Incidence and risk factors for surgical site infection post-gynecological operations in a tertiary hospital in Egypt: a retrospective study

Background: Surgical site infection (SSI) is the most common complication of surgical procedures in gynecology and it poses a significant burden for both patients and healthcare systems. Our objective was determining the incidence and risk factors for SSI post-gynecological operations during the period of five years.Methods: A matched case-control study at Minia maternity university, Egypt where A total of 18772 cases had undergone different gynecological procedures. The 876 cases were complicated with SSI (SSI cases group) and 2 matched controls per case were chosen from the rest of the cases and served as the control group (n=1752 cases).Results: The overall incidence of SSI post-gynecological operations was 4.67% and post-hysterectomy was 7.57%. SSI group had a significantly higher number of cases with diabetes, obesity, high parity (>4), increased blood loss and those had prolonged duration of surgery compared to the control group (all p<0.01).Conclusions: The identified risk factors are crucial for risk stratification of SSI and prioritizing interventions to improve the outcome. These results could give a picture for SSI post-gynecological operations in our country and identifying these risk factors is crucial for risk stratification of SSI and prioritizing interventions to improve the outcome.

Risk Factors for Acute Respiratory Infections in Children Between 0 and 23 Months of Age in a Peri-Urban District in Pakistan: A Matched Case–Control Study

Background: Acute respiratory infection (ARI) accounts for nearly 15% of all childhood mortality in South Asia, with children from rural areas at higher risk due to inaccessibility to healthcare facilities. We therefore aimed to identify risk factors associated with ARI in children under 2 years of age in rural Pakistan.Methods: A retrospective 1:2 matched case–control study was conducted between October and December 2018 in Taluka Kotri, Jamshoro District of Pakistan. Cases were identified as children between 0 and 23 months of age with a history of fever, cough, sore throat, fast breathing, difficulty breathing, or chest indrawing in the 2 weeks prior to the survey. Controls were participants without symptoms of ARI, matched based on age in months. Data analysis was conducted using STATA version 15. Univariate and multivariable conditional logistic regression analyses were used to identify factors associated with ARI, and p &lt; 0.05 was considered statistically significant.Results: We identified 1,071 cases of ARI who were matched with 2,142 controls. Multivariable analysis revealed that female gender [odds ratio (OR) 0.78, 95% confidence interval (CI): 0.67–0.91], exclusive breastfeeding (OR 0.81, 95% CI: 0.69–0.97), and comorbidity with diarrhea (OR: 1.64, 95% CI: 1.40–1.91) were significantly associated with ARI.Conclusion: Pakistan continues to progress toward reducing childhood mortality, particularly ARI-related deaths, for which it bears a great burden. This study identifies risk factors such as the male gender, breastfeeding, and comorbidities with diarrhea, which could open grounds for further programmatic implications in targeting a multifaceted approach to reducing incidences of ARI in rural areas of the country.

Durability of Protection against COVID-19 Breakthrough Infections and Severe Disease by Vaccines in the United States

Objectives: Determine durability of protection by the three currently available COVID-19 vaccines in the United States (US) following primary vaccination against breakthrough infections, hospitalizations, and intensive care unit (ICU) admissions. Methods: Using claims and laboratory data covering 168 million lives, we conducted a matched case-control study with fully vaccinated individuals between January 1 and September 7, 2021. Odds ratios (OR) for developing outcomes in months two through six following full vaccination were estimated relative to the first month after full vaccination for each vaccine separately. Results: Evidence of waning protection against infections started in month 2 from vaccination for both BNT162b2 (OR [95% CI] in month 6+, 2.93 [2.72, 3.15]) and mRNA-1273 (OR [95% CI] in month 6+, 2.76 [2.51, 3.04]), and in month 4 for Ad26.COV2.S (OR [95% CI] in month 5+, 1.31 [1.18, 1.47]). Evidence of waning protection against hospitalization started in month 2 for BNT162b2 (OR [95% CI], 3.97 [3.26, 4.83] in month 6+) and in month 3 for mRNA-1273 (OR 95% CI, 1.66 [1.26, 2.19] in month 6+). There was no evidence of waning protection against hospitalization for Ad26.COV2.S (OR [95% CI], 1.25 [0.86, 1.80] in month 5+). No waning of protection was observed at any time for ICU admissions for all three vaccines. Conclusions: Following primary vaccination, all three vaccines showed strong and durable protection against ICU admissions. Ad26.COV2.S showed a more durable level of protection against breakthrough infections and hospitalizations in line with published evidence of its durable antibody and cellular immune response, although its Vaccine Effectiveness (VE) at baseline after a single-dose is lower than that for the two-dose mRNA vaccines. Additional studies are needed to understand durability following homologous or heterologous boosters.

Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents

Background: The short-term effectiveness of a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, though, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months. Methods: Leveraging the centralized computerized database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where two outcomes were evaluated separately: a documented SARS-CoV-2 infection (regardless of symptoms) and a symptomatic infection (COVID-19). Cases were defined as individuals aged 12 to 16 with a positive PCR test occurring between June 15 and December 8, 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously. Results: We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% and 90% effectiveness against SARS-CoV-2 infection and COVID-19, respectively. However, in line with previous findings for adults, waning of vaccine effectiveness was evident in adolescents as well. Long-term protection conferred by the vaccine was reduced to 75-78% against infection and symptomatic infection, respectively, 3 to 5 months after the second dose, and waned to 58% against infection and 65% against COVID-19 after 5 months. Conclusions: Like adults, vaccine-induced protection against both SARS-CoV-2 infection and COVID-19 wanes with time, starting three months after inoculation and continuing for more than five months.

Ureaplasma and Prevotella Colonization with Lactobacillus Abundance During Pregnancy Facilitates Term Birth

Ureaplasma and Prevotella infections are well-known bacteria associated with preterm birth. However, with the development of metagenome sequencing techniques, it has been found that not all Ureaplasma and Prevotella colonizations cause preterm birth. The purpose of this study was to determine the association between Ureaplasma and Prevotella colonization with the induction of preterm birth even in the presence of Lactobacillus. In this matched case-control study, a total of 203 pregnant Korean women were selected and their cervicovaginal fluid samples were collected during mid-pregnancy. The microbiome profiles of the cervicovaginal fluid were analyzed using 16S rRNA gene amplification. Sequencing data were processed using QIIME1.9.1. Statistical analyses were performed using R software, and microbiome analysis was performed using the MicrobiomeAnalyst and Calypso software. A positive correlation between Ureaplasma and other genera was highly related to preterm birth, but interestingly, there was a negative correlation with Lactobacillus and term birth, with the same pattern observed with Prevotella. Ureaplasma and Prevotella colonization with Lactobacillus abundance during pregnancy facilitates term birth, although Ureaplasma and Prevotella are associated with preterm birth. Balanced colonization between Lactobacillus and Ureaplasma and Prevotella is important to prevent preterm birth.

African Swine Fever Outbreaks in Lithuanian Domestic Pigs in 2019

While numerous risk factors of African swine fever (ASF) transmission to domestic pigs have been described, ASF virus introduction has often not been traced back to one single defined cause. The large number of ASF outbreaks that occurred in domestic pigs in Lithuania from 2014 through to 2018 raised the question regarding whether outbreak-specific risk factors and transmission routes could be identified. Therefore, a prospective matched case-control study was designed. Data from 18 outbreaks that occurred in Lithuanian in 2019 and 36 control farms were analyzed. Conditional multivariable logistic regression showed that two or more visits by veterinary inspection of a farm had a significant preventive effect on the occurrence of ASF on a farm (Odds ratio (OR) 14.21, confidence interval (CI) 1.09–185.60 for farms not inspected vs. farms inspected twice or more a year), while certain practices (e.g., mushroom picking, sharing equipment, etc.), which might facilitate the indirect introduction of ASF from fields and forests into piggeries, significantly increased the odds of an outbreak (OR 5.18, CI 1.10–24.44). The results of the study highlight the importance of veterinary inspections for increasing the biosecurity level on pig farms and the awareness of ASF. The knowledge on potential protective and risk factors may help to improve the prevention and control of ASF outbreaks in domestic pig farms in Lithuania and other affected countries.