Archives of Clinical Infectious Diseases
Volume:20 Issue: 1, Feb 2025

Acute mediastinitis is a life-threatening condition requiring urgent intervention.

This study aims to describe the clinical, laboratory, imaging, and microbiological characteristics, as well as treatment outcomes, of acute mediastinitis cases.

A retrospective, descriptive study was conducted on 32 patients treated at the University Medical Center Ho Chi Minh City from February 2016 to April 2024. Data were collected on patient demographics, clinical features, laboratory results, imaging findings, microbiological cultures, and treatment outcomes.

The mean age was 55.7 years, with males comprising 59.4% of cases. Fever and chest pain were the most common symptoms. Staphylococcus aureus was the most frequently identified organism. Computed tomography (CT) scans typically showed mediastinal air-fluid levels and fat stranding. Surgical interventions included neck drainage and thoracotomy. Complications included severe sepsis, septic shock, and pneumonia, with a mortality rate of 9.4%.

Acute mediastinitis predominantly affects older males and presents significant clinical and diagnostic challenges. Effective multidisciplinary management is crucial for improving patient outcomes. This study provides valuable insights into the characteristics and treatment of acute mediastinitis in a Southeast Asian region.

Antibiotic resistance and adverse effects pose significant challenges to the effectiveness of Helicobacter pylori eradication therapies, such as clarithromycin-based triple therapy. Alternative treatments, including bismuth quadruple therapy, are effective in cases of clarithromycin resistance. Levofloxacin and metronidazole-based triple therapy have demonstrated high success rates with fewer side effects, making it a preferred option following clarithromycin treatment failure.

This study aimed to evaluate the effectiveness of levofloxacin and metronidazole in eradicating H. pylori among patients with chronic epigastric pain in Zakho, Iraq. It also assessed the accuracy of diagnostic tests, patient history, and post-treatment confirmation of eradication.

A prospective study was conducted involving 100 patients with chronic epigastric pain at Zakho General Teaching Hospital. Diagnosis was performed using the fecal antigen test, urea breath test (UBT), and endoscopy with biopsy. Patients were treated with a 14-day regimen comprising levofloxacin, metronidazole, and either esomeprazole or pantoprazole.

Of the 100 participants, 66% were female, with a mean age of 37.85 years. The fecal antigen test, performed on 60 patients, showed a positivity rate of 96.5%, while the UBT, conducted on 40 patients, revealed a positivity rate of 97.5%. The highest infection rate was observed in the 51 - 60 age group. The 14-day levofloxacin and metronidazole regimen achieved a 99% eradication rate with minimal side effects.

This study underscores the high efficacy of levofloxacin and metronidazole-based therapy for H. pylori eradication. It highlights the importance of non-invasive diagnostic methods, enhanced patient follow-up, and international collaboration to achieve optimal treatment outcomes.

The SARS-CoV-2 virus has shown various subtypes with unique characteristics, but the recurrence of COVID-19 in children and the use of antibiotics for secondary bacterial infections have not been thoroughly investigated.

This study aimed to analyze the frequency of COVID-19 infections in children and the prescription of antibiotics for secondary bacterial infections in pediatric outpatient cases.

This cross-sectional study was conducted at three outpatient centers from February 2020 to August 2022. It included children under 15 years old with complete medical records related to SARS-CoV-2 infection. The study assessed clinical symptoms, hospitalization needs, antibiotic prescriptions, and the number of COVID-19 episodes.

Out of 2,448 children diagnosed with COVID-19, 65% were male. A total of 192 children (7.84%) had two episodes, 35 (1.43%) had three episodes, 7 (0.29%) had four episodes, and 2 (0.14%) had five episodes. 143 children (5.84%) required hospitalization. Antibiotics were prescribed in 17.73% of cases (n = 434), primarily for acute bacterial sinusitis (12.21%) and middle ear infections (8.52%). Common antibiotics included Azithromycin, Amoxicillin, Cefuroxime, and Co-trimoxazole.

Different subtypes of SARS-CoV-2 display distinct clinical behaviors in the pediatric population. Children can contract COVID-19 multiple times; however, antibiotic use in outpatient settings is relatively low and mainly associated with specific conditions, such as acute sinusitis and middle ear infections.

We aimed to evaluate calcium (Ca) metabolism disorders in patients with COVID-19, a novel virus with numerous unknown aspects and potential complications. This study was conducted due to the scarcity of evidence on this subject and the crucial importance of conducting a comprehensive assessment.

We hypothesized that this research would shed light on this previously unexplored phenomenon.

This study was a descriptive cross-sectional study conducted on COVID-19 patients admitted to Afzalipur Kerman Medical Center, Iran, in 2021. Data collection involved demographic characteristics and laboratory results. A 5 cc blood sample was collected in a clot test tube to perform total Ca tests using the photometric method (Arsenazo III kit), ionized Ca tests via the ISE method, magnesium measurements with the photometric method using the Xylidyl blue kit, iPTH (intact parathyroid hormone) assessments, and 25-OH-VITD3 measurements using the ELISA technique with the Monobind kit.

The present study included 162 participants, comprising 59% males and 41% females, with an average age of 49 years. Among the patients, the most prevalent Ca metabolism disorders were low vitamin D levels, including both deficiency and insufficiency (59%), as well as elevated ionized Ca levels (43%). Conversely, the least common Ca metabolism disorders in these patients were hyperparathyroidism (7%) and excessive Ca adjustment (8%).

The findings suggest the possibility of Ca metabolism disorders, particularly hypocalcemia, in COVID-19 patients. Given the nature of this study, we recommend conducting longitudinal and more comprehensive research in this field to investigate contributing factors in more detail and establish a cause-and-effect relationship.

At the onset of the COVID-19 pandemic, a misunderstanding emerged, suggesting that the consumption of opioid combinations might have a protective effect against COVID-19.

To identify prognostic factors associated with in-hospital mortality among confirmed COVID-19 patients with a history of opioid combination consumption in southern Iran.

This retrospective cross-sectional study, conducted between September 2020 and March 2021, included patients over 14 years of age with a confirmed diagnosis of COVID-19 who were admitted to Shahid Faghihi Hospital in southern Iran (affiliated with Shiraz University of Medical Sciences). Patients with incomplete or unreadable medical records were excluded. Data were extracted from medical files and recorded in a structured data collection form comprising three main sections: (1) Demographic characteristics (e.g., age, gender, comorbidities, smoking status), (2) clinical and paraclinical findings, and (3) patient outcomes. Statistical analysis was subsequently performed.

Of 1,048 patients with confirmed COVID-19, 98 (8.55%) reported a history of opioid combination consumption. The mean ± SD age was 61.40 ± 14.50 years, and 81 (82.7%) were male. Thirty patients (30.6%) died in the hospital (P < 0.001). A comparison of survivors and non-survivors revealed that the mean age was significantly higher in non-survivors (P = 0.004). Non-survivors were more frequently admitted to the ICU (P = 0.001), and their mean length of ICU stay was significantly longer (P = 0.03). Multiple logistic regression analysis identified C-reactive protein (CRP) (OR = 0.92, P = 0.02) as the only independent predictor of mortality among opioid combination users with confirmed COVID-19.

Among confirmed COVID-19 patients with a history of opioid combination consumption, the CRP level was the sole independent predictor of in-hospital mortality.

The coronavirus disease 2019 (COVID-19) has become one of the deadliest pandemics in recent history. Despite the introduction of preventive measures such as physical distancing, wearing masks, remote work, isolation, and quarantine to slow the spread, these behavioral measures have had undesirable consequences, including negative psychological effects, deep depression, and other mental health issues. The development of a safe and effective vaccine emerged as the most promising strategy for combating COVID-19. Today, vaccination remains one of the most effective tools to fight against COVID-19.

The aim of this study was to analyze the clinical and laboratory differences between vaccinated and unvaccinated patients hospitalized for pneumonia caused by COVID-19.

The study included patients admitted to the clinic with COVID-19 between January 2021 and October 2021. Demographics, clinical features, and treatment outcomes were recorded. Additionally, the vaccination status of patients against COVID-19 was documented. The cases were divided into two groups: Those who had received the COVID-19 vaccine and those who had not. Complete vaccination was defined as receiving two doses (0.5 mL) intramuscularly with the last dose administered at least 14 days prior or receiving two doses (0.3 mL) intramuscularly with the last dose administered at least 21 days prior, and no more than 6 months after the last dose. The vaccines included in the study were Pfizer, QazVac, Sinopharm/Beijing, Sinovac, and Sputnik V.

In total, 510 cases were included in the study, divided into two groups based on vaccination status: 367 unvaccinated cases and 143 vaccinated cases. The unvaccinated group had a longer duration of hospitalization than the vaccinated group (9 days vs. 7 days, respectively) (P < 0.001). Although no differences were found between the two groups regarding the nature of the radiological lesions, the number of affected areas was significantly greater in the unvaccinated group (P < 0.05). There was no statistically significant difference in the number of complications between the two groups (97.9% in the vaccinated group, n = 140/143; 99.2% in the unvaccinated group, n = 364/367). In terms of mortality, 9.8% (14/143) of the vaccinated group died, compared to 21.3% (78/367) in the unvaccinated group, with a statistically significant difference (P = 0.002).When assessing the SPO 2 index at admission, statistically significant differences were observed (P < 0.001). Biochemical parameters such as urea, albumin, glucose, and creatinine were significantly higher in unvaccinated patients (urea: 4.2 ± 19.3; creatinine: 9.8 ± 18.5). Serum levels of C-reactive protein (CRP) and procalcitonin (PRK) were significantly higher in the vaccinated cases. Interleukin-6 (P < 0.001), troponin (P < 0.001), ferritin (P = 0.002), and D-dimer (P < 0.001) were significantly elevated in the unvaccinated group.

Vaccinated patients infected with COVID-19 had shorter hospital stays and less severe radiological lesions. The levels of severe COVID-19 predictors such as CRP, IL-6, D-dimer, and ferritin were statistically significant in the unvaccinated group. The mortality rate was higher in the unvaccinated group compared to the vaccinated group. Vaccination appears to be highly effective in mitigating the effects of COVID-19 in patients with chronic comorbidities and significantly reduces mortality in these patients.

Candida species are a leading cause of fungal infections worldwide. Candidiasis, the disease caused by Candida , represents a significant public health concern globally. Candida albicans is the most common causative agent, responsible for 50 - 90% of invasive candidiasis cases. Candida albicans employs various virulence factors to adhere to, invade host tissues, and cause disease.

This study aimed to detect and compare the virulence factors of C. albicans , including hydrophobicity, biofilm formation, ergosterol content, and secretory enzymes, in clinical and environmental samples.

A total of 105 clinical and 165 environmental samples suspected of containing C. albicans were collected from Imam Khomeini Hospital in Ahvaz, Iran. The isolates were evaluated for five potential virulence factors: Ergosterol content, cell surface hydrophobicity (CSH), biofilm formation, protease activity, and phospholipase activity.

Sixty C. albicans isolates were identified, consisting of 30 clinical and 30 environmental isolates. Biofilm production was observed in 100% of clinical isolates and 80% of environmental isolates (P < 0.001). Protease activity was detected in 66.6% of clinical isolates and 76.7% of environmental isolates (P = 0.008). Phospholipase activity was present in 60% of clinical isolates and 76.7% of environmental isolates (P = 0.262). Clinical isolates exhibited higher CSH (66.4 ± 9.8) compared to environmental isolates (47.7 ± 17.0) (P < 0.001). The ergosterol content was 1.2 ± 0.5 in clinical isolates and 1.1 ± 0.3 in environmental isolates.

Biofilm formation was a consistent characteristic of clinical isolates, while phospholipase and protease activity were more prevalent in environmental C. albicans isolates. The results suggest possible cross-contamination between patients and the environment, as the virulence factors of clinical and environmental isolates were similar.

The coronavirus (COVID-19) pandemic has caused global uncertainty. Recent studies indicate an increased risk of spontaneous abortion, spontaneous preterm labor, and severe maternal and neonatal complications caused by COVID-19.

The aim of our study is to investigate the impact of COVID-19 infection on maternal and neonatal perinatal outcomes.

This is a non-interventional, analytical clinical study. We conducted a retrospective analysis of 410 histories of pregnant women admitted to hospitals from 2020 to 2022 in the City Infectious Disease Centre and the City Infectious Disease Hospital of Shymkent.

In the main group, there were 48 (21.0%) babies, while in the control group, there were 18 (10.5%) babies. A weight above 2500 g was recorded in 79% (182) of newborns in the main group. When comparing the weight of newborns between the groups, we did not find statistically significant differences (P = 0.051). Births of babies weighing more than 2500 g were 2.26 times more common in the control group than in the main group (95% CI: 0.984 - 5.228). A birth height of less than 48 cm was recorded in 1.7% (3) cases in the control group and 13.8% (32) of newborns in the main group (P = 0.002). A birth height greater than 48 cm was recorded in 86.2% (198) of neonates in the main group and 98.3% (84) in the control group.

A large systematic review (28 studies involving 790,954 pregnant women, among whom 15,524 were diagnosed with SARS-CoV-2 infection) aimed to investigate the relationship between SARS-CoV-2 infection during pregnancy and the risk of pre-eclampsia. It should also be noted that SARS-CoV-2 during pregnancy increases the likelihood of developing severe pre-eclampsia and HELLP syndrome. In our study, preeclampsia (54 - 13.1%) and HELLP syndrome (4 - 1.1%) were more frequent in the main group than in the comparison group. It should also be noted that frequent complications of COVID-19 in pregnant women included preterm labor (80 - 19.4%) and antenatal fetal death (8 - 2.0%).Analysis of perinatal outcomes revealed that women with COVID-19 infection are significantly more likely to give birth to infants with low growth, prematurity, and lower Apgar scores, and these infants are more likely to stay in the neonatal pathology department compared to those born to women without COVID-19 infection.

In 2020, COVID-19 was a major cause of absenteeism.

To investigate the factors affecting the time taken to return to work after COVID-19 hospitalization.

This was a cross-sectional study conducted on 320 working individuals (295 men and 25 women) hospitalized in Yazd province, Iran, due to COVID-19 between September 2020 and March 2021. All patients who met the inclusion criteria and provided consent were enrolled in the study via census. The inclusion criteria were: A definite or probable diagnosis of COVID-19 and hospitalization for no reason other than COVID-19. The required information was collected through phone interviews using a researcher-developed questionnaire that included demographic, occupational, recent COVID-19 infection, and return-to-work information. Data were analyzed using SPSS software.

The average duration of absenteeism was 31.67 ± 33.47 days. Univariate regression analysis revealed a significant relationship between absenteeism lasting more than 21 days and several factors: Age (P = 0.005), gender (P = 0.044), marital status (P = 0.005), number of dependents (P < 0.001), diabetes (P = 0.004), BMI (P = 0.031), job experience (P < 0.001), type of employment (P = 0.008), workplace respiratory exposures (P = 0.042), lower respiratory symptoms (P = 0.024), duration of hospitalization and medication use (P < 0.001), pulmonary complications (P < 0.001), and mental complications (P = 0.004). After adjusting for confounding factors, only three factors were significantly associated with a delay in return to work of more than 21 days: Duration of medication use (P < 0.001), presence of pulmonary complications (P = 0.014), and presence of psychological complications (P = 0.040).

The severity of the disease, as indicated by the duration of medication use for COVID-19 after discharge, and the presence of pulmonary and psychological complications, directly influenced the return to work after COVID-19.