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The COVID-19 pandemic has led to significant changes in healthcare practices, including increased antibiotic usage. This study aimed to investigate the impact of the pandemic on the prevalence of extended-spectrum β-lactamase (ESBL) production and carbapenem resistance among key bacterial species causing urinary tract infections (UTIs). Conducted at King Fahad Medical City in Riyadh from January 2018 to December 2022, the study analyzed urine samples from 9697 UTI patients. Patients were categorized into 'pre-COVID-19' and 'during COVID-19' groups. Bacterial isolates were identified, and antimicrobial susceptibility testing was performed following guidelines. ESBL production was detected using the Double-Disc Synergy Test. Escherichia coli and Klebsiella pneumoniae were the main pathogens. During the pandemic, ESBL production decreased in E. coli by 1.9% and in K. pneumoniae by 6.0%. Carbapenem resistance also declined, with E. coli displaying a 1.2% reduction and K. pneumoniae and Pseudomonas aeruginosa displaying 10.7% and 7.9% reductions, respectively. Notably, logistic regression analysis revealed that the odds of ESBL presence were 10% lower during the COVID-19 pandemic (OR 0.91; 95% CI 0.83–0.99; p = 0.040), and there was a significant reduction in the odds of carbapenem resistance (OR 0.43; 95% CI 0.37–0.51; p < 0.001). This study reveals a significant decrease in ESBL production and carbapenem resistance among UTI pathogens during the COVID-19 pandemic, hinting at the impact of modified antibiotic and healthcare approaches. It emphasizes the need for persistent antimicrobial resistance surveillance and policy adaptation to address resistance challenges, offering key directions for future public health actions. [ABSTRACT FROM AUTHOR]

Aims: The present study aimed to assess the knowledge, beliefs, practices, and associated factors (educational level, gender, age, and socioeconomic status) that influence the decision to receive the influenza vaccine and determine whether health-care recommendations affect its acceptance among adults with chronic conditions in Riyadh from 2020 to 2021. Settings and Design: This analytical cross-sectional study was conducted using a convenience sampling technique in Riyadh, Saudi Arabia. Materials and Methods: An electronic questionnaire was distributed through social media, shopping centers, home care unit patients, and outpatient clinics at King Khalid University Hospital in Riyadh, Saudi Arabia. Statistical Analysis Used: Descriptive statistics (frequencies and percentages) were used to describe quantitative and categorical variables. Bivariate statistical analysis was performed using the Chi-square test. Statistical significance was set at P < 0.05. Results: The total number of participants was 518, and 66.4% of those who had received the vaccine (n = 211) had high knowledge. Of the 210 male participants, 68.1% had received the vaccine, and of the 308 female participants, 56.8% had received the vaccine. The main motives for vaccine uptake were worry about contracting influenza (48.1%) and health-care professionals' recommendations (44.6%). Conclusions: Influenza vaccination in adults with chronic diseases in Riyadh is suboptimal. Physician recommendations are the main motivator, whereas the fear of side effects is the main barrier. Educational campaigns should be conducted to promote knowledge and address misconceptions, fears, and false beliefs about the influenza vaccine, along with increasing physicians' recommendations. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C is a common viral infection worldwide. Finding the most effective diagnostic methods with low cost is always needed for laboratory improvement. In this study, we evaluated the performance of a quantitative chemiluminescent hepatitis C virus core antigen (HCV cAg) test by comparing it with the HCV confirmatory antibody line immunoblot assay (HCV Ab-LIA) test as well as the HCV quantitate reverse transcription-polymerase chain reaction (qRT-PCR) test. Methods: A total of 394 samples were enrolled in the retrospective study. Of these, 225 samples were tested using HCV Ab screening and confirmatory Ab-LIA along with chemiluminescent HCV core Ag testing, while 169 samples were tested using qRT-PCR for HCV RNA and chemiluminescent HCV core Ag testing. Results: Out of these, 225 positive samples tested by HCV Ab screening test were analyzed using the confirmatory Ab LIA and HCV cAg assays, a total of 183 samples (81.3 %) were confirmed to be Ab-positive, and among those, 77 samples (42.1%) were also positive for HCV cAg. Thirty-eight samples (20.76%) were HCV Ab indeterminate, and all of them were HCV cAg negative. Four samples (1.8%) were HCV Ab LIA-negative and negative for HCV cAg. Moreover, 169 samples were measured for qRT-PCR HCV viral load and quantitative HCV cAg test. One hundred and three samples were positive for HCV RNA, while 66 were negative. Among the positives, 96/103 samples were HCV cAg positive and 7/103 samples were negative. Out of the negatives, 4/66 samples were HCV cAg positive but 62/66 samples were negative. The HCV cAg results were concordant with the qRT-PCR results in 158 samples (93.5%); however, 11 samples (6.5%) were found to be discrepant. The sensitivity, specificity, positive predictive value, and negative predictive value of the quantitative HCV cAg were found to be 93%, 94%, 96%, and 90%, respectively. The overall coefficient of correlation between the HCV RNA levels and HCV cAg data was determined to be r² = 0.9. Conclusions: The HCV cAg test showed a high correlation with the HCV RNA levels and may potentially be used as a more cost-effective alternative to the HCV RNA qRT-PCR test. [ABSTRACT FROM AUTHOR]

Background: The prevalence of ear piercings is 8%-32%. Complications can be due to the factors such as the amount of tissue blood supply, the location of the piercing, the extent of hygiene techniques, and much more. Materials and Methods: A total of 586 females (age, 18-28 years) in Riyadh, Saudi Arabia, with at least one ear piercing were included in this analytical cross-sectional study by convenience sampling from September 2019 to April 2020. A link to an Arabic web-based questionnaire was distributed through social media (WhatsApp, Twitter, and Snapchat). It included questions related to both earlobe and ear cartilage piercings. Bivariate statistical tests were carried out. Results: The prevalence of a probable ear piercing-related infection for ear cartilage piercings was found to be significantly higher than for earlobe piercings (41.4% vs. 29.6%) (P = 0.0004) (confidence interval [CI] = 0.443-0.795). A significant association between piercing type (3.3% of earlobe piercings and 8.1% of ear cartilage piercings) and scar formation was observed (P = 0.0002) (CI = 0.209-0.722). The prevalence of ear piercing complications among participants who used piercing needles was lower for both earlobe piercings and ear cartilage piercings (3.65%, 8.75%) (P = 0.0015) than among those who used piercing guns (37.9%, 43.4%) (P = 0.114). Conclusion: Probable external ear infections were more common among those with cartilage ear piercings than those with earlobe piercings. Future studies should include participants of a broader age category and in different locations in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Health-care workers are at risk of contracting and transmitting infections. Few studies have assessed knowledge of transmission-based precautions during the COVID-19 pandemic. The aim of this study is to estimate the students' knowledge and practice of airborne and droplet precautions as well as knowledge of COVID-19 measures among medical, dental, and nursing students at King Saud University (KSU) during the COVID-19 pandemic. Subjects and Methods: This was a cross-sectional survey-based study conducted from August 2020 to October 2020 at KSU. Students that met the inclusion criteria were contacted and given questionnaires through social media; a convenience sampling technique was implemented due to limitations of contact during the pandemic. Results: 435 students were included in the study. Most of them were females (61.4%), and the distribution was 31.7%, 25.5%, and 42.8% for medical, dentistry, and nursing students, respectively. The mean knowledge of airborne and droplet precautions was 56.6%. Nursing and dentistry students displayed significantly lower knowledge of isolation precautions compared to medical students (P < 0.001). Knowledge of isolation precautions had correlated significantly and positively with self-rated better hygienic practices, r = 0.340, P < 0.010. The students' average knowledge score about COVID-19 was 81.37%. Moreover, results showed that students' overall mean willingness to take the vaccine for COVID-19 was 81%. Students' mean self-rated willingness to undergo COVID-19 vaccination correlated significantly and positively with their knowledge of infection control (r = 0.162, P < 0.010). Conclusion: Based on our study, the overall mean knowledge and practice of KSU health students were satisfactory, and their willingness to vaccinate against COVID-19 is acceptable. The study took place while students were learning online hence, we suggest future research to examine the practice of infection control measures after the pandemic. [ABSTRACT FROM AUTHOR]

Diarrhea is common among those visiting developing countries and is the most frequent travel related illness. Multiple guidelines suggest travelers' diarrhea should be treated with antimicrobials. Self-treatment with antibiotics has been shown to shorten illness by 1-2 days but not without the potential risk of side effects. This treatment also needs to be balanced with the impact of antimicrobial pressure on the generation of resistance. In the era of antimicrobial stewardship, and with increasing global resistance among many different pathogens including those causing travelers' diarrhea, perhaps the recommendations for self-treatment should be re-examined. In this review we will examine the question; is the modest improvement in symptoms in an otherwise self-limiting illness worth the antimicrobial pressure? [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the safety and effectiveness of monotherapy versus combination therapy for the treatment of infections caused by S. maltophilia ., Methods: This retrospective, multicenter, cohort study included patients treated with either monotherapy or combination therapy for infections caused by S. maltophilia . Primary outcomes included overall in-hospital mortality, 30-day mortality, and clinical cure. Safety outcomes were also evaluated. Multivariable logistic regression was used as a control for confounding variables., Results: A total of 407 patients were included, 330 patients received monotherapy and 77 patients received combination therapy. A total of 21% presented with concomitant bacteremia. After adjusting the differences between the two groups, there were no statistically significant differences between patients who received monotherapy versus combination therapy in clinical cure (55% vs 65%; OR, 0.72; 95% CI, 0.40-1.31) and overall in-hospital mortality (52% vs 49%; OR, 0.84; 95% CI, 0.45-1.57). However, patients who received monotherapy had a lower rate of 30-day mortality (28% vs 32%; OR, 0.45; 95% CI, 0.22-0.90) and acute kidney injury (9% vs 18%; OR, 0.35; 95% CI, 0.16-0.78)., Conclusion: Clinical outcomes did not significantly differ in patients who received combination therapy versus monotherapy. More data are needed to validate these findings.

Background: Non-tuberculous mycobacteria (NTM) are ubiquitous organisms that occasionally causes invasive diseases in humans, but they are under-reported in Saudi Arabia. We aimed to describe NTM infections and apply the American Thoracic Society/Infectious Diseases Society of America ATS/IDSA criteria., Method: Positive laboratory reports for NTM between January 2006 and December 2017 were retrospectively reviewed, and then classified into respiratory and non-respiratory specimens. ATS/IDSA criteria were applied to all respiratory specimens. Host status, clinical presentation, species identification, imaging, treatment, and outcome data were collected using a standardized form and analyzed. Cases with duplication or incomplete data were excluded., Results: 183 unique patients with positive NTM culture were included. Median age was 52 years and males represented 59%. Majority of cases were in the respiratory specimens group (n = 146), of which only 15 cases have met the ATS/IDSA criteria. Overall, cases were primarily known to have non-immunocompromising condition but 27% had either an active malignancy (n = 35), HIV (n = 13), or primary immunodeficiency (n = 8). 68.3% of cases presented with respiratory symptoms with or without fever. Among the identified NTM species (51.9%), slowly growing NTM were predominant. Anti-NTM therapy was provided in only 22.4% of this cohort. Death was documented only in 5 cases; all were in the respiratory group and were not treated., Conclusion: Though uncommon to isolate, only one in every ten respiratory NTM isolates was found potentially true pathogen in a single center in Saudi Arabia. Future studies on NTM prevalence in Saudi Arabia are recommended., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)