens of surgical site infection (SSI) reported are variable. This systematic review and meta-analysis aimed to find the pooled prevalence of SSI. Besides, it aimed to find pathogens of surgical site infection in Ethiopia.
METHODS
The databases for the search were PubMed, Web of Science, and Google Scholar by the date 21/08/2018. To assess publication bias Egger's test regression analysis was applied. Subgroup analysis was conducted based on the study population and region.
RESULTS
This meta-analysis included a total of 15 studies with 8418 study subjects. The pooled prevalence of surgical site infection was 25.22% (95% CI: 17.30 to 33.14%). (30.06%) was the most common pathogen identified. Followed by (19.73%), (17.27%), and (12.43%) were the commonly isolated pathogens.
CONCLUSIONS
The national prevalence of surgical site infection was high. The most common identified pathogen was . Followed by , and Coagulase-Negative staphylococci. Strict adherence to surgical site infection prevention techniques needs to get more attention.
PubMed: 32110246
DOI: 10.1186/s13037-020-00232-y -
Tropical Medicine and Infectious Disease Mar 2021Contaminated healthcare workers' (HCW) clothing risk transferring methicillin-resistant (MRSA) in healthcare facilities. We performed a systematic review in Pubmed and... (Review)
Review
Contaminated healthcare workers' (HCW) clothing risk transferring methicillin-resistant (MRSA) in healthcare facilities. We performed a systematic review in Pubmed and Scopus for 2000-2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to analyze evidence of MRSA on HCW attire. The primary study outcome was MRSA isolation rates on HCW clothing in healthcare settings. Out of 4425 articles, 23 studies were included: 18 with 1760 HCWs, four with 9755 HCW-patient interactions and one with 512 samples. There was a notable variation in HCWs surveyed, HCW attires, sampling techniques, culture methods and laundering practices. HCW attire was frequently colonized with MRSA with the highest rates in long-sleeved white coats (up to 79%) and ties (up to 32%). Eight studies reported additional multidrug-resistant bacteria on the sampled attire. HCW attire, particularly long-sleeved white coats and ties, is frequently contaminated with MRSA. Banning certain types and giving preference to in-house laundering in combination with contact precautions can effectively decrease MRSA contamination and spread.
PubMed: 33807299
DOI: 10.3390/tropicalmed6020042 -
The Brazilian Journal of Infectious... 2021Community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) emerged in the 1990s as a global community pathogen primarily involved in skin and soft tissue... (Review)
Review
BACKGROUND
Community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) emerged in the 1990s as a global community pathogen primarily involved in skin and soft tissue infections (SSTIs) and pneumonia. To date, the CG-MRSA SSTI burden in Latin America (LA) has not been assessed.
OBJECTIVE
The main objective of this study was to report the rate and genotypes of community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) causing community-onset skin and soft tissue infections (CO-SSTIs) in LA over the last two decades. In addition, this research determined relevant data related to SSTIs due to CG-MRSA, including risk factors, other invasive diseases, and mortality.
DATA SOURCES
Relevant literature was searched and extracted from five major databases: Embase, PubMed, LILACS, SciELO, and Web of Science.
METHODS
A systematic review was performed, and a narrative review was constructed.
RESULTS
An analysis of 11 studies identified epidemiological data across LA, with Argentina presenting the highest percentage of SSTIs caused by CG-MRSA (88%). Other countries had rates of CG-MRSA infection ranging from 0 to 51%. Brazil had one of the lowest rates of CG-MRSA SSTI (4.5-25%). In Argentina, being younger than 50 years of age and having purulent lesions were predictive factors for CG-MRSA CO-SSTIs. In addition, the predominant genetic lineages in LA belonged to sequence types 8, 30, and 5 (ST8, ST30, and ST5).
CONCLUSION
There are significant regional differences in the rates of CG-MRSA causing CO-SSTIs. It is not possible to conclude whether or not CG-MRSA CO-SSTIs resulted in more severe SSTI presentations or in a higher mortality rate.
Topics: Anti-Bacterial Agents; Argentina; Brazil; Community-Acquired Infections; Genotype; Humans; Latin America; Methicillin-Resistant Staphylococcus aureus; Soft Tissue Infections; Staphylococcal Infections; Staphylococcal Skin Infections
PubMed: 33607082
DOI: 10.1016/j.bjid.2021.101539 -
Porto Biomedical Journal 2021Enterococci are opportunistic pathogens and are one of the most important bacteria in hospital-acquired infections. Their resistance to antibiotics such as vancomycin... (Review)
Review
BACKGROUND
Enterococci are opportunistic pathogens and are one of the most important bacteria in hospital-acquired infections. Their resistance to antibiotics such as vancomycin has led to life-threatening and difficult-to-treat nosocomial infections. The true prevalence in clinical settings in Nigeria is not well known due to the lack of a comprehensive antibiotic surveillance system. This study aims to estimate the prevalence of vancomycin-resistant enterococci (VRE) in clinical infections in Nigeria.
METHODS
Databases (PubMed, , and Google scholar) were searched following the Preferred Reporting Items for Systematic review and meta-analysis protocols (PRISMA-P) 2015 statements for articles reporting VRE prevalence, and were published before August 5, 2020. Data from the studies were extracted and analyzed using Microsoft Excel and Comprehensive Meta-Analysis (CMA 3.0), respectively. The pooled prevalence of VRE was estimated with the random-effects model and the 95% confidence interval (CI). The heterogeneity level was assessed using Cochran Q and tests.
RESULTS
A total of 35 articles were scanned for eligibility, among which 7 were included in the study after fulfilling the eligibility criteria. The studies analyzed a total of 832 enterococci isolates and 90 VRE strains. The prevalence of and in this study are 361 (59.3%) and 248 (40.7%), respectively, among which 41 (63.1%) of the and 24 (36.9%) of the were vancomycin resistant. The pooled prevalence of VRE was estimated at (95% CI; 10.0-53.9%; = 93.50%; < .001). The highest prevalence of VRE was reported from western Nigeria, 14.6% (95% CI; = 97.27; < .001).
CONCLUSION
The prevalence of VRE in Nigeria according to the reports from this study is relatively high. The report of this study should help policymakers to put in place measures that will help curb the spread of VRE and associated resistant genes to other important clinical pathogens like .
PubMed: 33884321
DOI: 10.1097/j.pbj.0000000000000125 -
Tropical Medicine and Infectious Disease Apr 2023Treatments for COVID-19, including steroids, might exacerbate disease in patients with coinfection. We aimed to systematically review clinical and laboratory features... (Review)
Review
BACKGROUND
Treatments for COVID-19, including steroids, might exacerbate disease in patients with coinfection. We aimed to systematically review clinical and laboratory features of SARS-CoV-2 and coinfection, investigate possible interventions, assess outcomes, and identify research gaps requiring further attention.
METHODS
We searched two electronic databases, LitCOVID and WHO, up to August 2022, including SARS-CoV-2 and coinfection studies. We adapted the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system for standardized case causality assessment to evaluate if using corticosteroids or other immunosuppressive drugs in COVID-19 patients determined acute manifestations of strongyloidiasis.
RESULTS
We included 16 studies reporting 25 cases of and SARS-CoV-2 coinfection: 4 with hyperinfection syndrome; 2 with disseminated strongyloidiasis; 3 with cutaneous reactivation of strongyloidiasis; 3 with isolated digestive symptoms; and 2 with solely eosinophilia, without clinical manifestations. Eleven patients were asymptomatic regarding strongyloidiasis. Eosinopenia or normal eosinophil count was reported in 58.3% of patients with reactivation. Steroids were given to 18/21 (85.7%) cases. A total of 4 patients (19.1%) received tocilizumab and/or Anakirna in addition to steroids. Moreover, 2 patients (9.5%) did not receive any COVID-19 treatment. The causal relationship between reactivation and COVID-19 treatments was considered certain (4% of cases), probable (20% of patients), and possible (20% of patients). For 8% of cases, it was considered unlikely that COVID-19 treatment was associated with strongyloidiasis reactivations; the relationship between the infection and administration of COVID-19 treatment was unassessable/unclassifiable in 48% of cases. Of 13 assessable cases, 11 (84.6%) were considered to be causally associated with , ranging from certain to possible.
CONCLUSIONS
Further research is needed to assess the frequency and risk of reactivation in SARS-CoV-2 infection. Our limited data using causality assessment supports recommendations that clinicians should screen and treat for infection in patients with coinfection who receive immunosuppressive COVID-19 therapies. In addition, the male gender and older age (over 50 years) may be predisposing factors for reactivation. Standardized guidelines should be developed for reporting future research.
PubMed: 37235296
DOI: 10.3390/tropicalmed8050248 -
Toxins Feb 2020This review assessed the molecular characterization of the methicillin-resistant (MRSA)-ST80 clone with an emphasis on its proportion of total MRSA strains isolated,...
This review assessed the molecular characterization of the methicillin-resistant (MRSA)-ST80 clone with an emphasis on its proportion of total MRSA strains isolated, PVL production, -typing, antibiotic resistance, and virulence. A systematic review of the literature was conducted on MRSA-ST80 clone published between 1 January 2000 and 31 August 2019. Citations were chosen for a review of the full text if we found evidence that MRSA-ST80 clone was reported in the study. For each isolate, the country of isolation, the sampling period, the source of isolation (the type of infection, nasal swabs, or extra-human), the total number of MRSA strains isolated, number of MRSA-ST80 strains, antibiotic resistance patterns, PVL production, virulence genes, and type were recorded. The data from 103 articles were abstracted into an Excel database. Analysis of the data showed that the overall proportion of MRSA-ST80 has been decreasing in many countries in recent years. The majority of MRSA-ST80 were PVL positive with -type t044. Only six reports of MRSA-ST80 in extra-human niches were found. This review summarizes the rise of MRSA-ST80 and the evidence that suggests that it could be in decline in many countries.
Topics: Animals; Anti-Bacterial Agents; Bacterial Toxins; Drug Resistance, Multiple, Bacterial; Humans; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Molecular Epidemiology; Prevalence; Staphylococcal Infections; Virulence Factors
PubMed: 32075074
DOI: 10.3390/toxins12020119 -
PloS One 2021To compare between current evidence of novel glycopeptides against vancomycin for the treatment of gram-positive bacterial infections. (Meta-Analysis)
Meta-Analysis
Efficacy and safety of novel glycopeptides versus vancomycin for the treatment of gram-positive bacterial infections including methicillin resistant Staphylococcus aureus: A systematic review and meta-analysis.
OBJECTIVE
To compare between current evidence of novel glycopeptides against vancomycin for the treatment of gram-positive bacterial infections.
METHODOLOGY
A systematic review and meta-analysis was done. Major databases were searched for eligible randomized control trials that assessed clinical success, microbiological success and safety profile of novel glycopeptides versus vancomycin for infections caused by gram-positive bacteria.
RESULTS
This meta-analysis included eleven trials (7289 participants) comparing telavancin, dalbavancin and oritavancin with vancomycin. No differences were detected between novel glycopeptides and vancomycin for the treatment of skin and soft tissue infections (SSTIs) among modified intent-to-treat patients (OR: 1.04, CI: 0.92-1.17) as well as within the clinically evaluable patients (OR: 1.09, CI: 0.91-1.30). Data analysed from SSTIs, HAP and bacteremia studies on telavancin showed insignificant high clinical response in microbiologically evaluable patients infected with methicillin resistant Staphylococcus aureus (MRSA) (OR: 1.57, CI: 0.94-2.62, p: 0.08) and in the eradication of MRSA (OR: 1.39, CI: 0.99-1.96, P:0.06). Dalbavancin was non-inferior to vancomycin for the treatment of osteomyelitis in a phase II trial, while it was superior to vancomycin for the treatment of bacteremia in a phase II trial. Data analysed from all trials showed similar rates of all-cause mortality between compared antibiotics groups (OR: 0.67, CI: 0.11-4.03). Telavancin was significantly related with higher adverse events (OR: 1.24, CI: 1.07-1.44, P: <0.01) while dalbavancin and oritavancin were associated with significant fewer adverse events (OR: 0.73, CI: 0.57-0.94, p: 0.01; OR: 0.72, CI: 0.59-0.89, p: <0.01 respectively).
CONCLUSION
Efficacy and safety profiles of both dalbavancin and oritavancin were the same as vancomycin in the treatment of gram-positive bacterial infections in different clinical settings, while telavancin might be an effective alternative to vancomycin in MRSA infections, but caution is required during its clinical use due to the high risk of adverse events, especially nephrotoxicity.
Topics: Anti-Bacterial Agents; Glycopeptides; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Humans; Methicillin-Resistant Staphylococcus aureus; Treatment Outcome; Vancomycin
PubMed: 34843561
DOI: 10.1371/journal.pone.0260539