Acinetobacter species, particularly Acinetobacter baumannii , is the first pathogen on the critical priority list of pathogens for novel antibiotics to become a “red-alert” human pathogen. Acinetobacter baumannii is an emerging global antibiotic-resistant gram-negative bacteria that most typically causes biofilm-associated infections such as ventilator-associated pneumonia and catheter-related infection, both of which are resistant to antibiotic therapy. A. baumannii’s capacity to develop antibiotic resistance mechanisms allows the organism to thrive in hospital settings, facilitating the global spread of multidrug-resistant strains. Although Acinetobacter infections are quickly expanding throughout hospital environments around the world, the highest concentration of infections occurs in intensive care units (ICUs). Biofilms are populations of bacteria on biotic or abiotic surfaces that are encased in the extracellular matrix and play a crucial role in pathogenesis, making treatment options more difficult. Even though a variety of biological and environmental elements are involved in the production of A. baumannii biofilms, glucose is the most important component. Biofilm-mediated A. baumannii infections are the most common type of A. baumannii infection associated with medical equipment, and they are extremely difficult to treat. As a result, health care workers (HCWs) should focus on infection prevention and safety actions to avoid A. baumannii biofilm-related infections caused by medical devices, and they should be very selective when using treatments in combination with anti-biofilms. Therefore, this review discusses biofilm formation in A. baumannii , its role in disease pathogenesis, and its antimicrobial resistance mechanism.
Infections due to multidrug-resistant Enterobacteriaceae have become major international public health problem due to the inadequate treatment options and the historically lagged pace of development of novel antimicrobial drugs. Inappropriate antimicrobial use in humans and animals coupled with increased global connectivity aided to the transmission of drug-resistant Enterobacteriaceae infections. Carbapenems are the medications of choice for extended-spectrum beta-lactamase and AmpC producers, but alternatives are currently needed because carbapenem resistance is increasing globally. This review pointed to discuss emerging drug-resistant Enterobacteriaceae, its epidemiology and novel treatment options for infections, which date back from 2010 to 2019 by searching Google Scholar, PubMed, PMC, Hinari and other different websites. The occurrence of carbapenem-resistant Enterobacteriaceae is reported worldwide with great regional variability. The rise of carbapenem-resistant Enterobacteriaceae poses a threat to all nations. Enzyme synthesis, efflux pumps, and porin mutations are the main methods by which Enterobacteriaceae acquire resistance to carbapenems. The major resistance mechanism among these is enzyme synthesis. Most carbapenem resistance is caused by three enzyme groups: Klebsiella pneumoniae carbapenemase (Ambler class A), metallo-ß-lactamases (Ambler class B), and oxacillinase-48 (Ambler class D). Ceftazidime-avibactam, which was newly licensed for carbapenemase producers, is the most common treatment option for infections. Meropenem-vaborbactam, imipenem-relebactam, plazomicin, cefiderocol, eravacycline, and aztreonam-avibactam are recently reported to be active against carbapenem-resistant Enterobacteriaceae; and are also in ongoing trials for different populations and combinations with other antibacterial agents. Overall, treatment must be tailored to the patient's susceptibility profile, type and degree of infection, and personal characteristics.
Background:Hepatitis is an inflammation of the liver and often caused by viruses. Hepatitis viruses are the leading causes of liver-related morbidity and mortality worldwide, with Hepatitis B and C viruses share the great majority. Studies have shown that prison settings are one of the high-risk environments for the transmission of these viruses. However, there is limited information on the seroprevalence and associated factors of hepatitis B and C viral infection among Ethiopian prisoners. Methods: A facility-based cross-sectional study was conducted among 339 prisoners in Dessie town, Ethiopia from February to April 2020. Hepatitis B surface antigen and antibody against hepatitis C virus in serum were determined using Enzyme-Linked Immunosorbent Assay. We imputed the data using "EpiData 3.1" software and exported it to Statistical Package for Social Sciences version 20.0 for analysis, and a p-value of <0.05 was considered statistically significant. Results: The overall seroprevalence of hepatitis B surface antigen and anti-hepatitis C virus among prisoners was 22/339 (6.5%) (95% CI = 3.8-9.4), and 4/339 (1.2%) (95% CI = 0.0-2.4), respectively. Multiple sexual partners, previous imprisonment, body tattooing, and contact with the jaundiced patient were independently associated with hepatitis B virus infection. Prisoners who had a history of blood transfusion, and dental extraction were independently associated with hepatitis C virus infection. Conclusion:The seroprevalence of hepatitis B and hepatitis C viral infection among Dessie town prisoners was intermediate and low, respectively. The finding of a significant association between the presence of Hepatitis B surface antigen and hepatitis C virus antibodies among prisoners and factors calls for the need of serological testing for both Hepatitis B and C viruses to high-risk individuals. Strengthening screening strategies and prevention programs in prison settings is advisable to prevent disease transmission.
Chronic hepatitis B virus infection is a source of substantial global health problems, particularly in economically underdeveloped and/or developing countries. It is the primary cause of severe liver disorders such as liver fibrosis, cirrhosis, and hepatocellular carcinoma. The liver is connected by the bile duct to the small intestine that carries bile produced in the liver to the intestine. The liver is the initial organ exposed to materials originating from the gut including dietary compounds, bacteria, and their products. Human intestines harbor a wide diversity of the community of microbes which are collectively termed as gut microbiota. In chronic infection with the hepatitis B virus, microbial alteration of the gut is a source of systemic immune activation. Besides, gut permeability is altered in hepatitis B virus-infected patients with an increased bacterial translocation and endotoxin load in the portal vein that caused toll-like receptor activation in the liver, which facilitates immune-mediated liver injury. Toll-like receptors further triggered the host-wide inflammatory response by inducing signaling cascades such as nuclear factor-kappa B-linked pathways and by accelerating cytokine secretion like tumor necrosis factor-alpha, which evokes chronic inflammation and leads to liver lesion formation, fibrosis progression, and cirrhosis and hepatocellular carcinoma development. In conclusion, changes in intestinal flora play an important role in encouraging the production of chronic infection with the hepatitis B virus. Therefore, careful attention should be given to the maintenance of intestinal microecology of patients which can provide a sound foundation for the treatment of chronic infection with the hepatitis B virus.
Objective. Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) coinfection increases the incidence of end-stage liver disease which is more severe in immune-compromised HIV-infected patients than HCV infection alone. The aim of this study was to assess HCV infection and the associated risk factors among HIV/AIDS patients attending Dessie Referral Hospital, Northeastern Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 249 HIV-infected adults selected by a systematic random sampling technique from January to March 2018. A structured questionnaire was used to collect sociodemographic and risk factor data. Moreover, the blood specimen was collected and tested for CD4 count and anti-HCV antibody detection according to standard operating procedures. The data obtained were entered into SPSS version 20, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A P value ≤0.05 with a corresponding 95% confidence interval was considered as statistically significant. Result. Of a total of 249 HIV-infected study subjects, 120 (48.2%) were male and 129 (51.8%) were females, while the mean (±SD) age and CD4+ cells/mm3 were 39.10 (±11.507) years and 316.08 + 290.607 cells/mm3, respectively. Anti-HCV antibody was detected in 13 (5.2%) patients with higher prevalence rate found in males P = 0.078 and elders >50 years of age P = 0.013 than their counterparts. Age group of >50 years of age (AOR = 9.070, 95% CI: 1.578, 52.117, P = 0.013 ), longer duration of HIV treatment (AOR = 5.490, 95% CI: 1.341, 34.458, P = 0.041 ), WHO clinical stage III/IV (AOR = 12.768, 95% CI: 2.293, 71.106, P = 0.004 ), previous history of hospitalization (AOR = 10.234, 95% CI: 2.049, 51.118, P = 0.005 ), tooth extraction (AOR = 6.016, 95% CI: 1.137, 36.837, P = 0.048 ), and liver disease (AOR = 11.398, 95% CI: 1.275, 101.930, P = 0.029 ) were statistically significant predictors of HCV infection. Conclusion. The prevalence of HCV infection is still higher and causes concern. Therefore, screening of these high-risk groups should be critical to reduce mortality and to improve clinical outcomes.
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