Acinetobacter

This retrospective study was conducted at Hamad General Hospital, Qatar, to describe the demographic data, clinical features underlying diseases, antimicrobial susceptibility, and outcome of A. baumannii infection. It involved all adult patients 15 years of age or older who were managed at Hamad General Hospital for A. baumannii infection from January 1, 2012, to December 31, 2013. We identified a total of 239 patients with A. baumannii infection, of which 182 (76.2%) were males. The mean age was 49.10±19.57 years. The majority of the episodes (25.1%) occurred in elderly patients (≥65 years) and the most commonly identified site of A. baumannii infection was the respiratory tract, 117 (48.9%). Most episodes of infection, 231 (96.7%), were hospital-acquired and high rate of nosocomial infections occurred in the medical intensive care unit, 66 (28.6%). All patients had underlying medical conditions. Maximum resistance was seen to cefotaxime, 147 (58.3%), and minimum resistance was seen to colistin, 2 (1.4%). Of the 239 isolates, 102 (42.7%) were susceptible and 137 (57.3%) were multidrug-resistant. The in-hospital mortality in our study was 31%. Male gender, multidrug resistance, and septic shock were found to be independent mortality predictors

Disseminated tuberculosis complicated by hemophagocytic lymphohistiocytosis in an immunocompetent adult with favorable outcomes: A case report

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon hyperinflammatory syndrome characterized by excessive activation of macrophages and T-cells with high cytokines levels, causing multiorgan dysfunction.HLH has been associated with variable infectious etiologies, such as tuberculosis(TB). TB-associated HLH (TB-HLH) is a rare condition, but it is fatal if not treated. The diagnosis of TB-HLH is challenging and might be missed if not highly considered. The classic manifestations of HLH include pancytopenia, organomegaly, lymphadenopathy, and coagulopathy. Herein, we present a young immunocompetent adult diagnosed with disseminated TB complicated by HLH. Our patient responded well to the combination of antituberculosis therapy(ATT), corticosteroid, and intravenous immunoglobulin(IVIG). This case highlights the importance of considering this fatal complication in TB patients.Other InformationPublished in: IDCasesLicense: http://creativecommons.org/licenses/by/4.0/See article on publisher's website: https://dx.doi.org/10.1016/j.idcr.2021.e01370</p

A case report of Pasteurella multocida meningitis in a patient with non-traumatic skull base defect

Background: Pasteurella multocida is a gram-negative coccobacillus that is primarily found in oropharynx of dogs, cats and other animals. It causes infections in human beings through contact with animal saliva in the form of licks, bites and scratches of animals colonized by the bacteria. Meningitis due to Pasteurella multocida is rare in immunocompetent individuals. We report a case of meningitis due to Pasteurella multocida in an immunocompetent patient. Case report: A 30-year-old gentleman presented with 2-day history of fever and neck stiffness. 6 weeks earlier, he was treated as a case of bacterial meningitis. During that hospital stay, he was diagnosed to have bony defect in the sellar floor based on MRI head performed to evaluate for a prolonged history of CSF rhinorrhea. He was discharged and scheduled for an elective endoscopic endonasal/open repair of the skull base defect after resolution of meningitis. CSF findings during current admission also showed features of bacterial meningitis. CSF culture showed Pasteurella multocida sensitive to penicillin, ampicillin and ceftriaxone. Retrospective history revealed patient’s contact with stray cats as he used to feed them but there was no history of licks, bites. He was treated with intravenous ceftriaxone 2 g twice a day for 14 days with complete resolution of his symptoms. Conclusion: Pasteurella multocida is an important cause of bacterial meningitis in patients with skull defect. Patients with traumatic or non-traumatic bony defect of skull should avoid contact with dogs and cats to prevent the spread of infection the central nervous system

Remdesivir for Covid-19 pneumonia in patients with severe chronic kidney disease: Case series and review of the literature

Remdesivir was the first antiviral agent to receive FDA authorization for severe COVID-19 management, which restricts its use with severe renal impairment due to concerns that active metabolites might accumulate, causing renal toxicities. With limited treatment options, available evidence on such patient groups is important to assess for future safety.</jats:p

Acinetobacter Infections among Adult Patients in Qatar: A 2-Year Hospital-Based Study

This retrospective study was conducted at Hamad General Hospital, Qatar, to describe the demographic data, clinical features underlying diseases, antimicrobial susceptibility, and outcome of A. baumannii infection. It involved all adult patients 15 years of age or older who were managed at Hamad General Hospital for A. baumannii infection from January 1, 2012, to December 31, 2013. We identified a total of 239 patients with A. baumannii infection, of which 182 (76.2%) were males. The mean age was 49.10±19.57 years. The majority of the episodes (25.1%) occurred in elderly patients (≥65 years) and the most commonly identified site of A. baumannii infection was the respiratory tract, 117 (48.9%). Most episodes of infection, 231 (96.7%), were hospital-acquired and high rate of nosocomial infections occurred in the medical intensive care unit, 66 (28.6%). All patients had underlying medical conditions. Maximum resistance was seen to cefotaxime, 147 (58.3%), and minimum resistance was seen to colistin, 2 (1.4%). Of the 239 isolates, 102 (42.7%) were susceptible and 137 (57.3%) were multidrug-resistant. The in-hospital mortality in our study was 31%. Male gender, multidrug resistance, and septic shock were found to be independent mortality predictors

Psychological impact of the COVID-19 pandemic within institutional quarantine and isolation centres and its sociodemographic correlates in Qatar: a cross-sectional study

SettingThe State of Qatar has had one of the highest COVID-19 infection rates globally and has used state-managed quarantine and isolation centres to limit the spread of infection. Quarantine and isolation have been shown to negatively affect the mental health of individuals. Qatar has a unique population, with around 90% of the population being economic migrants and a majority being blue-collar workers and labourers.ObjectivesThis study was carried out to evaluate the psychological impact of institutional isolation and quarantine during the COVID-19 pandemic outbreak in Qatar. The study also explored the sociodemographic correlates of this psychological impact.Design, participants and interventionA cross-sectional study involving 748 consenting individuals in institutional quarantine and isolation in Qatar during the months of June and July 2020 was carried out. Relevant sociodemographic data along with depressive and anxiety symptomatology scores were collected from consenting adults at these facilities.Results37.4% (n=270) of respondents reported depressive symptoms and 25.9% (n=189) reported anxiety symptoms. The scores were higher for individuals in isolation facilities and higher for migrants from poor socioeconomic group (p&lt;0.001 for both). Within this group, although worries about infection were widely reported, lack of contact with the family was cited as one of the most important sources of distress. Respondents reported that contact with the family and reliable information were important factors that helped during the duration of isolation and quarantine.ConclusionsOur study reported significantly elevated scores for depression and anxiety during institutional quarantine, which is in keeping with emerging evidence. However, in contrast to other studies reporting mostly from native populations, this study of a population with an overwhelming majority of immigrants highlights the special mental health needs of this specific group and can inform future healthcare policies.</jats:sec