Background. Interleukin-10 (IL-10) is a key anti-inflammatory cytokine involved in maintaining immunological homeostasis by limiting excessive inflammatory responses, which, if uncontrolled, may lead to tissue damage and adverse outcomes during infection. Aim. The aim of this study was to evaluate time-dependent and sex-related changes in serum interleukin-10 levels in rats experimentally infected with Candida albicans. Material and method. A total of 100 rats were included, comprising 50 Candida albicans-infected animals and 50 controls, with equal numbers of males and females in each group. To facilitate fungal infection, rats in the experimental group received cyclosporine A (10 mg/kg) three days prior to inoculation (one does daily), whereas the control group received distilled water instead of C. albicans suspension. The experimental group was further subdivided into five subgroups. Animals in each subgroup were anesthetized, and blood samples were collected on days 4, 8, 12, 16, and 20 after treatment initiation to determine serum IL-10 levels. Control animals were similarly subdivided and evaluated using the same sampling schedule. Results. The present study demonstrated a significant increase (p < 0.05) in IL-10 concentration in both male and female rats infected with C. albicans compared to the control group of male and female rats. The study demonstrated a significant increase in IL-10 concentration in C. albicans infected rats of both sexes, with a p-value <0.05, as the duration of the experiment increased. In contrast, no significant changes were observed in the control group over the same time period. Conclusion. The research highlights the essential function of IL-10 in the immune response to Candida albicans infections, observing that the absence of notable differences between male and female rats suggests that additional factors affect IL-10 regulation. The necessity for additional research on the interactions between sex hormones and cytokines is underscored, offering insights into the sex- and time-dependent regulation of IL-10 during infections, while also highlighting the need for clarification of observed discrepancies and their underlying mechanisms.
Background and objective. The Bacillus Calmette-Guérin (BCG) vaccine may cause severe complications in children with inborn errors of immunity (IEI), particularly in those with severe combined immunodeficiency (SCID), Mendelian susceptibility to mycobacterial disease (MSMD), and chronic granulomatous disease (CGD). This study aimed to describe the clinical spectrum, immunological characteristics, and outcomes of BCG-related complications in pediatric patients with IEI. Methods. We conducted a retrospective, single-center descriptive study including children with confirmed IEI who developed BCG-related complications and were followed at the Ibn Rochd Children’s Hospital, Casablanca, between 2004 and 2023. HIV-infected patients were excluded. Clinical presentation, immunological findings, genetic analyses, and outcomes were reviewed. Results. Forty-eight children were included, with a mean age of 10.8 months and a male predominance (58.3%). The cohort comprised three main groups according to the underlying immunodeficiency: severe combined immunodeficiency (SCID, n = 20), Mendelian susceptibility to mycobacterial disease (MSMD, n = 14), and chronic granulomatous disease (CGD, n = 9). Five additional patients with atypical lymphocytic phenotypes were analyzed separately. Consanguinity was reported in 45% of cases. BCG-related complications were classified as localized in 25% of patients, locoregional in 44%, and disseminated in 31%. Clinical manifestations included lymphadenitis, bone and skin involvement, and systemic symptoms. Genetic confirmation was available for all patients with MSMD and for a subset of patients with SCID and CGD. Disseminated forms were more frequent among children with SCID. Conclusion. BCG-related complications may represent an important early manifestation of underlying IEI in infancy, particularly in severe forms such as SCID. These findings highlight the need for increased clinical awareness of IEI in infants presenting with post-BCG complications.
Background. Miller Fisher syndrome (MFS), a rare Guillain-Barré syndrome (GBS) variant, usually presents with classical triad of ophthalmoplegia, ataxia, and areflexia. It is typically post-infectious and immune mediated; para-infectious presentations associated with dengue virus are uncommon. Case presentation. We report a 65-year-old man with type 2 diabetes mellitus who presented with a five-day history of high-grade fever and a two-day history of diplopia, bilateral ptosis, and gait unsteadiness. Examination revealed ophthalmoplegia, areflexia, and ataxia. Laboratory evaluation showed severe thrombocytopenia. Dengue NS1 antigen and IgM antibody were positive. MRI brain was normal, and nerve conduction studies demonstrated motor axonal polyneuropathy. Anti-GQ1b antibody was negative. The patient was treated with IVIG and supportive care, resulting in complete neurological recovery. Conclusion. Acute dengue infection associated MFS is rare. This case highlights that neurological manifestations may occur during the active phase of dengue, even in the absence of anti-GQ1b antibodies, suggesting alternative pathogenic mechanisms. Early recognition of the classical clinical triad and timely immunotherapy can lead to favorable neurological outcomes.
Introduction. Down syndrome (DS) is characterized by a unique immunological profile that predisposes affected individuals to severe viral infections. Alterations in both innate and adaptive immunity, along with common comorbidities such as hypotonia and airway anomalies, heighten the risk of complications from pathogens like Influenza B. Case presentation. We report on the case of a 4-year-old girl with DS who developed acute respiratory failure secondary to Influenza B infection. Imaging and laboratory findings pointed out bilateral pneumonia with ground-glass opacities and elevated inflammatory markers. Treatment included high-flow oxygen, oseltamivir, corticosteroids, antibiotics, and supportive care. The patient showed gradual clinical improvement and was discharged in a hemodynamically stable condition. Conclusions. This case illustrates the increased risk of severe outcomes in children with DS during otherwise moderate viral infections. It underscores the need for early diagnosis, aggressive intervention, and routine Influenza vaccination in this vulnerable population to mitigate serious complications.
A 31-year-old man with advanced HIV presented with bilateral periorbital swelling and a rapidly enlarging dark lesion over the nasal bridge. He had been diagnosed with HIV one month earlier, with a CD4 count of 11 cells/µL. Within days, progressive eyelid edema and central facial necrosis developed. A Tzanck smear was consistent with a clinical diagnosis of presumed herpes zoster ophthalmicus (HZO), while both blood and pus cultures grew Pseudomonas aeruginosa, confirming bacteremia with associated soft tissue involvement. A combination of viral reactivation and secondary bacterial infection may have contributed to the development of periorbital necrotizing fasciitis with orbital involvement. Targeted intravenous antiviral therapy and culture-guided antipseudomonal therapy stabilized the systemic infection, although visual function in the affected eye was not preserved. Reports describing a similar combination of presumed HZO-associated facial necrotizing fasciitis and Pseudomonas aeruginosa bacteremia in advanced HIV remain limited. This case underscores the importance of early microbiological confirmation and aggressive multidisciplinary management in severely immunocompromised patients presenting with rapidly progressive facial necrosis.
Background. Sexually transmitted infections (STIs) continue to represent a significant global burden of infectious disease, particularly among individuals aged 15–29 years. Numerous STIs manifest with mild or asymptomatic clinical presentations, resulting in delayed diagnoses, ongoing transmission, and an elevated risk of long-term complications. A lack of adequate knowledge and inconsistent preventive practices among young populations considerably exacerbate these clinical and epidemiological challenges. Aim. This study aimed to assess STI-related knowledge, preventive practices, and testing behaviour among university students in Korçë, Albania, and to identify behavioural and educational factors that may influence the risk of undetected STI transmission. Methods. A cross-sectional study was conducted among 228 university students using a structured 32-item questionnaire. Participants were selected by stratified random sampling from different academic programmes and study years. STI-related knowledge was assessed using 10 questions covering transmission routes, symptoms, prevention, testing, and complications. Scores ranged from 0 to 10 and were classified as low (0–3), moderate (4–7), or high (8–10). Data were analyzed using descriptive statistics and chi-square (χ²) tests. Results. Moderate STI-related knowledge was observed in 62.7% of participants, while 21.5% had high knowledge and 15.8% had low knowledge. Among sexually active students, only 41.2% reported consistent condom use. Most participants (80.7%) had never undergone STI testing. Significant associations were found between knowledge level and gender (p = 0.015), and between prior sexual experience and STI testing behaviour (p = 0.003). Conclusions. Gaps in STI-related knowledge, inconsistent preventive practices, and low testing uptake may increase vulnerability to undetected sexually transmitted infections among university students. These findings highlight the need for improved sexual health education, expanded screening programmes, and targeted prevention strategies.
This viewpoint highlights the evolving threat of microbial pathogens in the post-pandemic era, where beyond COVID-19, a parallel and less visible shift is occurring across healthcare and environmental settings, driven by antimicrobial misuse, globalization, climate change, and increased human–animal interactions. Emerging pathogens such as Candida auris, Elizabethkingia anophelis, Mycobacterium chimaera, and the resurgence of mpox illustrate the growing complexity of infectious diseases. On the other hands, antimicrobial resistance remains the main driver, limiting therapeutic options and necessitating innovative approaches, including combination therapies, novel antifungals, and drug repurposing. Seen from this point of view, adopting a One Health framework is essential to address interconnected human, animal, and environmental determinants. Strengthened surveillance, antimicrobial innovation, equitable access, and international collaboration are critical to confronting this ongoing microbial evolution and mitigating future infectious threats. The article discusses key drivers of this phenomenon, such as antimicrobial resistance, climate change, globalization, healthcare-associated factors, and zoonotic spillover. It also outlines current therapeutic and diagnostic challenges, emphasizing the need for antimicrobial innovation, rapid detection tools, One Health strategies, and equitable global access to effective interventions.
Introduction. Chlamydia trachomatis is a common sexually transmitted pathogen that may remain asymptomatic and lead to serious reproductive complications in women. Although nucleic acid amplification tests are considered the diagnostic gold standard, their availability may be limited in low-resource settings. This study aimed to compare the detection rate of C. trachomatis in urethral and endocervical specimens using immunohistochemistry. Material and methods. This analytical cross-sectional study included 50 sexually active women aged 18–45 years who reported more than one sexual partner within the previous 12 months. Paired urethral and endocervical swab specimens were collected from each participant and processed for immunohistochemical staining using monoclonal anti-Chlamydia trachomatis antibodies. Positive staining was defined as brown cytoplasmic chromogenic deposits within epithelial cells following DAB visualization. Paired categorical data were analyzed using McNemar’s test, with p < 0.05 considered statistically significant. Results. Chlamydia trachomatis was detected in 16 urethral specimens (32%) and 25 endocervical specimens (50%). Paired analysis showed that 12 participants were positive at both anatomical sites, 21 were negative at both sites, 4 were positive only in urethral specimens, and 13 were positive only in endocervical specimens. McNemar’s test showed a statistically significant difference in detection rates between the two specimen sites (p = 0.021). Conclusions. Endocervical specimens demonstrated a higher positivity rate than urethral specimens for immunohistochemical detection of Chlamydia trachomatis in this study population. These findings suggest that endocervical sampling may provide greater diagnostic yield in settings where molecular testing is not readily available. Further studies using molecular reference methods are required to confirm these findings.
Introduction. Brain abscesses are localized collections of purulent material within the brain parenchyma that may develop through contiguous spread from ear, sinus, or dental infections, or via hematogenous dissemination. They may also occur following recent neurosurgical procedures. Materials and methods. Patients aged 18 years and older who were treated for brain abscesses in our neurosurgery department between January 2020 and December 2024 were included in this study. The localization of the abscesses, diagnostic modalities, symptoms and signs, microorganisms isolated from abscess cultures, and treatment approaches were evaluated retrospectively. Results. Of the 30 patients, 10 (33.3%) were male and 20 (66.7%) were female, with a mean age of 56 years (range, 24–86). Intracranial surgical intervention prior to abscess formation was present in 70% (n=21). The most common presenting complaint was headache (53.3%, n=16), and the most frequent clinical finding was neurological deficit (56.7%, n=17). Diagnosis was established by CT in 13 patients (43.3%) and by MRI in 17 patients (56.7%). A causative pathogen was isolated from abscess material in 13 patients (43.3%), most commonly methicillin-sensitive Staphylococcus aureus (n=4), and in one patient the same pathogen was isolated from blood culture. Surgical drainage was performed in 21 patients (70%) electively and in 9 (30%) emergently. Post-treatment abscess recurrence was 10% (n=3), and mortality was 33.3% (n=10). Conclusion. The optimal treatment approach for brain abscesses is surgical drainage combined with antimicrobial therapy. Selection of antimicrobial agents should consider their ability to penetrate brain tissue and abscess cavities, as well as the likely causative pathogens. Our study represents one of the largest single-center series in our region.
Background. Serratia marcescens (SM) is a Gram-negative pathogen identified by the Italian chemist Bizio in 1819. Serratia marcescens is increasingly recognized as a multidrug-resistant pathogen; it exhibits resistance to various antibiotics, such as penicillin, cephalosporins, tetracyclines, macrolides, nitrofurantoin, and colistin, as documented in the literature.Purpose. This study investigated the prevalence and molecular characterization of RND efflux pump genes in pediatric urinary isolates. Method. A total of 120 urine samples were collected from children with urinary tract infections (UTIs). Serratia marcescens was identified using biochemical assays and PCR. Antimicrobial susceptibility testing and efflux pump gene analysis were conducted. The samples were obtained from pediatric patients with UTIs at Al-Hussein Teaching Hospital in Al Smawah City. Result. 16.6% of the samples were positive for Serratia marcescens. High resistance was observed to the tested aminoglycosides and beta-lactams. 70% (14 out of 20) of the isolates exhibited multidrug resistance. The SdeB and SdeY efflux pump genes were detected in 40% (8/20) and 50% (10/20) of the isolates, respectively. The isolates exhibited significant resistance to gentamicin, ampicillin, and chloramphenicol (85%, 80%, and 70%, respectively), and moderate to low resistance to cloxacillin, ciprofloxacin, and ofloxacin (50%), as well as nalidixic acid, meropenem, and imipenem (25%, 10%, 20%, respectively), with no resistance observed to ertapenem. Conclusion. RND efflux pumps may contribute to multidrug resistance in Serratia marcescens strains isolated from pediatric urinary tract infections.
Background and objectives. Hepatitis E virus (HEV) poses a significant risk to pregnant women, leading to severe maternal and fetal complications. Although several meta-analyses have previously examined HEV seroprevalence, most were restricted to earlier periods or specific regions. This updated global meta-analysis integrates recent data (up to 2025) and applies rigorous statistical methods to provide a comprehensive estimate of anti-HEV IgG and IgM prevalence among pregnant women worldwide. Material and methods. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines, analyzing 30 observational studies identified through PubMed, Scopus, and Web of Science. Data on HEV seroprevalence were extracted, and pooled prevalence estimates were calculated using a random-effects model (REML estimator). Heterogeneity was assessed using Cochran’s Q test and quantified with the I² statistic, while publication bias was evaluated using funnel plots and Egger’s test. Outcomes. Thirty studies were included, covering diverse geographic regions. The global pooled seroprevalence of anti-HEV IgG was 14.68% (95% CI: 9.79–19.58; I² = 96.42%, p < 0.001, Q test), with the highest rates reported in Pakistan (60.0%) and Ethiopia (42.4%) and the lowest in Croatia (1.7%). The pooled prevalence of anti-HEV IgM, indicating recent infection, was 2.36% (95% CI: 0.86–3.85; I² = 94.25%, p < 0.001, Q test), with the highest values observed in Nigeria (15.0%) and Pakistan (13.3%). Despite substantial heterogeneity confirmed by the Q test, no significant publication bias was detected (Egger’s test, p > 0.05). Conclusions. HEV seroprevalence among pregnant women varies widely, reflecting differences in regional sanitation, exposure risk, and diagnostic methodologies. Targeted screening and preventive vaccination programs should be prioritized in high-prevalence regions, alongside the adoption of standardized diagnostic assays and strengthened epidemiological surveillance, to mitigate the burden of HEV infection during pregnancy.
Background. Acanthamoeba is an opportunistic amoeba that can live as a free-living organism or as a parasite and is widely distributed in various soil and water environments. It is also a causative agent of some life-threatening diseases, such as granulomatous amebic encephalitis (GAE). This study aimed to evaluate the prevalence of Acanthamoeba in different clinical and ecological samples. Methodology. The study was performed from May 2023 to September 2024 in Nasiriyah city, Iraq, and involved 263 ecological samples from different water and soil sources. In addition, 116 clinical samples were collected, including sputum from patients with suspected tuberculosis who had negative acid-fast bacilli (AFB) staining results, pleural fluid, stool, urine, and formalin-fixed paraffin-embedded (FFPE) tissues from cases of cystic neutrophilic granulomatous mastitis. The samples were examined microscopically and cultured on non-nutrient agar (NNA) media, with periodic examination for one month. Acanthamoeba was diagnosed based on morphological features and molecular characteristics using PCR. The chi-square test was used for comparison of results, and differences were considered statistically significant at P ≤ 0.05. Results. The prevalence of Acanthamoeba in ecological samples was 21.7%, while in clinical samples it was 12.9%, with significant differences. The highest rate of isolation was recorded in garden soils (5.3%), whereas the lowest rate (0.4%) was detected in water tanks and wastewater. The amoeba was detected in 15 (12.9%) clinical samples; eleven of these isolates were detected in patients with pneumonia, with a significant difference (P = 0.036). No significant association was found between age or sex and the prevalence of Acanthamoeba (P = 0.369 and P = 0.330, respectively). However, residence was significantly associated with Acanthamoeba prevalence, as 13 out of 15 positive cases were detected in urban areas (P = 0.013). Conclusion. Acanthamoeba spp. were found to be widely distributed across different environmental sources in southern Iraq, particularly those directly associated with human activity. The findings highlight the role of this free-living amoeba as a potential opportunistic pathogen, especially in pneumonia among immunocompromised patients. Diagnosis of Acanthamoeba should be recommended in routine diagnostic programs for cases with unknown causes or treatment-resistant infections.
This report aims to highlight an uncommon case of Cryptosporidium infection in a patient with systemic lupus erythematosus (SLE) on immunosuppressive therapy. A 53-year-old woman with a known history of Systemic Lupus Erythematosus (SLE), Sjogren’s syndrome, lupus nephritis, and hypothyroidism presented with complaints of tiredness and watery stools occurring after meals. She was on long-term immunosuppressive therapy including mycophenolate mofetil 500 mg twice daily, hydroxychloroquine 200 mg once daily, and corticosteroid therapy for systemic lupus erythematosus for approximately two years. On examination, she showed signs of mild dehydration and abdominal tenderness. Stool examination revealed oocysts of Cryptosporidium species, confirmed by both Modified Ziehl-Neelsen and Auramine staining, as well as PCR testing, which was used as a confirmatory test following microscopic identification. Blood investigations showed mild anemia (Hb 10.5 g/dL), a normal white cell and platelet count, slightly elevated TSH with normal thyroid hormones, and a positive ANA IIF test with a cytoplasmic speckled pattern at a titre of 1:320. Inflammatory markers were within normal limits. She was treated with supportive care including rehydration and antidiarrheal medications, along with nitazoxanide 500 mg three times daily for seven days. Her symptoms improved significantly within five days, and she made a complete recovery by the end of two weeks. This case highlights the importance of considering Cryptosporidium infection in immunocompromised patients presenting with diarrhea and demonstrates that early diagnosis and appropriate treatment can lead to a full recovery even in complex cases.
Background. Microbiology tests play a crucial role in tuberculosis (TB) diagnosis. This study aimed to evaluate the performance of fluorescence microscopy in detecting TB. Materials and methods. It was a retrospective laboratory-based study conducted from January 2019 to November 2023. A total of 169384 sputum samples of presumptive TB and previously treated TB were concentrated and stained with auramine smear for acid-fast bacillus (AFB) fluorescence microscopy, which was compared to the overall culture of Mycobacteria Growth Indicator Tube (MGIT) and solid slants of Lowenstein-Jensen (LJ) as the reference standard. Outcomes. Out of 169384 samples, 8370 (5.2%) were found positive-AFB and 13317 (7.9%) for Mycobacterium tuberculosis (MTB) recovery. The contamination rate associated with MGIT was 13742 (8.1%) versus 17389 (10.3%) with LJ, and 1691 (1%) with overall culture, p < 0.001. The overall culture rate of previously treated was significantly lower than newly diagnosed (4.0% versus 8.9%, p < 0.001). Among 13317 pulmonary TB, positive MTB cultures were 93.4% for MGIT versus 64.9% for LJ, p < 0.001. Performance of AFB showed 37.4% (95% confidence interval (CI), 36.5%-48.2%), 98.4% (95% CI, 98.3%-98.5%), 70.6% (95% CI, 69.6%-71.7%), 94.0% (95% CI, 93.9%-94.2%), and 92.9% (95% CI, 92.8%-93.0%) for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy; respectively. Conclusions. In this study, AFB testing was the least sensitive test. MGIT culture showed higher sensitivity but a lower contamination rate than LJ culture. The combined culture of both MGIT and LJ increased to reveal active MTB for detecting pulmonary TB.
Background. Asthma is a chronic airway inflammatory disorder that differs in the clinical expression and is frequently accompanied by acute attacks. There has been increasing interest on the IL-33/ST2 axis due to its pivotal role in airway inflammation type 2. Whereas IL-33 facilitates inflammatory action, a soluble receptor sST2 can negate this action. In spite of existing biomarkers, there is still a clinically difficult situation in differentiating stable asthma and exacerbation and more valid biomarkers are required. Objectives. The objectives of the case-control study were to determine the difference in serum IL-33 and sST2 between patients with exacerbated asthma, patients with healthy asthma, and healthy controls. Another aim was to determine whether IL-33/sST2 ratio has better discriminatory ability than either of the two. Methods and materials. In this case-control study, 134 individuals were involved comprising 50 acute asthma exacerbation patients, 44 clinically stable asthma patients and 40 healthy controls. The interleukin-33 (IL-33), soluble ST2 (sST2), and the IL-33/sST2 ratio were determined using an enzyme-linked immunosorbent assay (ELISA). Moreover, diagnostic utility of each biomarker and the ratio of IL-33/sST2 was assessed with receiver operating characteristic (ROC) curve analysis to to determine their ability to differentiate exacerbated asthma and stable disease. Results. The levels of serum IL-33 were lowest in the group of healthy controls (25 ± 5 pg/mL), higher in patients with stable asthma (60 ± 15 pg/mL), and highest in patients with exacerbated asthma (95 ± 20 pg/mL), and the differences were significant (p < 0.001). On the same note, the levels of sST2 in asthma patients were higher, and they were 150 ± 30 pg/mL in controls, and 350 ± 60 pg/mL in stable asthma and 600 ± 100 pg/mL in exacerbated asthma. The IL-33/sST2 ratio was different among groups of studies. ROC analysis had revealed that IL-33/sST2 ratio could better discriminate exacerbated and stable asthma, than either IL-33 or sST2. Conclusion. The ratio IL-33/sST2 could add value to distinguishing between the exacerbated and stable asthma and may be useful in the clinical evaluation of the disease activity. Nonetheless, further and bigger research and longitudinal studies are required to prove its utility, until it can be implemented in standard clinical practice.
Candida auris is an emerging multidrug-resistant fungus that has been increasingly associated with severe healthcare-associated infections worldwide. This case report describes a bloodstream infection caused by Candida auris in a resource-limited hospital in southern Vietnam. The patient, a 56-year-old woman with multiple risk factors, including prolonged corticosteroid use and invasive interventions, experienced diagnostic delays, with pathogen confirmation achieved only on day 71 of admission due to limited access to advanced fungal identification methods. Upon pathogen confirmation, prompt multidisciplinary infection control measures—including patient isolation, environmental disinfection, and screening of five close contacts (of whom two were found to be colonized)—were implemented. This case highlights critical diagnostic gaps and underscores the urgent need for enhanced surveillance, a sustained high clinical index of suspicion, and the establishment of regional reference laboratory networks to prevent Candida auris from becoming endemic.
Epstein-Barr virus (EBV) is a widespread pathogen among the adult population, with a common asymptomatic primary infection among younger age groups. It typically presents as asymptomatic in children, due to a decreased immune response. In pediatric patients of older age, infectious mononucleosis may present with the typical triad: fever, lymphadenopathy and pharyngitis. We present the case of a 7-year-old pediatric patient, admitted after laboratory investigations indicated thrombocytopenia and leukocytosis, with a modified biochemistry panel suggesting impaired hepatic function with cholestasis syndrome. Physical revealed a febrile patient with pharyngitis, bilateral adenopathies and hepato-splenomegaly. After implementing a precise diagnostic strategy which involved the initial exclusion of infectious etiologies for the hepatic cytolysis syndrome, viral capsid antigen immunoglobulin M (anti IgM VCA) returned as reactive with a value of 2,19 S/CO. Treatment consisted of hepato-protective medication in association with ursodeoxycholic acid was administered. As a result of the administered treatment, the patient presented an improved overall clinical condition with gradual improvement of the laboratory and biochemical profiles. This case presentation underscores that, even in pediatric patients, EBV infection may present with an atypical set of symptoms, and even complications such as hepatitis with cholestatic syndrome. The patient presented a favorable outcome, which emphasizes once more that the overall expected prognosis of infectious mononucleosis is good, and therapeutic focus is on symptom management.
Background. Cytomegalovirus (CMV) is a common opportunistic pathogen in immunocompromised patients, particularly those with hematological malignancies such as acute myeloid leukemia (AML). CMV reactivation can significantly complicate disease management and affect prognosis. Aim. This study aimed to assess the prevalence of CMV DNA positivity among AML patients and examine associations with age and sex. While CMV monitoring is well-established in transplant settings, there is a notable lack of data on CMV prevalence in non-transplant AML cohorts, particularly from the Middle East. Addressing this gap is critical for understanding CMV's clinical relevance in immunocompromised populations in this region. Materials and methods. The study was conducted at Baghdad Teaching Laboratories between April 2022 and December 2023. CMV DNA detection was performed using quantitative polymerase chain reaction (qPCR) in 249 AML patients. Statistical analysis of age and sex distributions was performed using chi-square tests. Although the qPCR platform used is capable of quantitative analysis, in this study it was used in a qualitative method to determine only the presence or absence of CMV DNA, with a detection threshold of 100 copies/mL. Results. Out of 249 patients, 245 (98.4%) tested positive for CMV DNA. A statistically significant association was found between CMV positivity and sex (p = 0.031), with all male patients testing positive compared to 95.6% of females. No significant association was observed between age group and CMV DNA status (p = 0.903). Conclusion. CMV DNA positivity was highly prevalent among AML patients, particularly males. Routine CMV monitoring is essential in AML care, and further studies are needed to explore the impact of CMV on disease progression and treatment outcomes in Iraqi populations.
Background and objectives. Catheter-related bloodstream infection (CRBI) is a major complication associated with the use of short-term double-lumen catheters (DLCs) in hemodialysis patients. This study aimed to compare the efficacy of a 70% ethanol lock versus a standard heparin lock in preventing CRBI in this high-risk population. Materials and methods. We conducted a single-blind, single-center, randomized controlled trial involving 40 adult patients with chronic kidney disease undergoing hemodialysis at Dr. Wahidin Sudirohusodo Hospital, Makassar. Participants with newly inserted short-term DLCs were randomly assigned (1:1) to receive either a 3 mL 70% ethanol lock (n=20) or a 3 mL heparin lock (5000 IU/mL, n=20) during the interdialytic period. The primary outcome was the incidence of CRBI. Results. The incidence of CRBI was significantly lower in the ethanol lock group compared to the heparin lock group (10.0% [2/20] vs. 40.0% [8/20]; p=0.028). Participants in the ethanol group also had significantly longer catheter durations (mean 16.10 ± 1.94 vs. 9.25 ± 2.69 days; p < 0.001) and lower final leukocyte counts (mean 12.60 ± 1.90 vs. 17.36 ± 4.03 × 10³/µL; p < 0.001). Conclusions. In this trial, a 70% ethanol lock was more effective than a heparin lock in preventing CRBI in patients with short-term DLCs. While the ethanol lock appears to be a promising alternative, larger multi-center trials are warranted to confirm these findings and establish long-term safety before its widespread adoption into clinical practice can be recommended.
Background and objectives. Staphylococcus aureus is implicated in a wide range of infectious diseases. Previous studies have recognized that colony characteristics of Staphylococcus aureus might be useful in identifying methicillin-resistant Staphylococcus aureus (MRSA), particularly in resource-limited settings. However, the correlation between MRSA colony characteristics and biofilm formation has not been fully assessed. This study aimed to investigate the presence of dome-shaped (T2) and target-shaped (T1) colony morphology among MRSA isolated from clinical samples and to evaluate the correlation between these morphologies and biofilm-forming ability. Materials and methods. A total of 14 S. aureus isolates were analyzed. Identification was confirmed using the VITEK® 2 system. Isolates were obtained from clinical swabs at Al-Kafeel Hospital between November 2023 and February 2024. Colony morphology was determined by culturing on blood and nutrient agar. Antimicrobial susceptibility testing was performed using the disk diffusion method to detect MRSA. The biofilm-forming capacity of the isolates was also assessed. Results. All 14 isolates were identified as MRSA. Half of the isolates displayed target-shaped morphology (T1), and half displayed dome-shaped morphology (T2). T2 isolates exhibited a trend toward greater biofilm-forming capacity than T1 isolates; however, the difference was not statistically significant (p > 0.05). These findings highlight the need for larger studies to determine whether a significant association exists. Conclusions. In this small sample, colony morphology was visually distinct but not significantly associated with biofilm-forming capacity. Interestingly, T1 isolates demonstrated slightly greater biofilm formation than T2 isolates. Further research with larger sample sizes is required to clarify these observations.
