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Identifying reliable biomarkers of response to improve patient selection and avoid toxicities will be critical in this process.Endolimax nana is a commensal protozoan of the colon. We report a case of chronic urticaria associated with E. nana in a 34-year-old Italian woman. The patient suffered from abdominal pain, diarrhoea and weight loss. The disease appeared after a trip to Vietnam. Laboratory examinations showed mild blood eosinophilia. Three coproparasitological examinations were positive for cysts of E. nana. The patient was successfully treated with two courses of metronidazole (2 g/day for 10 days each). No antihistamines were used. Three coproparasitological examinations, carried out at the end of the therapy, were negative. Follow up (six months) was negative. E. nana can be responsible for very rare cases of abdominal pain, diarrhoea, polyarthritis and urticaria. Copyright (c) 2020 Stefano Veraldi, Luisa Angileri, Luisa Carlotta Rossi, Gianluca Nazzaro.INTRODUCTION We present the findings on high-resolution computed tomography (HRCT) of influenza A (H1N1) virus-associated pneumonia of 140 patients with acute and post-acute pneumonia, totaling 189 exams in a retrospective observational study evaluating the importance of HRCT as a diagnostic imaging method in the acute phase and in the follow-up of pneumonia. METHODOLOGY We performed a retrospective observational study evaluating the HRCT findings of 140 adult patients with confirmed diagnosis of influenza A (H1N1) pneumonia and without other associated infectious processes. Chest X-ray exams were also performed in these patients. RESULTS The main HRCT findings of lung involvement were airspace consolidation (57 cases), ground-glass opacities (40 cases) and an association of both aspects (43 cases), with a predominantly bilateral and peripheral distribution. CONCLUSIONS HRCT is able to distinguish small lesions, such as small areas of consolidation or ground glass opacities, with little increase in lung attenuation, when chest X-rays was normal, allowing a prompt diagnosis and treatment after imaging. Copyright (c) 2020 Cristina AP Fontes, Alair Augusto SMD dos Santos, Solange A de Oliveira.INTRODUCTION Melioidosis, caused by the soil saprophyte B. pseudomallei, is a 'neglected' infectious disease in many Asian countries. It remained undiagnosed or misdiagnosed in India for long due to a lack of awareness and facilities to diagnose the disease; however, it is slowly gaining the status of an emerging disease recently. The disease is well known as a great mimicker, as the presentations are very similar to many other tropical diseases, and more importantly, to tuberculosis . METHODOLOGY A prospective observational study was conducted from January 2016 - December 2018 to find the occurance of melioidosis  in patients with 'recurrent' tuberculosis infection in a tertiary health care hospital from southern India. All suspected cases of recurrent tuberculosis were simultaneously tested for the presence of B. pseudomallei, and basic demographics and clinical details were documented. RESULT Among 11,138 patients admitted with suspected tuberculosis infection, 586 (5.2%) patients were confirmed. There was recurrent Mycobacterium tuberculosis infection in 11/586 (1.8%) cases, and 7/586 (1.2%) had growth of B. pseudomallei in culture. Patients with melioidosis had either pulmonary involvement, or bone and joint infections and deep abscesses.  Uncontrolled diabetes mellitus was the major risk factor. CONCLUSION The study foreshadows the need for prompt and accurate microbiological diagnosis along with a high index of suspicion from the clinicians in countries which are endemic for both melioidosis and tuberculosis, thus ameliorating the irrational anti-tuberculosis treatment. Copyright (c) 2020 Rahul Garg, Tushar Shaw, Kalwaje E Vandana, Rahul Magazine, Chiranjay Mukhopadhyay.INTRODUCTION The most prominent characteristic of adult attention deficit hyperactivity disorder (ADHD) is impulsive behavior and deficits in executive functions, which require long-term organization and discipline. This may have serious implications in terms of adherence to treatment among adults living with HIV (PLWH). This study aimed to determine the prevalence of ADHD among non-perinatally infected PLWH and its effect on adherence to antiretroviral treatment (ART) and scheduled appointments. METHODOLOGY The PLWH admitted to our centers between January 2012 and February 2016 were invited to the study. ADHD diagnosis was made according to the novel criteria guided interviews. The first ART interruption for ≥ 6 days per month (≤ 80%) was defined as ART-event and the first non-attendance of any scheduled appointment was defined as appointment-event. Kaplan-Meier plot with a Log-rank test was used for event-free adherence (EFA). RESULTS Twenty-five patients out of 85 were diagnosed with ADHD (29.4 %) which was significantly higher than the highest percentage reported (7.3 %) for the general population (p less then 0.0001). Both ART-event (p = 0.0002) and appointment-event (p = 0.02) were significantly higher among ADHD participants compared to those without. Additionally, both ART-EFA (p = 0.00014) and appointment-EFA (p = 0.023) were significantly shorter among ADHD participants compared to those without. CONCLUSION ADHD is significantly higher in adult PLWH and people with ADHD had a significant tendency for non-adherence to ART and follow-up. Screening for ADHD as well as providing treatment when required would be beneficial to achieve and maintain virologic success. Copyright (c) 2020 Serhat Uysal, Hayriye Elbi, Gulsen Mermut, Ozen Onen Sertoz, Figen Kaptan, Demet Gulpek, Deniz Gokengin.INTRODUCTION Socioeconomic factors play an important role in the prevalence of Helicobacter pylori (HP) infection. The aim of this study is to investigate HP prevalence among symptomatic patients in the upper socioeconomic segment of the population undergoing gastroscopy in an endemic urban region. METHODOLOGY Over a 12-month period, data were collected from the first consecutive 1000 patients (500 from university hospital, 500 from community hospital) who had gastroscopy and HP evaluation. RESULTS Overall, 211/1000 patients (21.1 %) were found to have HP in gastric biopsies. The specificity, sensitivity, positive predictive value, negative predictive value and diagnostic accuracy of rapid urease test were 87.5%, 99.7%, 99%, 96.5%, and 96.9% respectively. Atrophic gastritis, gastric and duodenal ulcers were significantly more common in HP positive patients. Age based distribution of HP prevalence > 6 decades (15.5%), 3rd-5th decades (26.1%), less then 3rd decades (10.4%). CONCLUSION In an HP endemic country, the prevalence of HP infection among symptomatic patients belonging to the upper socioeconomic segment of the population appears to be markedly lower. The lowest prevalence in young patients is expected to result in future decrease in HP prevalence. Copyright (c) 2020 Tan Attila, Mujdat Zeybel, Yesim Esen Yigit, Bulent Baran, Emel Ahishali, Emrah Alper, Fatih Aslan, Onder Ergonul, Zeynel Mungan.INTRODUCTION Staphylococcus aureus is considered one of the most important human pathogens, and its levels of resistance to methicillin have increased even in strains isolated from people without nosocomial risk factors. Molecular analysis is essential for understanding the patterns of dissemination. The objective of this study was to identify community-acquired methicillin-resistant S. aureus (CA-MRSA) clones that infected Paraguayan children patients in two periods of time. METHODOLOGY An observational, descriptive study was designed to determine the genetic variability of 115 isolates of CA-MRSA recovered from children who attended four reference centers in Paraguay between 2009-2010 and 2012-2013. RESULTS The combined use of Pulsed Field Gel Electrophoresis (PFGE), Multi-Locus Sequencing Typing, Multi-Locus Variable Analysis (MLVA) and Spa typing techniques allowed the identification of two dominant clones ST30-IV-t019 (77%) and ST5-IV-t311 (10%), and the establishment of the former as the leading cause of CA-MRSA infections in children during the study period. CONCLUSIONS This is the first study that provides epidemiological information as well as microbiological and molecular characteristics of CA-MRSA isolates recovered from children from Asunción and the Central Department of Paraguay. Copyright (c) 2020 Fatima Rodriguez, Claudia Salinas, Silvina Fernandez, Sol Haim, Marta Mollerach, Wilma Basualdo, Hector Castro, Beatriz Quinonez, Rocio Arguello, Monica Rodriguez, Lorena Grau, Carmen Espínola, Gladys Velazquez, Gloria Samudio, Gloria Gomez, Ana Campuzano, Juana Ortellado, Patricia Almada, Rosa Guillen.INTRODUCTION Several studies suggest increasing rates of antibiotic resistance among adult populations with Urinary tract infections (UTI). Escherichia coli (E. coli), is the predominant bacterium both in the community and in hospital environments causing uropathogenic infections. This study aimed to estimate the common uropathogen bacteria that cause UTI among outpatients as well as to determine the antibiotic resistance pattern of E. coli isolates among outpatients with UTI infections at Shaafi hospital, Mogadishu, Somalia. METHODOLOGY A cross-sectional study was conducted at Shaafi Hospital, Mogadishu, Somalia. A total of 128 samples were collected from outpatients suspected of UTI and tested through bacteriological investigations and antimicrobial susceptibility tests following the Kirby-Bauer agar disc diffusion method. RESULTS E. coli was isolated in 34 (41%) out of the total 83 samples that showed growth followed by Staphylococcus aureus 22 (26.5%), Pseudomonas aeruginosa, 13 (15.7%), Klebsiella pneumoniae 8 (9.6 %) and Proteus spp. 6 (7.2%). E. coli was highly sensitive to nitrofurantoin, 29 (85.3%), and ciprofloxacin (n = 23, 67.6%), and had the highest resistance rate of ceftriaxone, 33 (97.1%). The odds of having UTI were higher in patients with a history of UTI (Odds ratio OR = 0.211, 95% confidence interval CI 0.080, 0.553) and history of antibiotic use (OR = 0.322, 95% CI 0.113, 0.917). Increased resistance rate of E. coli against cephalosporins could be due to its excessive use as empirical therapy. CONCLUSION The study indicates that outpatients with UTI could be at high risk of antibiotic resistance, suggesting regular surveillance and monitoring of antibiotics. Copyright (c) 2020 Malyun Adam Mohamed, Omar Abdifetah, Fatima Abdullahi Hussein, Sa’adia Abdullahi Karie.INTRODUCTION Surveillance and antimicrobial resistance (AMR) monitoring are fundamental to Health care associated infections control. Limited data are available from developing countries for both. This study aimed to evaluate incidence and risk factors of surgical site infections (SSIs), etiological pathogens and AMR patterns identification. METHODOLOGY A prospective active surveillance study was implemented over a 24- month period at a 110-bed multispecialty non-teaching tertiary hospital. Follow up data were collected for 30-90 days. SSI was diagnosed according to Centers for Disease Control and Prevention and National Healthcare Safety Network (CDC/NHSN) criteria. https://www.selleckchem.com/products/SGI-1776.html The SSI isolates were identified by Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDITOF/MS). Antibiotics susceptibility test was performed according to Clinical Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST). RESULTS Out of a total of 3,642 patients, 70% had complete follow-up.