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Background Blood culture is a laboratory test designed to detect the presence of bacteria or fungi in the blood of patients suspected of blood stream infection. While speedy initiation of antibiotic treatment is a critical determinant of patient survival, it is recommended that sample for blood culture should be collected before initiation of antibiotic therapy. The present study assessed the effects of antibiotic treatment on blood culture negativity. Methods A retrospective observational study was conducted to review blood culture results from June 2021 to December 2022. Blood culture results from patients aged 0 to 60 years were examined. Blood culture results whose samples were obtained prior to antibiotic treatment were analysed in comparison to those obtained during antibiotic treatment. Altogether a total of 165 results from various wards were analysed. Results Out of 94 blood cultures tested prior to antibiotic treatment, 54 were negative reflecting a negativity rate of 57%. Furthermore, from 71 blood cultures analysed after initiating antibiotic treatment, 56 were negative, representing a negativity rate of 79% (56/71). Thus, blood samples collected post antibiotic treatment exhibited a higher blood culture negativity rate in comparison to blood samples collected before the onset of antibiotic treatment. Conclusions This study revealed that collecting blood culture samples after the start of antibiotic treatment promotes blood culture negativity. While prompt initiation of antibiotic therapy is vital for patient recovery and survival in sepsis or bacteraemia, we encourage the practice of collecting blood culture samples prior to the commencement of treatment.

Objective The aim of our study was to determine the extent of exposure of the student population to SARS-CoV-2 and its associated factors. 166 students were enrolled in our study representing a 100% response rate. Results The SARS-CoV-2 antibody seroprevalence in the sampled student population was 78%. Gender of the respondents was a significant modulator of SARS-CoV-2 seropositivity (p

Summary Candida albicans is a commensal of the urogenital tract and the predominant cause of vulvovaginal candidiasis (VVC). Factors that increase circulatory estrogen levels such as pregnancy, the use of oral contraceptives, and hormone replacement therapy predispose women to VVC, but the reasons for this are largely unknown. Here, we investigate how adaptation of C. albicans to estrogen impacts the fungal host-pathogen interaction. Estrogen promotes fungal virulence by enabling C. albicans to avoid the actions of the innate immune system. Estrogen-induced innate immune evasion is mediated via inhibition of opsonophagocytosis through enhanced acquisition of the human complement regulatory protein, Factor H, on the fungal cell surface. Estrogen-induced accumulation of Factor H is dependent on the fungal cell surface protein Gpd2. The discovery of this hormone-sensing pathway might pave the way in explaining gender biases associated with fungal infections and may provide an alternative approach to improving women's health., Graphical abstract, Highlights • Estrogen promotes the virulence of Candida albicans by reducing phagocytosis • Estrogen-adapted C. albicans binds more Factor H on its cell surface • Estrogen-induced innate immune evasion of C. albicans is dependent on Gpd2 • Overexpression of GPD2 promotes the virulence of C. albicans, Women with high estrogen levels have an increased risk of developing genital thrush caused by Candida albicans. Kumwenda et al. show that C. albicans grown in estrogen is not recognized and killed efficiently by white blood cells. This reduced immune recognition could enable C. albicans to proliferate and cause infection.

Objective The aim of this study was to characterize Covid-19 cases and explore risk factors associated with mortality among hypertensive patients with COVID-19 country-wide. Methods We used a retrospective case control study design to provide a detailed account of cases and explore risk factors associated with mortality among hypertensive patients with COVID-19 country-wide. A total of 441 patients were included in the study in the ratio of one case to two controls (1:2), matched by age. Results Deaths due to Covid-19 varied with hypertensive condition with more deaths registered in hypertensive patients. Clinical signs and symptoms in Covid-19 patients varied greatly between hypertensive and non-hypertensive patients, with a leaning favouring the latter. The risk of death due to Covid-19 among hypertensive patients increased with age and meaningfully associated with underlining comorbidities such as HIV, TB, cardiovascular, and liver disease. Conclusion Our study reveals predictive factors for mortality in COVID-19 hypertensive patients that can be used by policy makers and health care practioners to identify those at a higher risk and determine proper treatment approach to achieve best possible clinical outcomes.

We estimated the seroprevalence of anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) antibodies in residents of African countries and explored its associated factors. We searched PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases for peer reviewed articles and pre‐prints that reported anti‐SARS‐CoV‐2 antibody seroprevalence of general or specific human populations resident in Africa. The eligible studies were evaluated using Joana Briggs Institute prevalence critical appraisal tool. Twenty‐three studies involving 27,735 individuals were included in our paper. The pooled seroprevalence of anti‐SARS‐CoV‐2 antibodies in Africa was 22% (95%CI: 14–31) with very high heterogeneity (I 2 = 100%, p

Gender is a risk factor for several infections that, for many pathogens, has been linked to sex hormones impacting host immunity and directly affecting microbial virulence.Candida albicansis a commensal of the urogenital tract and the predominant cause of vulvovaginal candidiasis (VVC). Factors that increase circulatory oestrogen levels like pregnancy, the use of oral contraceptives, and hormone replacement therapy predispose women to VVC, but the reasons for this are largely unknown. Here, we investigate how adaptation ofC. albicansto oestrogen impacts the fungal host-pathogen interaction. Physiologically relevant concentrations of oestrogen promoted fungal virulence by enablingC. albicansto avoid the actions of the innate immune system. Oestrogen-induced innate immune evasion was mediated via inhibition of opsonophagocytosis through enhanced acquisition of the human complement regulatory protein, Factor H, on the fungal cell surface. Oestrogen induced accumulation of Factor H was dependent on the fungal cell surface protein Gpd2, with oestrogen dependent derepression ofGPD2being mediated via a non-canonical signalling pathway involving Ebp1 and Bcr1. Therefore, we propose that, in addition to affecting the antifungal potential of vaginal epithelial cells, elevated oestrogen levels predispose women to VVC by directly enhancing fungal pathogenicity through the inactivation of complement. The discovery of this new hormone sensing pathway might pave the way in explaining gender biases associated with fungal infections and may provide an alternative approach to improving women’s health.

Background Bacterial infections are a significant cause of sickness and death in sub-Saharan Africa. This study aimed at establishing the prevalence, distribution and antimicrobial susceptibility pattern of major bacterial isolates from patients accessing medical care at a tertiary hospital in Malawi. Methods We retrospectively reviewed bacteria culture and antimicrobial susceptibility records for 4617 patients from 2002 to 2014 at Mzuzu Central Hospital (MCH). No inclusion and exclusion criteria were followed. Data was analysed using excel (Microsoft office, USA) and GraphPad prism 7 software programs. Results The most prevalent isolates were S. aureus (34.7%, n = 783), Klebsiella species (17.4%, n = 393) and Proteus species (11.4%, n = 256). Most microorganisms were isolated from adults (88.3%, n = 3889) and pus was the main source (69.3%, n = 1224). S. pneumoniae was predominantly isolated from cerebrospinal fluid (60.3%, n = 44) largely collected from children (88.2%, n = 64). Overall, most bacteria exhibited high resistance to all regularly used antimicrobials excluding ciprofloxacin. Conclusions Our report demonstrates an increase in bacterial infection burden in sites other than blood stream and subsequent increase in prevalence of antimicrobial resistance for all major isolates. Creating an epidemiological survey unit at MCH will be essential to help inform better treatment and management options for patients with bacterial infections.

The ability to cause disease extends from the ability to grow within the host environment. The human host provides a dynamic environment to which fungal pathogens must adapt to in order to survive. The ability to grow under a particular condition (i.e., the ability to grow at mammalian body temperature) is considered a fitness attribute and is essential for growth within the human host. On the other hand, some environmental conditions activate signaling mechanisms resulting in the expression of virulence factors, which aid pathogenicity. Therefore, pathogenic fungi have evolved fitness and virulence attributes to enable them to colonize and infect humans. This review highlights how some of the major pathogenic fungi respond and adapt to key environmental signals within the human host.