Search

Synanthropic cockroaches are a public health concern, because they can carry pathogens and allergens. These insects inhabit urban spaces and must be constantly monitored in order to assess the pest emergence outbreaks. Here, we combined spatial population monitoring with microbiological testing to survey the main pest cockroach species found inside residences of the city of Quetta, Pakistan. We evaluated the distribution of pest cockroaches at two scales: landscape (neighborhood) and patch (inside houses). We found at least one of the following pest species in the 73.2% of the total residences surveyed (n = 112): Shelfordella lateralis 37.1%, Periplaneta americana 23%, Blatella germanica 16.7%, Blatta orientalis 13.4% and Polyphaga aegyptiaca 9.8%. At landscape scale, the most common was S. lateralis, presenting a clustered distribution in two sampled zones, also heavily urbanized. At indoor scale, S. lateralis were most frequently found in kitchens. When we studied the bacterial loads in this species, we found that S. lateralis carried several pathogenic bacteria. Susceptibility tests tested on these strains against 10 common formulations showed antibiotic resistance for some bacteria. For instance, Pasteurella spp was susceptible towards six antibiotics tested, while Helicobacter spp showed resistance against eight antibiotics tested. Our evidence suggests that S. lateralis have the potential to displace main cosmopolitan pests and, most concerning, also carry antibiotic‐resistant pathogenic bacteria. Considering that this emergent Asian‐native pest is now present in Europe and America, it may correspond to a relevant urban pest deserving further international public health attention. [ABSTRACT FROM AUTHOR]

Background: Short duration, antimicrobial prophylaxis that includes antistaphylococcal activity is recommended at the time of left ventricular assist device (LVAD) implantation to reduce infection‐related complications. There continues to be wide variability in surgical infection prophylaxis (SIP) regimens among implantation centers. The aim of this study is to characterize current SIP regimens at different LVAD centers. Methods: A survey study was conducted from 26 September 2017 to 25 October 2017. Surveys were distributed electronically to LVAD coordinators and infectious diseases specialists at 75 US medical centers identified as having an LVAD program. Data collection included information about antimicrobial selection, duration, Staphylococcus aureus screening, and decolonization procedures. Results: We received 29 survey responses. The majority of surveys were completed by infectious diseases physicians (72.4% [21 out of 29]). Most responding centers reported LVAD programs established for greater than 10 years (20 out of 29 [69%]). Cardiac transplantation was performed in 28 out of 29 (96%) centers. Of centers reporting a defined SIP regimen for non‐penicillin allergic patients (96% [28 out of 29]), 17.9% (5 out of 28) reported a four‐drug regimen, 35.7% (10 out of 28) reported a three‐drug regimen, and 46.4% (13 out of 28) reported a two‐drug regimen, while no centers reported a single‐drug regimen. Empiric fluconazole was common (50% [14 out of 28]) and 96.4% (27 out of 28) of regimens included vancomycin. Duration of antimicrobial prophylaxis (24 hours to 5 days), S. aureus screening, decolonization procedures, and alterations due to drug allergies varied across participating centers. Conclusions: Our survey results indicate wide variation in SIP regimens among participating LVAD centers. These results highlight the need for studies evaluating the implications of SIP regimens, and whether clinical factors that prolong antimicrobial duration impact postoperative infection rates. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions Belatacept is a costimulatory blocker that can be used to prevent and treat rejection in lung transplant recipients (LuTRs). The epidemiology of infections in belatacept‐treated LuTRs has not been systematically evaluated.We performed a single‐center retrospective study of all adult LuTRs who received belatacept as prevention or treatment of antibody‐mediated rejection (desensitization) or as part of maintenance immunosuppression from January 1, 2011, to June 30, 2022. We assessed the epidemiology of infections that occurred within 12 months following the first belatacept dose.Fifty‐two LuTRs received at least one dose of belatacept as either desensitization (n = 32) or maintenance immunosuppression (n = 20). Among 45 patients who were cytomegalovirus (CMV) donor and/or recipient seropositive, nine (20%) developed CMV infection. Seven (77%) CMV infections occurred despite valganciclovir prophylaxis and four (44%) were associated with antiviral resistance. Three (6%) LuTRs developed Epstein‐Barr virus (EBV) associated post‐transplant lymphoproliferative disorder (PTLD). Twenty‐five (48%) LuTRs developed 43 bacterial infections and five (10%) developed proven or probable invasive fungal disease. Incidence rates of viral, bacterial, and fungal infections were similar between the desensitization and maintenance groups: incidence rate ratios (95% confidence interval) were 0.70 (0.32–1.57), 1.31 (0.70–2.46), and 2.82 (0.31–25.2), respectively. Infection/PTLD prompted belatacept discontinuation in eight (15%) patients.In the first year after belatacept initiation, LuTRs commonly developed CMV infections, EBV+ PTLD, and bacterial infections. Multicenter collaborations are needed to better understand infection risks in LuTRs treated with belatacept. [ABSTRACT FROM AUTHOR]