29 research outputs found
Lysis Centrifugation Method for the Direct Identification of Positive Blood Cultures Using MALDI-TOF MS
No full textIRIS in a person living with HIV due to disseminated Mycobacterium simiae infection possibly acquired after a remote travel history to Thailand
No full textWe report a case of a man living with HIV with a baseline CD4 count of 7 cells/μl, who initially presented with vision loss due to CMV retinitis and cervical lymphadenopathy. Upon initiating antiretroviral therapy, his lymph node swelling increased, and a biopsy culture grew Mycobacterium simiae. The patient had a remote history of travel to Thailand, where he had frequent close encounters with monkeys. Primates may harbour non-tuberculous mycobacteria (NTM), and zoonotic transmission from monkeys to humans is feasible. Despite antimicrobial therapy, his condition worsened with increased lymph node swelling and abscess formation, which required surgical drainage, and he was determined to have developed immune reconstitution inflammatory syndrome (IRIS). Corticosteroid therapy was started, which showed a quick clinical response
Prevalence of bacterial bloodstream infections and association between neutropenia and 30-day mortality among oncology inpatients at a university hospital in Saudi Arabia
No full textBACKGROUND: Cancer patients are highly prone to develop bacterial bloodstream infections (BSI) and are also at risk of neutropenia. Knowledge of the prevalence of these infections and whether neutropenia is associated with a change in mortality is important to more effective management and reducing mortality and morbidity. OBJECTIVES: Estimate the prevalence of bacterial BSI among oncology inpatients and assess the associations of 30-day mortality with Gram stain results and neutropenia. DESIGN: Retrospective cross-sectional SETTING: University hospital in Saudi Arabia. PATIENTS AND METHODS: We retrieved records of oncology inpatients at King Khalid University Hospital, excluding patients without malignancy and with non-bacterial BSI. The number of records included in the analysis was reduced based on a sample size calculation and systematic random sampling used to select patients to include in the study. MAIN OUTCOME MEASURES: Prevalence of bacterial BSI and association between neutropenia and 30-day mortality. SAMPLE SIZE: 423. RESULTS: The prevalence of bacterial bloodstream infections was 18.9% (n=80). Gram-negative bacteria were more prevalent (n=48, 60.0%) than gram-positive bacteria, with the most common being Escherichia coli (n=20, 25.0%). The 23 patients (28.8%) who died included 16 (69.6%) with gram-negative infections and 7 (30.4%) with gram-positive infections. There was no statistically significant association of bacterial BSI-related 30-day mortality with Gram stain (P=.32). Of 18 patients (22.5%) who were neutropenic, only one (5.6%) died. Sixty-two (77.5%) patients were non-neutropenic, of whom 22 (35.50%) died. We found a statistically significant association between the presence of neutropenia and bacterial BSI-related 30-day mortality (P=.016), with mortality being lower among neutropenic patients. CONCLUSIONS: Gram-negative bacteria are more prevalent in bacterial BSI than gram-positive bacteria. No statistically significant association of Gram stain result with mortality was found. However, the 30-day mortality rate was lower among neutropenic patients than among non-neutropenic patients. We recommend further investigation with a larger sample size in multiple regions to further unravel the association of neutropenia with bacterial bloodstream infection-related 30-day mortality. LIMITATIONS: Lack of regional data and sample size. CONFLICT OF INTEREST: None
VACCINES OVER ANTIBIOTICS: SAUDI ARABIA'S JOURNEY OF MANAGING PEDIATRIC BACTERIAL MENINGITIS
No full textBackground: Saudi Arabia had high rates of bacterial meningitis in the late 90s. Children are at highest risk of this devastating disease with poor outcomes.
Objective: The study aims to evaluate the prevalence, causative pathogens, and antibiotic
resistance patterns in pediatric bacterial meningitis cases at a tertiary hospital in Riyadh, Saudi
Arabia.
Materials and Methods: Single-center retrospective chart review and cross-sectional methodology was conducted at King Saud University Medical City (KSUMC) from 2015 to 2023.
Result: Reviewing 8 years of CSF culture results only yielded 37 cases. This is only 0.5% of total hospital admissions over 8 years. The majority of cases were for children under the age of 2 years (82%). Gender of cases was almost equal and there was no seasonal variation. The most common organisms were gram-positive (14, 38%) including Group B streptococcus (GBS) (4, 11%), Streptococcus pneumoniae (4, 11%). Gram-negative organisms caused 8 cases (22%) by 5 different organisms. There was no Haemophilus influenza type B or meningococcus found in any of the CSF cultures. The single sample of Staphylococcus aureus was methicillin-resistant Staphylococcus aureus (MRSA) and three gram-negative organisms were multidrug resistant.
Conclusion: Saudi Arabia provides an example of the success of a mass vaccination program to curb the burden of pediatric bacterial meningitis. Future efforts should focus on antibiotic stewardship, mass screening of GBS, and adopting additional strains for the pneumococcus vaccine. Further research is needed to address the rising number of gram-negative organisms causing pediatric bacterial meningitis in Saudi Arabia and globally.
Fatal Case of a Child Harboring Enterobius vermicularis
No full textEnterobius vermicularis is a threadlike parasite also known as “pinworms”. It is the most common helminth infection, affecting the gastrointestinal tracts of children worldwide, although it seldom causes any fatalities. Enterobius vermicularis infections are usually asymptomatic and may only cause anal pruritis, with occasional reported cases of ectopic migration into the appendix or the female genital tract by adult pinworms. Here, we report a case of a 15-year-old girl who presented to the emergency department with high-grade fever, vomiting, and vague abdominal pain for three days. She was diagnosed with acute abdominal pain and underwent emergency ileocecectomy, but died the following day. Pathological examination of ileocecal junction showed intraluminal and intramural Enterobius vermicularis, which were attributed as the cause of her death in the absence of any other pathologies. Death due to Enterobius vermicularis is rare; this case calls for clinicians to be vigilant in exploring Enterobius vermicularis infections in patients with undiagnosed acute abdominal pain, since it could be a potential cause of death
Description of Candida auris Occurrence in a Tertiary Health Institution in Riyadh, Saudi Arabia
No full textBackground: Candida auris is an emerging multidrug-resistant fungal pathogen that represents a current serious threat to healthcare settings. Objective: The objective was to determine the prevalence of C. auris in a Riyadh hospital since its initial detection in late 2019. Methods: Using an adapted risk assessment tool, we reviewed the charts and medical files of all suspected and confirmed cases of C. auris infections reported at King Khalid University Hospital, Riyadh, between November 2019 and December 2022. Anonymized data were retrieved in a pre-established datasheet and analyzed to determine the epidemiological characteristics of C. auris infections in our facility. We analyzed prevalence by age, gender, risk factors, and according to sampling source. Results: Of the 53 confirmed C. auris-positive cases during the study period, 33 (62%) were males. Their ages ranged between 15 and 98, with most positive cases occurring in those aged 50 and above. Only one of the confirmed cases was hospital-acquired. All patients had at least one risk factor, and urine samples yielded the greatest number of positive cases, while admission to healthcare facilities constituted the highest risk in our study. Conclusion: Establishing a local prevalence pattern could serve as a baseline/benchmark to compare with regional and international benchmarks
Efficacy of povidone-iodine nasal rinse and mouth wash in COVID-19 management: a prospective, randomized pilot clinical trial (povidone-iodine in COVID-19 management)
No full textAbstract Objectives/Hypothesis To assess the efficacy of 0.23% povidone-iodine (PVP-I) nasal rinses and mouth washes on detectability of the coronavirus disease 2019 (COVID-19) virus and cycle threshold (Ct) values in nasopharyngeal swabs. Study design This was an open-label, prospective, randomized, placebo-controlled clinical trial. Setting The study was conducted in King Saud University Medical City, Riyadh, Saudi Arabia, from August 2021 to July 2022. Methods Participants diagnosed with SARS-CoV-2 were randomly assigned to one of three groups, with participants receiving either 0.23% PVP-I, 0.9% normal saline (NS) nasal rinses and mouth washes, or no intervention (control group). Nasopharyngeal swabs were taken 4, 8, 12, and 18 days after the first swab to measure the detectability of the virus and the Ct. Results A total of 19 participants were involved in this study. The mean viral survival was 9.8, 12, and 12.6 days for the PVP-I, NS, and control groups, respectively, with a statistically significant difference (p = 0.046). The Ct mean values were 23 ± 3.4, 23.5 ± 6.3, and 26.3 ± 5.9 at the time of recruitment and 25.2 ± 3.5, 15 ± 11.7, and 26.9 ± 6.4 after 4 days for the PVP-I, NS, and control groups, respectively. Conclusions When used continuously at a concentration of 0.23%, PVP-I showed promising results in terms of decreasing the pandemic burden by reducing the period of infectiousness and viral load. However, the use of PVP-I did not result in significantly different changes in the quality-of-life parameters in recently vaccinated and mild COVID-19 patients
