Three Tuberculosis Spondylitis Patients With Resistant Rifampicin From the Transpedicular Debridement Surgery Network

Background: TB spondylitis is a disease that can cause neurological disorders, ranging from 1-2% of the total cases of tuberculosis where the most frequent infection is the spine followed by other large joints such as hips, knees and shoulders. The increase in TB spondylitis associated with MDR TB in 2015 showed 52% or about 32,000 incidences globally.Collaboration of individual alloy MDR TB therapy with surgery in TB spondylitis can reduce patient mortality and morbidity. Case: We report three cases of patients in 2017-2018 in Dr. Saiful Anwar with complaints of back pain and lumps in the back, from the results of anamnesa, physical examination and supporting examination of patients diagnosed with TB spondylitis, patients were given medical management, operative and rehabilitation. Conclusion: This case is interesting because from the results of Molecular Rapid Tests whose samples were obtained from a biopsy of the transpendicular debridement surgery tissue obtained the results of Resistant Rifampicin, all three patients received individualized OAT treatment, the development of the conditions of the three patients improved and quality of life improved.

Retrospective Study of Nosocomial Infections in the Orthopaedic and Rehabilitation Clinic of the Medical University of Lublin in the Years 2018–2020

Nosocomial infections appear in patients treated in hospital, which are not the initial cause of admission. A retrospective study concerning nosocomial infections was conducted to provide data about the amount, frequency and types of nosocomial infections in the rehabilitation ward in the Orthopaedics and Rehabilitation Clinic of Lublin. The study was conducted on a group of 49 patients that were admitted or transferred to the ward over a period of 20 months in the years 2018–2020. The patients and therefore the infections were divided by age, sex, time of hospitalization and the underlying disease. The study also provided data about the most frequent infection types in these patients, as well as the most commonly used drugs to treat those infections. The results showed that in fact all of the examined factors have an impact on the frequency of nosocomial infections appearance rates. Furthermore, results in the study showed that factors examined by the study also have an impact on what type of infection was present in these groups of patients.

A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil

Autopsy continues to play an essential role in monitoring opportunistic fungal infections. However, few studies have analysed the historical trends of fungal infections in autopsies. Here, we analyse available data on fungal infections obtained from autopsy reports during 85 years of autopsies performed by the largest autopsy service in Brazil. All invasive fungal infections presented in autopsy reports between 1930 and 2015 were included. Of the 158,404 autopsy reports analysed, 1096 involved invasive fungal infections. In general, paracoccidioidomycosis (24%) was the most frequent infection, followed by candidiasis (18%), pneumocystosis (11.7%), cryptococcosis (11%), aspergillosis (11%) and histoplasmosis (3.8%). Paracoccidioidomycosis decreased after the 1950s, whereas opportunistic fungal infections increased steadily after the 1980s during the peak of the AIDS pandemic. The lung was the most frequently affected organ (73%). Disseminated infection was present in 64.5% of cases. In 26% of the 513 cases for which clinical charts were available for review, the diagnosis of opportunistic fungal infections was performed only at autopsy. Our unique 85-year history of autopsies showed a transition from endemic to opportunistic fungal infections in São Paulo, Brazil, reflecting increased urbanization, the appearance of novel diseases, such as AIDS in the 1980s, and advances in medical care over time.

Lymph flow directs rapid neutrophil positioning in the lymph node in infection

Soon after Staphylococcus aureus (S. aureus) skin infection, neutrophils infiltrate the LN via the high endothelial venules (HEVs) to restrain and kill the invading microbes to prevent systemic spread of microbes. In this study, we found that rapid neutrophil migration depends on lymph flow, through which inflammatory chemokines/cytokines produced in the infected tissue are transported to the LN. Without lymph flow, bacteria accumulation in the LN was insufficient to stimulate chemokine production or neutrophil migration. Oxazolone (OX)-induced skin inflammation impaired lymphatic function, and reduced chemokines in the LN after a secondary infection with S. aureus. Due to LN reconstruction and impaired conduit-mediated lymph flow, neutrophil preferentially transmigrated in HEVs located in the medullary sinus, where the HEVs remained exposed to lymph-borne chemokines. Altered neutrophil migration resulted in persistent infection in the LN. Our studies showed that lymph flow directed chemokine dispersal in the LN and ensured rapid neutrophil migration for timely immune protection in infection. The impaired lymph flow and neutrophil migration may contribute to the frequent infection in skin inflammation, such as atopic dermatitis.

ADHERENCE TO VENTILATOR-ASSOCIATED PNEUMONIA PREVENTION MEASURES IN INTENSIVE CARE

Introduction: Ventilator-Associated Pneumonia (VAP) is a frequent infection in patients admitted to intensive care units. The occurrence of VAP prolongs hospital stay and increases health care costs. The objective of this study is to assess adherence of health professionals to a VAP prevention package of interventions (Bundle). Outline: Retrospective, documentary study performed in an intensive care unit of a university hospital. The sample consisted of patients hospitalized in the period from January to June 2014, who met the inclusion criteria. The data collection was carried out through examination of medical records. Results: Increase in hospital stay of patients with VAP and low adherence to Bundle items were verified. Proper cuff pressure and oral hygiene with standardized antiseptic were the items with lower adherence. Implications: The adherence to some Bundle VAP prevention measures was not different between groups of patients (with or without VAP) and showed low values of adherence.

The Presence of Helicobacter pylori in cases of Chronic Tonsillitis in Medan

Background: Helicobacter pylori is a well known pathogen which is recognized as the most frequent infection of individuals. Helicobacter pylori plays important role in the etiology og gastritis, gastric and duodenal ulcers. We investigated the presence of Helicobacter pylori as an extragastric reservoir in the tonsilectomy specimens. Aim: To determine the presence of Helicobacter pylori in cases of chronic tonsillitis in tonsilectomy specimens. Methods: This is a descriptive study with cross sectional which the sample will be obtained using consecutive sampling method. We collect 43 cases with chronic tonsilitis were examined in tonsillectomy specimens for which available tissue for routin staining could be retrieved were histopathology chronic tonsillitis. The colonization of the helicobacter pylori have been evaluated with hematoxylin & Eosin and Giemsa stains under the light microscope. Results: With H&E staining, Helicobacter pylori has been detected in 23 cases (53,48%) of the tonsil-lectomy specimens in total. No colonization has been observed in the remaining 20 cases (46,51%). With giemsa staining Helicobacter pylori has been detected in 29 cases (67,74%) of the tonsillectomy specimens in total. No colonization has been observed in the remaining 14 cases (32,55%). Keywords: Helicobacter pylori, Chronic Tonsillitis, H&E, Giemsa.

Influence of Pneumonia on the Survival of Patients with COPD

Background: Pneumonia is a frequent infection. Chronic obstructive pulmonary disease (COPD) can present with comorbidities, including pneumonia. It is known that COPD worsens the evolution of pneumonia, but few studies describe the impact of pneumonia on COPD evolution. This study analyzes the influence of pneumonia on the survival of COPD patients. Methods: Observational study of a cohort of 273 patients with COPD who attended spirometry in 2011, with a prospective follow-up of six years. Patients were divided into two groups according to their acquisition of pneumonia during follow-up. The difference in survival between the two groups was analyzed. Results: Survival was lower in the group with pneumonia compared with that without pneumonia (p = 0.000), both globally and after stratification by COPD phenotype. Pneumonia (Hazard Ratio -HR- 2.65; 95% Confidence Interval -CI- 1.57–4.48), advanced age (HR 1.08; 95% CI 1.03–1.09), and high Charlson index (HR 1.31; 95% CI 1.17–1.47) were identified as risk factors independently associated with mortality, while a high body mass index (HR 0.92; 95% CI 0.87–0.96) was identified as a protective factor. Conclusions: Pneumonia is associated with worse prognosis in COPD patients. It is important to take into account this comorbidity for a comprehensive care of these patients.

Sero-prevalence of Transfusion Transmissible Infections among Voluntary Blood Donors of Khulna Medical College Hospital

Transfusion transmitted infections (TTI) are a great concern of safety for patients. Blood transfusion is a lifesaving procedure but always caries a potential risk of infections.The present study was designed to evaluate the prevalence of infectious disease markers and frequency in males and females of various age groups among healthy blood donors. A retrospective review of donor record over a period of 2 years between 2015 to2016 was done at the department of transfusion medicine Khulna medical college Hospital, Khulna, Bangladesh.Among the total 37,266 donors,358(0.96%) donors were infected and therefore not suitable for blood donations.HBV was found to be the most frequent infection with a total frequency of 0.72% followed by TP (0.20%), HCV (0.03%) and HIV (0.01%). None of the blood samples showed positivity for malarial parasite.Majority of the seropositive donors, (47.96%) were in the age group of 26 to 35 years followed by 29.47% in 18 to 25 years’ age group. Bangladesh Med J. 2017 May; 46 (2): 16-21