Pseudomonas aeruginosa (PAE) is among the most frequent causes of bloodstream infections (BSIs) in cancer patients. Resistant strains are associated with increased morbidity and mortality. A retrospective study was conducted at a tertiary oncology hospital in Mexico City, including all episodes of PAE-BSI. The isolates were classified as susceptible, carbapenem-resistant (CR), multidrug-resistant (MDR), or difficult-to-treat resistant (DTR). A total of 259 PAE-BSI episodes were analyzed: 202 (78.4%) susceptible, 19 (7.3%) CR, 13 (5.0%) MDR, and 25 (9.7%) DTR. Resistant strains were significantly associated with prior antibiotic use (84.2% vs. 52.5%), more extended hospital stays (18 vs. 9 days), septic shock (36.8% vs. 19.8%), and inappropriate empiric therapy (54.4% vs. 19.3%). Overall, 30-day mortality was 38.2%, rising to 47.4% in CR, 84.6% in MDR, and 76% in DTR cases; compared with 29.7% in susceptible isolates (p < 0.001). No mortality benefit was observed with combination therapy compared to monotherapy. Multivariate analysis indicated that age ≥ 60 years, advanced oncological status, secondary bacteremia, septic shock, invasive mechanical ventilation, inadequate source control, and carbapenem strains were independent predictors of 30-day mortality. Appropriate antimicrobial therapy was a protective factor. Resistant PAE-BSI in cancer patients was associated with longer hospitalizations and a significantly increased mortality rate. Appropriate antimicrobial therapy can lead to a reduction in mortality.

This study aimed to evaluate the psychological and behavioral impacts of the coronavirus disease-2019 (COVID-19) pandemic on cancer diagnosis and staging, with particular focus on patient delays and changes in healthcare-seeking behavior before and after the onset of COVID-19. Data pertaining to 8 cancer types, including breast cancer, hepatocellular carcinoma, oral cancer, prostate cancer, gastric cancer, esophageal cancer, colon cancer, and lung cancer, sourced from the cancer registry database of Taichung Veterans General Hospital, was analyzed. The focus was on the comparisons of data between the pre-pandemic period (2017-2019) and the pandemic year (2020). Breast cancer (p < 0.001), hepatocellular carcinoma (p = 0.004), prostate cancer (p < 0.001), gastric cancer (p = 0.037), and esophageal cancer (p < 0.001) exhibited a decrease in the rate of early stage patients and an increase in the rate of advanced stage patients after the COVID-19 outbreak. Furthermore, the number of newly diagnosed patients per year decreased for hepatocellular carcinoma, oral cancer, prostate cancer, gastric cancer, esophageal cancer, colon cancer, and lung cancer. The COVID-19 pandemic disrupted cancer care, resulting in delayed diagnoses, stage migration, and a decline in newly diagnosed cases. These findings highlight the need for resilient healthcare systems to ensure continuity of cancer screening and treatment during global health crises.

This study aims to compare the cleaning effectiveness of the pulsed vacuum cleaning and disinfection machine (PVD) and the spraying cleaning and disinfection machine (SCD) in cleaning rigid endoscope instruments. A total of 900 postoperative rigid endoscope instruments from the sterilization supply room of our hospital, collected between July and December 2024, were included in the study. Instruments were randomly divided into two groups using a computer-generated random number sequence, ensuring a 1:1 allocation ratio: the research group (450 items) and the control group (450 items). The research group used the PVD machine, while the control group used the SCD machine. The sterilization effectiveness, cleaning quality, ATP bioluminescence assay, and protein residue measurement were compared between the two groups. The sterilization time in the research group was longer than that in the control group. The instrument damage rate and endotoxin positive rate were significantly lower in the research group (p < 0.05). The research group showed significantly higher results in the paper test method compared to the control group (p < 0.05). No significant difference was found between the two groups in visual inspection and blood residue comparison (p > 0.05). The ATP bioluminescence detection and protein residue pass rates were higher in the research group than in the control group, with a statistically significant difference (p < 0.05). The pulsed vacuum cleaning and disinfection machine performs better than the spraying cleaning and disinfection machine in cleaning rigid endoscope instruments, offering potential benefits for patient safety and instrument longevity.

Chronic lung diseases (CLD) are associated with increased susceptibility to respiratory infections and may influence COVID-19 outcomes. This research aims to assess the clinical, laboratory findings, and prognostic outcomes in critically ill COVID-19 patients with and without CLD, and to explore differences between various CLD types. A retrospective analysis was conducted on 406 critically ill COVID-19 patients, comparing those with CLD and those without. Clinical characteristics, laboratory markers, and mortality rates were assessed. Subgroup analyses evaluated differences between COPD, asthma, and other CLD types. Patients with CLD were older and had significantly lower lymphocyte and platelet levels than those without CLD (p values were 0.034, 0.021, and 0.013, respectively). The mean age, urea level, and platelet count in the COPD group showed significant differences compared to the other groups. Among critically ill COVID-19 patients, mortality rates were observed to be higher in the CLD group compared to those without CLD, and in the COPD group compared to other CLD types; however, these differences did not reach statistical significance. Systemic steroid use was associated with reduced 3-month (OR: 0.403, 95% CI: 0.226-0.719, p = 0.002) and 1-year mortality (OR: 0.513, 95% CI: 0.288-0.914, p = 0.023). Inhaled corticosteroid use did not increase mortality and was predominantly utilized for symptom management. Laboratory markers such as lymphopenia and thrombocytopenia were significantly associated with worse outcomes. CLD and its subtypes were not independently linked to mortality in critically ill COVID-19 patients; however, their association with older age and worse laboratory profiles highlights their clinical significance.

Edwardsiella tarda is a Gram-negative facultative anaerobe commonly isolated from fish and reptiles. This bacterium infrequently causes disease in humans, but the mortality rate is very high when associated with sepsis. This case report describes an 80-year-old female patient with Edwardsiella tarda infection who rapidly deteriorated, ultimately succumbing to infection within 9 hours after presenting to the emergency department. This patient was diagnosed with sepsis, hemolytic, emphysematous liver abscess. This report underscores the potential fatality and rapid progression of Edwardsiella tarda infection, highlighting the importance of early recognition and intervention.

This study investigated the epidemiological characteristics, subtype distribution, and clinical correlations of cervical human papillomavirus (HPV) infection in Jingmen, China. A retrospective study of 5,155 women screened at Jingmen Central Hospital (2022-2024). The participants were categorized into 6 age groups: ≤ 20 years (n = 54), 21-30 years (n = 791), 31-40 years (n = 1,757), 41-50 years (n = 1,371), 51-60 years (n = 968), and ≥ 61 years (n = 214). HPV genotyping and histopathology were used to assess infection patterns and lesion correlations. The infection rates of high-risk HPV (HR-HPV), low-risk HPV (LR-HPV), and mixed infections were 18.10% (933/5,155), 3.38% (174/5,155), and 3.38% (174/5,155), respectively. HR-HPV infections exhibited a bimodal age distribution, with peak prevalence in women aged ≤ 20 years (33.33%) and ≥ 61 years (39.25%). This age-related difference was statistically significant (χ² = 81.430, p < 0.001). The dominant subtypes were HPV52 (23.5%), HPV16 (13.9%), and HPV58 (13.3%). Notably, HPV16 was significantly more prevalent in high-grade squamous intraepithelial lesions (HSIL; 44.3%) and cervical cancer (CC; 55.5%), compared with low-grade lesions (p < 0.01). This study identified both adolescent/young women (≤ 20 years) and older women (≥ 61 years) as high-risk populations for HR-HPV infection. Notably, HPV16 (55.5%) exhibited significantly higher detection rates in cervical cancer cases, emphasizing the importance of prioritizing this subtype in region-specific vaccine-based prevention strategies. These findings underscore the need for tailored clinical management approaches based on viral subtype distribution and lesion severity.

The global dissemination of colistin resistance poses a critical challenge to antimicrobial therapy amid increasing multidrug resistance. The objective of this study was to characterize the epidemiology and transmission of colistin resistance mediated by the mcr-1 gene in multidrug-resistant (MDR) Enterobacteriaceae isolated from hospitalized patients with bloodstream infections and adjacent aquatic environments. A three-year study was conducted to collect MDR Enterobacteriaceae isolates from two distinct sources: blood samples and environmental water samples from five distinct aquatic environments adjacent to the hospital. A systematic analysis was conducted on patient demographic data, bacterial identification, antimicrobial susceptibility profiles, mcr-1 gene screening, and conjugation assays. A total of 159 MDR Enterobacteriaceae were isolated from blood samples, demonstrating an overall colistin resistance rate of 4.4%. Three mcr-1-harbouring Escherichia coli (E. coli) strains were identified: one from an inpatient without colistin exposure, and two from aquatic environmental sources, classified into sequence types (STs) ST10, ST131, and ST155. Conjugation experiments revealed higher transfer frequencies for environmental mcr-1-positive E. coli strains within and across genera. A comparative analysis under varying nutrient conditions identified delayed transfer kinetics in aquatic isolates. Moreover, most transconjugants exhibited levels of colistin resistance that were comparable to or surpassing donor strains, with minimum inhibitory concentrations (MICs) ranging from 4 to 16 mg/L. This study documents the epidemiological patterns of mcr-1-mediated colistin resistance in clinical and aquatic MDR Enterobacteriaceae. The present findings indicate the dissemination of resistance traits within aquatic environments, where persistence and amplification were observed.

Giardia lamblia and Trichomonas vaginalis are flagellated protozoan parasites that often cause asymptomatic infections but may lead to gastrointestinal or genitourinary symptoms. Improved treatment options are needed due to emerging resistance. However, selecting an appropriate method for assessing the in vitro susceptibility of G. lamblia and T. vaginalis in the presence of potential therapeutic compounds remains challenging due to the variability in these methods. This study aimed to provide an overview of commonly employed methods for determining trophozoite viability in the presence of potential therapeutic compounds and to propose a standardized viability assay for susceptibility testing for G. lamblia and T. vaginalis. A systematic literature review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement, using databases including MEDLINE, ScienceDirect, and Web of Science, with the following search equation: "in vitro" AND "method" AND ("susceptibility" OR "viability" OR "sensitivity") AND ("giardia" OR "trichomonas"). The search identified 32 experimental studies with diverse viability assays. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, adherence inhibition assay, and [3H]-thymidine incorporation assay were prominent for G. lamblia. The trypan blue assay, motility assessment, and resazurin assay were frequently used for T. vaginalis. These findings underscore the diversity in viability assessment methods, highlighting the importance of standardizing viability assays to ensure accurate and reproducible results in drug susceptibility studies. The fluorometric resazurin assay has emerged as a suitable choice for standardization in both parasites, offering cost-effectiveness, reliability, and ease of use.

Timely and effective diagnosis plays a pivotal role in schistosomiasis control efforts. This study aims to assess the utility of combined Schistosoma haematobium soluble egg antigen (Sh SEA) and S. mansoni worm antigen (Sm SWA) in serological diagnosis of urogenital schistosomiasis. Admixtures containing 10 µg/mL of both Sm SEA and Sh SEA, as well as Sm SWA and Sh SWA, were employed to detect S. haematobium infection via an indirect enzyme-linked immunosorbent assay (ELISA) using sera and urine from microscopically confirmed positive samples from an endemic population, along with confirmed negative samples from both endemic (NE) and non-endemic (NNE) populations. The diagnostic performance of Schistosoma eggs and worm antigen mixtures varied depending on sample type and negative endemicity. The Sm SEA and Sh SEA mixtures performed poorly with sera and urine from the pair of positive vs negative endemic samples, as well as positive vs non-endemic samples, but excellently with positive vs negative endemic urine samples pair (sensitivity 91.67%; specificity 66.67%). Conversely, SWA mixtures showed superior performance, particularly with the positive vs negative non-endemic sera samples pair (sensitivity 93.75%; specificity 72.92%). Other SWA-based mixtures, except SWA admixture using urine in positive vs NE samples, exhibited acceptable performance. Antibody titers varied significantly, with higher titers generally observed in negative endemic samples for SWA mixtures and in negative non-endemic urine samples for SEA mixtures (p < 0.05). Combined antigens improve Schistosoma diagnostics: SEA admixtures suit endemic urine samples, while SWA admixtures aid non-endemic sera detection.

Sepsis is a major cause of morbidity and mortality in premature infants. Rapid diagnosis and initiation of treatment are of great importance. This study aims to evaluate the role of the Neonatal Sequential Organ Failure Assessment (nSOFA) score in predicting the causal agents and outcomes of late-onset sepsis in preterm neonates. In this single-center, retrospectively designed study, nSOFA scores of preterm infants born before 32 gestational weeks and weighing under 1500 g with a diagnosis of culture-proven late-onset sepsis (LOS) were compared at different timepoints in relation to mortality. Thirteen of 117 preterms included in the study died. At all the timepoints examined, the median nSOFA score was found to be higher in the mortality group (all p < 0.001). A 3.5 cutoff value of nSOFA showed the best differentiation, with AUC = 0.97 (95% CI: 0.94-1.00), 100% sensitivity, and 91.4% specificity. When nSOFA scores were compared in patients grouped as gram-positive sepsis and gram-negative sepsis, scores at T0, T6, T12, and T24 timepoints were determined to be significantly higher in the exitus group (all p < 0.008). In preterm infants born before 28 gestational weeks, mortality was predicted with the 3.5 cutoff value at T6, T12, T24, and T48 timepoints (AUC = 0.947, 0.943, 0.972, and 0.940, respectively, all p < 0.001). The results showed that the nSOFA score is useful for predicting sepsis-related mortality in preterm infants and correlates with the severity of gram-negative sepsis.