Molecular screening of Bartonella in free-ranging capybaras (Hydrochoerus hydrochaeris) from Paraná State, Southern Brazil

Bartonella is an emerging group of facultative intracellular bacteria causing circulatory and systemic disorders. Hosts for Bartonella are mostly mammals, specifically rodents, having a growing number of Bartonella species related to their infection. Capybaras (Hydrochoerus hydrochaeris) are abundant native rodents of Brazil, commonly found in urban parks. In the present study, we aimed to perform molecular screening of capybaras for Bartonella spp. Blood samples were collected from 17 free-ranging animals captured in Paraná State, Southern Brazil. None of the collected samples tested positive for the Bartonella-nuoG gene by quantitative polymerase chain reaction (qPCR), although all of them successfully amplified the mammal endogenous glyceraldehyde-3-phosphate dehydrogenase (gapdh) gene. Additionally, all animals were infested exclusively by Amblyomma dubitatum ticks at the time of sampling. This study was part of an active surveillance program, which is critical for monitoring animal health status, particularly in capybaras.

Surveillance of Hemodialysis Related Infections: A Prospective Multicenter Study

There is neither a surveillance system nor a study to reveal the HD related infection rates in Turkey. We aimed to investigate the infection rate among HD outpatients and implement CDC’s surveillance system. A multicenter prospective surveillance study is performed to investigate the infection rate among HD patients. CDC National Healthcare Safety Network dialysis event (DE) protocol is adopted for definitions and reporting. During April 2016–April 2018, 9 centers reported data. A total of 199 DEs reported in 10035 patient-months, and the overall DE rate was 1.98 per 100 patient-months. Risk of blood culture positivity is found to be 17.6 times higher when hemodialysis was through a tunneled catheter than through an arteriovenous fistula. DE rate was significantly lower in patients educated about the care of their vascular access site. Staphylococcus aureus was the most causative microorganism among mortal patients. Outcomes of DEs were hospitalization (73%), loss of vascular access (18.2%), and death (7.7%). This first surveillance study revealed the baseline status of HD related infections in Turkey and showed that NHSN DE surveillance system can be easily implemented even in a high workload dialysis unit and be adopted as a nationwide DE surveillance program.

Whole-Body MRI Surveillance—Baseline Findings in the Swedish Multicentre Hereditary TP53-Related Cancer Syndrome Study (SWEP53)

A surveillance strategy of the heritable TP53-related cancer syndrome (hTP53rc), commonly referred to as the Li–Fraumeni syndrome (LFS), is studied in a prospective observational nationwide multi-centre study in Sweden (SWEP53). The aim of this sub-study is to evaluate whole-body MRI (WB-MRI) regarding the rate of malignant, indeterminate, and benign imaging findings and the associated further workup generated by the baseline examination. Individuals with hTP53rc were enrolled in a surveillance program including annual whole-body MRI (WB-MRI), brain-MRI, and in female carriers, dedicated breast MRI. A total of 68 adults ≥18 years old have been enrolled to date. Of these, 61 fulfilled the inclusion criteria for the baseline MRI scan. In total, 42 showed a normal scan, while 19 (31%) needed further workup, of whom three individuals (3/19 = 16%) were diagnosed with asymptomatic malignant tumours (thyroid cancer, disseminated upper GI cancer, and liver metastasis from a previous breast cancer). Forty-three participants were women, of whom 21 had performed risk-reducing mastectomy prior to inclusion. The remaining were monitored with breast MRI, and no breast tumours were detected on baseline MRI. WB-MRI has the potential to identify asymptomatic tumours in individuals with hTP53rc syndrome. The challenge is to adequately and efficiently investigate all indeterminate findings. Thus, a multidisciplinary team should be considered in surveillance programs for individuals with hTP53rc syndrome.

Estimated Costs Associated with Surgical Site Infections in Patients Undergoing Cholecystectomy

Among healthcare-associated infections, surgical site infections (SSIs) are the most frequent in Spain. The aim of this work was to estimate the costs of SSIs in patients who underwent a cholecystectomy at the Hospital General Universitario de Alicante (Spain) between 2012–2017. This was a prospective observational cohort study. The Active Epidemiological Surveillance Program at our hospital recorded all the cholecystectomies performed. Risk factors associated with the development of SSIs were determined by multivariate analysis and two homogeneous comparison groups were obtained by using the propensity score. The number of extra days of hospital stay were recorded for patients with an SSI and with the cost per hospitalised day data, the additional cost attributed to SSIs was calculated. A total of 2200 cholecystectomies were considered; 110 patients (5.0%) developed an SSI. The average length of hospital stay was 5.6 days longer among patients with an SSI. The cost per SSI was EUR 1890.60 per patient, with the total cost for this period being EUR 207,961.60. SSIs after cholecystectomy lead to a prolongation of hospital stay and an increase in economic costs. It is essential to implement infection surveillance and control programs to reduce SSIs, improve patient safety, and reduce economic burden.

CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults

BackgroundFor the first time, the 2020 WHO guidelines on physical activity recommend reducing sedentary behaviors due to their health consequences. Less is known on the effect of prolonged occupational sitting, especially in the context of low physical activity engagement.This study aims at quantifying cardiovascular risk associated with prolonged occupational sitting and determining the additional amount of physical activity that may be needed to attenuate it.MethodsA cohort comprising 481,688 participants in a health surveillance program in Taiwan was followed between 1996 and 2017, collecting data on occupational sitting time, leisure-time physical activity (LTPA) habits, lifestyle, and metabolic parameters. The all-cause and expanded cardiovascular disease (CVD + diabetes mellitus + kidney disease) mortality associated with three occupational sitting volumes (mostly sitting, alternating sitting and non-sitting, mostly non-sitting) was analyzed applying multivariate Cox regression models to calculate the hazard ratios (HRs) for all participants and by subgroups, including five levels of LTPA. Deaths in the first two years of follow-up were excluded to avoid reverse causality.ResultsThe study recorded 26,257 deaths during a mean follow-up period of 12.85 years. Individuals mostly sitting at work had a higher mortality risk than those mostly non-sitting, both from all causes (HR: 1.16, 95% CI: 1.11-1.20) and from expanded CVD (HR:1.46, 95% CI:1.35-1.58), after adjusting for gender, age, education, smoking, drinking, and body mass index. Individuals alternating sitting and non-sitting at work did not experience increased risk for all-cause mortality, compared to individuals mostly non-sitting at work (HR: 1.01, 95% CI: 0.97-1.05), but did experience higher risk of deaths due to expanded CVD (HR: 1.13, 95% CI: 1.04-1.23). Individuals engaged in low (15-29 min/day) or no (<15 min/day) LTPA, who mostly sit at work, would need to increase their LTPA by 15 and 30 minutes respectively to reduce their risk of mortality to that of similarly inactive individuals who mostly do not sit at work.ConclusionsAs part of modern lifestyles, prolonged occupational sitting is considered normal and has not received due attention, even though its deleterious effect has been largely proved. Alternating sitting and non-sitting at work, as well as an extra 15 to 30 min/day of LTPA, can attenuate the harms of prolonged occupational sitting. Thus, emphasizing the associated harms and suggesting workplace system changes could help the society to de-normalize this common behavior, similarly to the process of de-normalizing smoking.

A Coordinated, Risk-Based, National Forest Biosecurity Surveillance Program for Australian Forests

Australia has a comprehensive plant biosecurity system, with the Australian Government responsible for pre-border (e.g., off-shore compliance) and border (e.g., import inspections) activities, while state governments undertake a variety of post-border activities (e.g., post-border surveillance, management of pest incursions, and regulation of pests) designed to reduce alien pest and pathogen arrival and establishment. Once an alien pest or pathogen has established and spread, its management becomes the responsibility of the land manager. There has been a growing understanding among plant industries of the need to be more engaged in post-border biosecurity activities, including resourcing and undertaking early detection surveillance and contingency planning. Here we summarize Australia’s broader plant biosecurity system along with current forest-specific biosecurity surveillance activities. We describe the development of a proposed forest biosecurity partnership between the Australian Government, state governments and the forest sector to establish a post-border, risk-based National Forest Pest Surveillance Program. We outline why there is a recognized need for such a program, how it would improve biosecurity outcomes in relation to forests, its component activities, and key stakeholders and beneficiaries.

Genomic Surveillance Enables the Identification of Co-infections With Multiple SARS-CoV-2 Lineages in Equatorial Guinea

COVID-19 disease caused by SARS-CoV-2 represents an ongoing global public health emergency. Rapid identification of emergence, evolution, and spread of SARS-CoV-2 variants of concern (VOC) would enable timely and tailored responses by public health decision-making bodies. Yet, global disparities in current SARS-CoV-2 genomic surveillance activities reveal serious geographical gaps. Here, we discuss the experiences and lessons learned from the SARS-CoV-2 monitoring and surveillance program at the Public Health Laboratory on Bioko Island, Equatorial Guinea that was implemented as part of the national COVID-19 response and monitoring activities. We report how three distinct SARS-CoV-2 variants have dominated the epidemiological situation in Equatorial Guinea since March 2020. In addition, a case of co-infection of two SARS-CoV-2 VOC, Beta and Delta, in a clinically asymptomatic and fully COVID-19 vaccinated man living in Equatorial Guinea is presented. To our knowledge, this is the first report of a person co-infected with Beta and Delta VOC globally. Rapid identification of co-infections is relevant since these might provide an opportunity for genetic recombination resulting in emergence of novel SARS-CoV-2 lineages with enhanced transmission or immune evasion potential.

Characteristics of persons who died by suicide in prison in France: 2017–2018

Background In northern countries, suicide rates among prisoners are at least three times higher for men and nine times higher for women than in the general population. The objective of this study is to describe the sociodemographic, penal, health characteristics and circumstances of suicide of French prisoners who died by suicide. Methods This study is an intermediate analysis of the French epidemiological surveillance program of suicides in prison. All suicides in prison in 2017–2018 in France were included in the study. Archival sociodemographic and penal data and specific data on the circumstances of the suicidal act were provided by the National Prison Service. Health data was provided by physicians working in prison using a standardized questionnaire. Results In 2017–2018, 235 prisoners died by suicide. The suicide rate was 16.8/10 000 person-years. Among suicide cases, 94.9% were male, 27.2% were under 30, 25.1% were aged 30 to 39, 27.7% were aged 40 to 49 and 20.0% were 50 or older. At the time of suicide, 48.5% were on custodial remand. Incarceration is associated with a threefold increase in the frequency of anxio-depressive disorders (24.6% in prison versus 8.2% before prison). The week before the suicidal act, 60% of prisoners visited the health unit and a significant event was detected for 61% of all cases. Suicide was less than 1 week after prison entry for 11.9% of prisoners, corresponding to a suicide rate 6.4 (CI95% [4.3 – 9.5]) times higher than for the remaining time in prison, and was more than 1 year after entry for 33.7% of them. Conclusions The high frequency of events the week before suicide in our study suggests that events in prison could play a role in the occurrence of suicides. Comparative studies are needed to further explore the time association between events and suicide in prison. As most of prisoners who died by suicide visited the health unit the week before suicide, the identification of triggering factors could help psychiatrists and other health professionals to assess the short-term risk of suicide and to implement preventive measures.

Increasing azithromycin resistance in Neisseria gonorrhoeae due to NG-MAST 12302 clonal spread in Canada, 2015-2018

Objectives: Azithromycin resistant (AZIR) gonorrhea has been steadily increasing in Canada over the past decade which is cause for alarm as azithromycin (AZI) has been part of the combination therapy recommended by the Canadian Guidelines on Sexually Transmitted Infections (CGSTI) since 2012. Method: Neisseria gonorrhoeae (NG) with AZI MICs ≥ 1 mg/L collected between 2015 and 2018 as part of the Gonococcal Antimicrobial Surveillance Program-Canada underwent antimicrobial susceptibility testing, molecular typing and whole genome sequencing. Regional, demographic and clinical isolation site comparisons were made to aid in our understanding of AZI susceptibility trending. Results: 3,447 NG with AZI MICs ≥ 1 mg/L were identified in Canada, increasing from 6.3% in 2015 to 26.5% of isolates in 2018. Central Canada had the highest proportion rising from 9.2% in 2015 to 31.2% in 2018. 273 different NG-MAST sequence types were identified among these isolates with ST-12302 the most prevalent (50.9%). Whole genome sequencing identified the Neisseria lactamica -like mosaic mtr locus as the mechanism of AZIR in isolates of ST-12302 and isolates genetically similar (differ by ≤ 5 base pairs) designated as the ST-12302 genogroup, accounting for 65.2% of study isolateswhich were originally identified in central Canada but spread to other regions by 2018. Conclusion: Genomic analysis indicated that AZIR in Canadian NG expanded rapidly due to clonal spread of the ST-12302 genogroup. The rapid expansion of this AZIR clonal group in all regions of Canada is of concern. CGSTI are currently under review to address the increase in AZIR in Canada.