Silver ions (Ag+) have been shown to possess antimicrobial properties. However, some Gram-negative bacteria have evolved sophisticated mechanisms to tolerate their toxicity. Among these, the plasmid-encoded Sil system and the chromosomal Cus system are key efflux-based resistance mechanisms. The Sil system is composed of a two-component regulator (SilS and SilR), periplasmic chaperones (SilF, SilG, and SilE), a P-type ATPase (SilP), and a tripartite efflux pump (SilABC) to sense, sequester, and export Ag+. SilE, a small periplasmic protein, plays a pivotal role by binding multiple Ag+ through histidine and methionine residues, which undergo a transition from disordered to α-helical conformations upon Ag+ coordination. A comparative analysis with the Cus system reveals that, while CusF and CusABC perform analogous metal-binding and efflux functions, Cus primarily targets Cu+ and lacks auxiliary components such as SilP and SilE. Collectively, these two systems demonstrate the adaptive strategies that bacteria have developed to regulate toxic metal ion concentrations.
In sepsis, the most decisive modifiable factor influencing survival is the early administration of appropriate antimicrobial therapy. The turnaround time to obtain the conventional antimicrobial susceptibility testing results is 16–24 hours post-blood culture-positive results, which can delay targeted therapy administration and prolong empirical broad-spectrum antibiotic usage. The rapid antimicrobial susceptibility testing (RAST) method proposed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) enables disk diffusion-based susceptibility interpretation directly from positive blood cultures within 4–8 hours. However, the clinical utility of RAST is dependent on rigorous laboratory validation to ensure acceptable analytical performance and minimize categorical errors. This mini review summarizes recent evidence on the EUCAST RAST methodology, validation requirements, analytical performance metrics, implementation strategies, and clinical impact in bloodstream infections and sepsis. The importance of local validation aligning with EUCAST quality control recommendations and the role of RAST in strengthening antimicrobial stewardship programs and supporting global antimicrobial resistance containment efforts have been discussed.
Despite biomedical advances that have made HIV a manageable chronic illness and the outcry over increasing access to care for marginalized groups, African, Caribbean, and Black (ACB) communities in Canada still experience disproportionate HIV rates and worse health outcomes related to HIV. A recent phenomenological study by Osuji, Domingo, and Olokude (2025) examines the lived experiences of ACB individuals in Alberta as they navigate HIV care. Objective: This commentary critically analyses the findings of this study through the lenses of Critical Race Theory, intersectionality, public health policy, and health equity. Discussion: This study's themes—health literacy and empowerment, non-belonging and invisibility, barriers to adherence, and psychosocial life impact—highlight how structural racism, stigma, and systemic neglect influence HIV care for ACB populations in Alberta. This commentary asserts that these inequities are not incidental but are deeply embedded in healthcare systems and broader societal structures. The invisibility of ACB people within HIV policy and data exemplifies structural racism, leading to poorer health outcomes and wider failures in public health. Implications: Public health policies and practices must prioritize culturally responsive care, community-based interventions, disaggregated data collection, psychosocial support, and reforms to address the social determinants of health. Without intentional action, Canada will not achieve its HIV elimination targets or uphold its commitment to equity. Conclusion: Ending HIV requires more than biomedical solutions. It involves dismantling systemic racism, fostering a sense of belonging, and creating inclusive systems where Black lives are visible, valued, and supported.
Background: Smartphones are now widely used in clinical settings for communication, documentation, and even diagnostic procedures such as digital auscultation. However, their frequent handling makes them potential carriers of microorganisms. Simple and effective cleaning methods are therefore essential to prevent the spread of healthcare-associated infections. Methods: This study evaluated the efficacy of disinfectant wipes in reducing microbial contamination on mobile device surfaces used in clinical practice. Three commercially available smartphones were experimentally contaminated with bacterial suspensions of Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae supplemented with 5% bovine serum. After drying, each surface was wiped with CaviWipes™ containing isopropanol and quaternary ammonium compounds. Samples were then neutralized in Letheen broth, plated, and incubated to determine bacterial survival. Results: Cleaning with disinfectant wipes completely eliminated all tested bacteria. No viable colonies were detected after treatment, corresponding to reductions greater than six log₁₀ units for each strain. These results confirm full bactericidal activity in accordance with accepted criteria for low-level disinfection of non-critical medical devices. Conclusions: Regular cleaning of smartphones with disinfectant wipes is a fast, effective, and laboratory-confirmed method for maintaining microbiological safety in clinical use. This practical approach requires no additional equipment and should be incorporated into routine infection prevention practices in healthcare facilities.
Like the hands, the stethoscope serially touches many patients throughout the clinical day. But unlike hands, mandatory hygiene is rare and potentially ineffective. Even when cleaned with an alcohol swab for 60 seconds, cultures from the stethoscope diaphragm still will demonstrate pathogens in 28% of cases. Central Line-Associated Bloodstream Infections (CLABSI) are a potentially fatal hospital associated infection (HAI), estimated to cause a >300% increase in death and result in multiple weeks longer hospitalization. These challenges persist, despite being standard prevention targets. Intensive efforts, such as total body washing with chlorhexidine gluconate (CHG) swabs, and intravenous line antiseptic barrier capping, decrease but do not eliminate the occurrence of CLABSI. In 2025, data from a 17 bed ICU study of an intervention that combined the combination of CHG intravenous line dressing and the use of touch free aseptic disposable single use stethoscope diaphragm covers, was reported. This combination strategy resulted in CLABSI rates that declined to 0%, and which were sustained at 0% for more than 1 year. Failing to provide a clean contact with the hands is potentially fatal for selected patients. It is likely that is the same for the stethoscope for which the addition of a aseptic barrier may save thousands of lives.
Antimicrobial resistance in gram-negative bacilli is an ecological problem with a major impact on public health. Extended-spectrum β-lactamases (ESBLs) are enzymes that inactivate broad-spectrum antibiotics, penicillins, third and fourth generation cephalosporins. There are many factors associated with the global spread of ESBLs, such as the use of over-the-counter antibiotics, the food industry, travel abroad, and the lack of implementation of control strategies in hospitals and at the community level. Fecal carriers of ESBLs are increasingly commonly encountered in routine hospital settings as many hospitals have implemented rectal screening for ESBLs, however, the utility of this clinical practice and the routine isolation of patients carrying these bacteria has controversial benefits. There are challenges in selecting suitable patients for empirical therapy with carbapenems for the treatment of presumed severe ESBLs infections. Inappropriate empirical therapy is associated with high mortality in bloodstream infections. Carbapenems are the standard of care for severe invasive ESBL-E infections outside the urinary tract, however, overuse of carbapenems may lead to the emergence of carbapenem-resistant Enterobacterales. This mini review is intended to contribute to understanding about ESBLs as a global ecological problem, causing a considerable impact on health care services and posing enormous challenges in everyday antimicrobial therapy.
Introduction: Literature data suggest that people living with the human immunodeficiency virus (PLHIV) are at increased risk of severe forms of Coronavirus 2019 (COVID-19) infection and related mortality. The aim of this study was to investigate the anti-SARS-CoV-2 serological profile in adults living with HIV followed at the Departmental and Teaching Hospital of Borgou (DTH-B) in 2022 and to identify factors associated with anti-SARS-CoV-2 seropositivity in the latter. Methods: This was a descriptive and analytical cross-sectional study conducted in the Internal Medicine Department at DTH-B, from June 27, 2022 to July 27, 2022. PLHIV were systematically recruited after informed consent. A survey form was used to collect epidemiological, clinical, paraclinical and therapeutic data. Anti-SARS-CoV-2 antibodies (IgG and IgM) were tested using the BIOSYNEX COVID-19 BSS rapid test (Biosynex SA, France). Data were analyzed using STATA/MP14.1 software. The significance level was 5%. Results: A total of 135 adults living with HIV were included in the study. The sex ratio was 0.34 and the mean age 45 ± 11.03 years. Anti-SARS-CoV-2 seroprevalence was 50.37%. Only one respondent reported a confirmed COVID-19, while vaccination coverage was 37.78%. Anti-SARS-CoV-2 seroprevalence in unvaccinated patients was 40.48%. Factors significantly associated with anti-SARS-CoV-2 seropositivity in multivariate analysis were vaccination status (p=0.02) and viral load (p=0.001). Conclusion: Anti-SARS-CoV-2 antibodies were detectable in more than half the PLHIV. Their presence was associated with the notion of vaccination and an undetectable viral load. This study therefore suggests the need to promote COVID-19 vaccination among PLHIV followed up at DTH-B, as well as the continuation of adequate management of HIV infection in order to reduce COVID-19-related morbidity and mortality in this so-called vulnerable population.
During the 2022-2023 season, influenza circulation levels in the European Union (EU) have increased substantially compared to the 2021-2022 season but were still generally somewhat lower compared to pre-pandemic influenza seasons. Studies have shown that influenza epidemics in the EU countries were associated with a heavy toll of mortality for different principal causes of death including respiratory, cardiac and other causes. Mortality data also suggest that residents of long-term care facilities represent a sizeable share of all cases of death in the EU, and an even higher share among deaths stemming from infections with respiratory viruses, including influenza. Influenza vaccination coverage for healthcare workers in nursing homes in many EU countries is moderate to low, whereas evidence in the literature suggests that higher influenza vaccination coverage levels for healthcare workers result in a significant reduction in all-cause mortality during influenza seasons, both in nursing home residents as well as in hospital patients, though the magnitude of that effect varies with influenza season. Here, we review the above evidence, and as well as the effect of different strategies for boosting influenza vaccination coverage in healthcare workers, such as mandatory vaccination, educational initiatives/outreach activities and availability of on-sight vaccination.
Linezolid is an effective second-line anti-tuberculosis drug. However, the use of linezolid has been associated with rare adverse drug reactions (ADRs), one of which is the linezolid-associated black hairy tongue (BHT). This reaction is characterized by a black or dark brown discoloration of the tongue, which may be accompanied by a metallic or bitter taste. In this case report, we present a 19-year-old male patient who developed linezolid-associated black tongue while receiving linezolid as part of an all-oral, longer-course treatment regime for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB). The patient's BHT was only cosmetic and resolved upon discontinuation of linezolid. This case report aims to raise awareness of this rare ADR and the importance of close monitoring and potential withdrawal of linezolid to optimize treatment outcomes.
Case report of a 73-year-old man with Mycobacterium bovis BCG supra renal saccular aortic aneurysm eight months after intravesical BCG therapy.
COVID-19 infection can lead to severe consequences, especially among ethnic minorities. Data about COVID-19 infection outcomes in the Arab American population as a minority ethnic group compared to other racial and ethnic minorities are lacking. We conducted a retrospective observational cohort study that included 1,740 hospitalized adult patients with confirmed COVID-19 infection from March 12th, 2020, to January 30th, 2021, at a single center to compare baseline characteristics and outcomes in Arabs hospitalized with COVID-19 to patients from other ethnic groups during the same study period. Of those, we identified 320 Arab patients. We found that Arab American population suffered similar odds of complications and adverse outcomes despite having fewer risk factors for severe illness.
Methods: This was a single centre case control study of adults presenting to emergency department with syncope (n = 98), over 3 months’ duration. Patients particulars, contact profile and blood investigation results were recorded. Patients were called up to ascertain development of serious outcome of syncope within 7 days. Blood parameters such as hemoglobin, hematocrit, serum urea, serum sodium and Troponin I were compared between serious outcome and non-serious outcome group.
The COVID-19 infection has highlighted the most vulnerable patients. Indeed, COVID-19 patients suffering from another pathology including NCDs such as Arterial Hypertension (Hypertension), diabetes, cancers and respiratory diseases are paying a heavy price for this pandemic. We undertook a study in Niger to better document this comorbidity in a cross-sectional study that brought together patients hospitalized at the Niamey General Reference Hospital for COVID-19 infection and suffering from one or more NCDs. Among 273 patients hospitalized from March 19 to June 03, 2020, 34.8% had a non-communicable disease associated with COVID-19. The average age of the patients was 55 years (22 years to 94 years) and the sex ratio was 2.64 (72.5 % men and 27.5% women). Hypertension was the most represented NCD with 24.5%, followed by diabetes in 17.9% of cases, respiratory diseases 3.66% and other diseases (Heart disease, Obesity, Dyslipidemia, Gout, Chronic renal failure) with 3%. Health workers were the most affected by the disease with 38.6% of cases. The average consultation time was 3.77 days with extremes ranging from 1 to 8 days. The clinical symptoms characterizing the two main groups of patients (hypertensive and diabetic) were almost identical. It consisted mainly of cough, fever, chills, sore throat and rhinorrhea. According to the WHO clinical criteria for the severity of COVID-19, 34 patients or 16.11% were severe and 177 patients or 83% moderate. The clinical severity of the disease is significantly correlated with the patient's age (over 50 years) and the presence of an NCD associated with COVID-19. A total of 35.8% were hospitalized in intensive care in the NCD and COVID-19 group and 14.6% in the NCD group (p <0.001). The average length of patient hospitalization was 6.87 days overall, it was 7 days in intensive care. In 61.7% of cases the length of hospitalization was greater than 4 days. There was 22.1% in the NCD group and 7.3% in the just COVID-19 group (p <0.001). A total of 90.6% of registered deaths occurred in intensive care.
Background:In Burkina Faso, the first cases of tegumentary leismaniasis were reported in 1960.But it was not until the 1990s that the disease was really known by the Burkinabè with the epidemic that Ouagadougou experienced at that time.Since 2000, the disease has become neglected.However, the frequency of cases diagnosed in hospitals suggests that tegumentary leismaniasis is still endemic in Ouagadougou.Hence the present study whose purpose and assess the current state of the disease in the city of Ouagadougou from 2012 to 2016. Methods:We conducted a descriptive study on retrospective data collected from January 2012 to December 2016 in different hospitals in the city of Ouagadougou.Data were collected from clinical and laboratory registers.Results: a total of 96 parasitologically-confirmed cases were identified.Clinical forms were mentioned in 43 patients.Localized cutaneous leishmaniasis was the most common form 25/43 (58.14%), followed by mucocutaneous leishmaniasis 8/43 (18.60%), diffuse cutaneous leishmaniasis 7/43 (16.28%) and finally pseudo-leprosy Leishmaniasis 3/43 (6.98%).The Leishmaniasis / HIV association was found in 15 patients/96 (15.63%).The parasitological examination in search of amastigote forms had a positivity rate of 92/209 (44.02%).Meglumine antimoniate (Glucantime®), the WHO reference drug, was the most prescribed 35/42 (83.33%). Conclusion:Tegumentary Leishmaniasis still exists in Ouagadougou.Thus, precautions must be taken to avoid an upsurge of cutaneous Leishmaniasis in Ouagadougou.
The use of prophylactic antibiotics for ablation of renal tumors varies and is a practice that has little to no supporting evidence1-3. Prior studies on renal tumor ablation typically do not mention whether antibiotics were used or not, and in those that do, a wide variety of antibiotic choices has been described3. Despite renal tumor ablation becoming a common practice in the early 2000s4,5, currently there is no consensus on the use of routine antibiotic prophylaxis for tumor ablation, per the Society of Interventional Radiology (SIR)6. The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) guidelines for percutaneous ablation of small renal cell carcinomas recommend prophylactic antibiotics in patients with specific risk factors: diabetes, patients with a ureteric stent, and patients with an ileal loop diversion7. The purpose of this paper is to examine the recent article entitled, “Infectious Outcomes from Renal Tumor Ablation: Prophylactic Antibiotics or Not?”, and to discuss the current and recent literature regarding the topic.
Results: A total of 1605 throat swabs were collected. The results of quantitative RT-PCR showed that there were 40 (2.5%) cases of influenza A virus positive. No significant differences were found in gender, age and country distribution. However, in terms of entry time, the positive rate of influenza A virus was the highest in the first quarter compared with other quarters, and the difference was statistically significant. At the same time, there were 13 (0.8%) cases of influenza B virus positive in this survey. No significant differences were found in gender, country distribution and entry time, but in terms of the age of entry personnel, the positive detection rate of children and young people with influenza B infection was higher, and the difference between different age groups was statistically significant.
Intracranial subdural empyema is a rare but devastating infection of the brain.With improvements in investigations and treatment, the previously seen mortality of 100% has now been reduced to 4-9%.The underlying factor in this improvement is the reduction in time to treat.To achieve this, the first barrier is identifying the possibility of the condition.There have been multiple case reports, series, and retrospective studies on the matter, but over time the clinical epidemiology has changed.In this report, we give a up to date review of the infection and highlight the important features clinicians should consider when assessing patients with possible intracranial subdural empyema.
