COVID-19-Associated Mucormycosis Outbreak, India M ucormycosis is an invasive fungal infection associated with high death rates. Poorly controlled diabetes mellitus, organ transplantation, hematological malignancies, and immunosuppression are the known predisposing factors for mucormycosis (1). During the second wave of the COVID-19 pandemic (April-June 2021), a large number of cases of COVID-19-associated mucormycosis (CAM) were reported globally, primarily in India (2-5). The explanation for this outbreak of CAM in India remains unclear. Diabetes mellitus and glucocorticoids (used for treating COVID-19) have been identified as risk factors for CAM (2,6). Other factors proposed in the pathogenesis of CAM include altered iron metabolism, the severity of COVID-19, and immune dysfunction resulting from COVID-19 (e.g., lymphopenia and others) (7,8).A high burden of Mucorales (in the hospital and outdoor environments) has been reported in India

Objectives: Cefepime/tazobactam is a new ß-lactam/ß-lactamase inhibitor combination licensed for clinical use by Drugs Controller General of India. Aim of our study was to analyze the clinical efficacy and safety of cefepime/tazobactam in patients with sepsis. To the best of our knowledge, this is the first published clinical study on this drug. Materials and methods:A retrospective observational study on the efficacy and safety of cefepime/tazobactam was conducted at a tertiary care hospital, South India. Patients who had a clear source of infection, having a single organism as the causative agent and being treated with cefepime/tazobactam alone were analyzed for efficacy and those cases who had a clear source of infection but either had multiple organism grown or cultures being negative or those patients who received a combination of antibiotics were analyzed for the safety analysis.Results: Thirty two patients satisfied our study criteria. All 15 patients in the efficacy group (nine with ventilator associated pneumonia, three tracheitis, two bacteraemia and one with urosepsis) had complete clinical cure, with microbiological cure in cases where a repeat culture was indicated. There were no significant side effects in any of the evaluable 32 patients assessed for safety. Gereç ve yöntem:Sefepim/tazobaktam'ın etkinlik ve güvenilirliği üzerine Güney Hindistan'da üçüncü basamak bir bakım merkezinde retrospektif bir gözlem çalışması yapıldı. Enfeksiyon kaynağı belli olan, tek bir mikroorganizmanın etken olarak izole edildiği ve tek başına sefepim/tazobaktam ile tedavi edilen hastalar etkinlik açısından incelendi ve belirgin bir enfeksiyon kaynağı olduğu halde birden çok organizma üreyen veya kültürü negatif olan yada tedavi için bir antibiyotik kombinasyonu alan hastalar güvenilirlilik analizi için incelendi.

Infectious diseases are the second most common cause of death in end-stage renal disease (ESRD) patients. Patients with ESRD are at high risk for several infections, due to exposure to blood products and frequent dialysis. The increased susceptibility to infections among these patients is indicative of a complex and varied state of immunodeficiency manifested by abnormal phagocytosis, T and B lymphocytes abnormalities and impaired response to T cell dependent pathogens such as hepatitis B and influenza viruses. These immunologic abnormalities are complicated by the use of immunosuppressive drugs used to treat and control underlying disease and exacerbated by nutritional deficiency and the dialysis procedure. Though many of these infections can be prevented by appropriate vaccination, the usual schedules of vaccination may be less effective.The aim of this paper is to review the studies on the use of vaccines in ESRD patients and summarize the vaccines required in this population.

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