International Journal of Infection
Volume:6 Issue: 3, Jul 2019

The role of cardiac pacemakers (PPMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices has increasingly prominent in cardiac disease management in the last 50 years. Evidence Acquisition: We reviewed the literature for cardiovascular implantable electronic device (CIED)-related infections, their diagnosis, treatment, complications, and long-term treatment. The most common signs of CIED infection include inflammatory changes in the generator pocket area. Evidence of dehiscence of the infected skin due to percutaneous exposure to the generator or even its leads is commonly reported. Timely diagnosis and subsequent treatment of patients with possible CIED infections are vital, which could otherwise affect prognosis. In the case of CIED-related infections close to the surface of the pocket site without the direct involvement of the device, removal is not deemed necessary. The oral administration of antibiotics with antistaphylococcal activity is suggested for 7 to 10 days. If there is the infection of bloodstream or endocarditis, the extraction of the entire system is considered mandatory along with antimicrobial therapy. Patients who suffer from CIED infections and cannot be subjected to device removal using percutaneous or surgical methods must be given long-term antimicrobial suppressive therapy. Such cases are those who are expected to have a short-term life expectancy or do not accept device removal. CIED infection is life-threatening. Early diagnosis is crucial to the survival of the patients. The use of antibiotics and a conservative approach without the CIED system removal may not be enough to cure this condition.

Iran has been known as an area with low-intermediate prevalence for the hepatitis B virus (HBV) infection. This cross-sectional study was performed to assess the prevalence of serological markers and the potential risk factors of HBV infection among people who referred to the Neyshabur Lab of Academic Center for Education, Culture, and Research (ACECR), Razavi Khorasan Branch, northeast of Iran. The 2669 serum samples were assessed to detect the hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA) during June 2015 to February 2016. In the case of HBsAg positive, hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb), total hepatitis B core antibody (anti-HBc), and IgM anti-HBc were evaluated. Moreover, demographic data and risk factors related to HBV infection were assessed. A total of 2099 (78.6%) females and 570 (21.4%) males with a mean age of 32.413.1 years were enrolled. HBsAg seropositivity was observed in 90 (3.37%) individuals. ELISA tests for HBeAg, anti-HBe, total anti-HBc, and IgM anti-HBc were positive in 8 (8.9%), 75 (83.3%), 90 (100%), and 11(12.2%) of 90 HBsAg-positive cases, respectively. Age, sex, household size, and education level were significant risk factors for the infection. Prevalence of HBV infection in Neyshabur could be considered as an intermediate level. Although some reasons for which individuals referred, were suggesting hepatitis.

The prevalence of HIV is increasing in Iran, so obtaining an estimate of the survival of HIV-infected persons can be helpful to prevent and control this infection. This research aimed to use the Bayesian joint model by which identifies factors associated with the survival and determine the relationship between the trend of CD4+ T cell counts and survival time in HIV-infected persons. In this retrospective cohort study, we collected HIV/AIDS surveillance data from Mashhad’s Counseling Center of Behavioral Diseases in the province of Khorasan Razavi, Northeast of Iran, during 1994 - 2014. Data collection included variables CD4+ T cells count, survival time, and other related factors. We used the Bayesian joint model to estimate the survival time and identify the factors associated with survival time in HIV-infected persons. The study included 260 individuals, of whom 212 (81.54%) were male. The survival sub-model of the joint model identified gender (95% credible interval (CI): 0.486, 3.197) and antiretroviral treatment (95% CI: -1.935, -0.641) as the variables associated with the patients’ survival. The longitudinal sub-model, which determined the variables associated with the number of CD4+ T-cells included time (95% CI: -0.934, -0.554), age (95% CI: -0.152, -0.011), and antiretroviral treatment (95% CI: -6.193, -3.505). Using CD4+ T cells as a covariate in the Bayesian joint model, the survival time for HIV-infected persons was estimated more precisely than separate model and it can be inferred that at the beginning of antiretroviral treatment, especially in men and controls, the CD4+ T cell counts can increase the survival time of HIV-infected persons.

A correct diagnosis of a disease among several diseases with the same clinical symptoms is very important and is a difficult task in medical science. Misdiagnosis of these diseases in the short term causes very high and serious damage to the health of patients and usually results in loss of golden time. In this paper, our purpose is to achieve the best conclusion, which contributes to the diagnosis of the critical illness without losing the golden opportunity based on clinical data and using mathematical models, especially fuzzy mathematics. The data regarding patient’s signs and symptoms were collected in the hospitals. We attained the best choice of diseases among the considered options of diseases by using basic fuzzy rules, fuzzy control techniques, fuzzy mathematics and fuzzy systems. To write the basic fuzzy rules, the information that we used was adopted by experts in infectious diseases or data records of patients who reached a definite diagnosis of disease by various tests. Then, by using these rules, the system of mathematical equations was formed. By solving this system, coefficients of a linear equation were estimated witch its values according to the clinical signs of a patient indicates the probability that the patient will be infected with that disease. In this process, the number of patients studied is n not effective. But the more patients are studied, the more accurately the coefficients of the diagnosis equation are obtained. The symptoms of some patients whose disease have been definitely diagnosed were used as inputs of the system of our equations and it was observed that the system’s outputs approximately coincide the exact diagnosis of the disease, which indicates that the equations obtained for the diagnosis of diseases are acceptable. The findings of this study can help to correctly diagnose the disease without losing golden opportunities. We hope that using the results of this research, the error in the initial diagnosis of diseases is significantly reduced.

Infant milk powder (IMP) is a very suitablemediumfor the growth of micro-organisms such as Bacillus cereus. B. cereus is a spore-producer that can survive easily during the pasteurization process to cause some health problems. This study was carried out to determine the antibiotic resistance pattern of B. cereus isolates producing metallo-- lactamase (MBL) enzymes in IMP samples. After preparing 50 samples of IMP, they were cultured to detect the presence of B. cereus. The Kirby-Bauermethodwas used to determine antibiotic susceptibility and theDDSTmethodto phenotypically detectMBLenzymes. MBLgenes blaVIM, blaSMP-1, and blaIMP were genotypically examined in the isolates by the PCR method. Most samples of IMP had a high level of contamination with B. cereus when compared to national and international standards. The highest percentage of resistance was related to ceftazidime and oxacillin (100%) and the lowest resistance to tetracycline (21.4%) and ciprofloxacin (26.3%). All B. cereus isolates were the producers of MBLin the DDST test. None of the isolates was positive for the blaSPM gene. Of the other MBL genes, the blaVIM gene was seen in all isolates (100%) and the blaIMP gene in 16 isolates (84.21%). Antibiotic resistance is on the rise in the study region due to the production of MBL enzymes. Among MBL-producing isolates, the frequency of the blaVIM gene was more than that of blaIMP and blaSPM-1.

Tuberculosis (TB) is a major public health challenge, especially in resource-limited settings. The burden of the disease is particularly larger in developing countries due to factors like poverty, undernutrition, and even HIV, which propagate its spread and complicates its control. West Africa, with its high levels of poverty, hunger, overcrowding, and infectious diseases like HIV, is not left out in the tuberculosis epidemic. Our study aimed to review the burden of TB and the challenges hindering its eradication in West Africa.

This review assesses available evidence on issues relating to the burden of tuberculosis and the challenges facing its eradication in West Africa. Search for relevant medical literature in biomedical databases such as PubMed, Google Scholars, and OVID was conducted with the appropriate key terms without date restriction. Fifty-seven articles were found in a search through the database; 33 data sources, including reports, were selected and reviewed in order to contribute data to this study.

From the study, the incidence of tuberculosis is high in West Africa, especially considering the high rate of factors, which propagate its spread. TB/HIV co-infection is also an issue in this region, as evidenced by the high burdens in Nigeria, Ghana, Liberia, and Guinea Bissau. In fact, Nigeria still holds the position of the country with the highest TB burden in West Africa and also account for about 4% of the TB incidence globally. However, the burden only represents an estimate due to paucity of data attributed to ineffective surveillance method. The rate at which the incidence of tuberculosis is declining is slow due to various challenges facing its eradication such as poverty, endemic of the causative agents, drug resistant tuberculosis, and inefficient diagnostic methods, among others.

There is now increasing evidence to support that TB prevalence in West Africa is on a continual projection in which the futuristic outcome is worrisome, considering the challenges the region continually faces. The challenges need to be addressed by selecting the most appropriate strategy for the region, and efforts should be made to improve the surveillance system. Leveraging on the public-private partnership and cost-effectiveness evaluation should also be encouraged.