bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-138. Effect of diabetes mellitus on the disease entity and clinical parameters in culture positive melioidosis
Authors: Piyasiri Bhagya , Krishantha Jayasekera Pathirawasam , Marie Corea Enoka 
Published: January 2025

Abstract

Background
Melioidosis is a multi-system infection caused by Burkholderia pseudomallei, a bacterium living in soil which is transmitted to humans through inoculation, inhalation or ingestion. According to numerous studies, diabetes mellitus (DM) is the major risk factor, not only predisposing to melioidosis but also altering the immune response to the infection.
Objectives of this study were; to analyze the prevalence of DM among a local cohort of culture positive melioidosis patients and to assess the effect of DM on the disease entity and clinical parameters.

Methods
Anonymized data of 83 culture positive melioidosis patients from December 2014 to February 2024 were accessed to analyze disease entity, risk factors and laboratory investigations on admission. Fisher’s exact test was used to determine any statistical association between variables and a p value of less than 0.05 was taken as significant.

Results
Among 83 patients, 59 (71.1%) were diabetics. Age groups &gt;60yrs females and &lt; 20yrs males were 100% diabetics. Among 40-60yrs males had 88% prevalence of DM. There were patients with abscesses including deep seated ones (35, 42%), pneumonia (17, 21%), septic arthritis (7, 9%), pyelonephritis (6, 7%) and other disease entities (18, 22%) including rare ones like endocarditis (2, 2%). Mortality rate was 18/83 (22%) of which 13 (72%) were DM.
There was a significant association between abscesses/pus formation and the presence of DM (p=0.0016). Melioidosis antibody titer was tested in 64 (77%) and there was a highly significant association of high titers &gt;1:160 with the presence of DM (p=0.0004). Associations of white cell count (WCC) &gt;11000/µL, and ESR &gt;100mm/1st hr. with DM were statistically significant (p=0.0219 and p=0.0305 respectively). Association of high platelet counts ( &gt;400000/µL) with DM was not statistically significant (p=0.19750).

Conclusion
Diabetes was a significant comorbidity in culture positive Melioidosis. Meticulous investigation for pus formation in melioidosis among diabetics is recommended to ensure proper treatment including pus drainage. Presence of DM is in significant association with higher antibody titres, high ESR and high WCC which may indicate more chronic or extensive disease needing aggressive and prolonged treatment.

Disclosures
All Authors: No reported disclosures
P-166. Susceptibility to Measles among immigrants in South Korea
Authors: Lee Ran , Gwan Yoon Jang , Park A Ram , Hyun Bae So , Hwi Cho Jun , Kim Jin , Park Kyung-Hwa , Woo Choi Seong , Kyu Sun Bong , Hak Kim Kyung , Seog Kweon Sun , Eun Kim Seong 
Published: January 2025

Abstract

Background
Despite the World Health Organization's declaration of measles elimination in Korea in 2014, the country continues to encounter outbreaks, predominantly from cases imported via international travel. This study investigates the susceptibility to measles among immigrants residing in Korea, with an emphasis on their immunity status.

Methods
Conducted in Gwangju, Republic of Korea, this research measured measles immunoglobulin G (IgG) serum levels among immigrants from various nationalities.

Results
The study enrolled 415 participants, predominantly from Vietnam (18.8%), Uzbekistan (17.1%), Kazakhstan (10.4%), and the Russian Federation (10.1%). Overall, 82.2% exhibited seropositivity for measles IgG. Individuals under 30 years showed significantly lower seroprevalence at 61.8%, compared to 90.8% in those aged 30 and above. The lowest seroprevalences were noted in Cambodia (64.9%), the Russian Federation (69.8%), Ukraine and Mongolia (71.4% each), Nepal (75.0%), Kazakhstan (76.7%), and Uzbekistan (86.5%). The countries with the largest gaps from WHO/UNICEF published MCV2 coverage rates were Russian Federation and Mongolia (average MCV2 coverage rate 95.9% and 95.5% from 2000 to 2022, respectively). There were also significant disparities in measles immunity based on visa types, with work visa holders showing considerably lower immunity (75%) compared to those with residence visas (87.2%; Chi-square test, P=0.02).

Conclusion
The results highlight significant disparities in measles immunity among immigrants, particularly according to age, countries, and visas. The study underscores the critical need for targeted vaccination strategies and enhanced surveillance in Korea. Implementing tailored catch-up vaccination programs is essential to reduce the risk of measles outbreaks within this vulnerable population.

Disclosures
All Authors: No reported disclosures
P-173. An Exploration of the Reported Cases of Acanthamoeba Keratitis
Authors: Nagi Nazia , Farid Tahsin 
Published: January 2025

Abstract

Background
Acanthamoeba keratitis (AK) is a rare manifestation of infection caused by this ubiquitous protozoan parasite. Treatment is complicated by the absence of FDA approved treatments. Here we aim to review reported cases of AK to identify case characteristics and potential successful treatments.
WHO Region wise distribution of Acanthamoeba Keratitis

Methods
All cases of AK from 2012-2024 reported on PubMed (684) and Embase (816) were identified using relevant keywords, MeSH terms and Emtree terms. Rayyan.ai was used to screen cases using PRISMA protocol. Cases meeting inclusion criteria were uploaded to CureID. All AK cases in CURE ID (170) were then analyzed in aggregate.
Outcomes in Patients with Acanthamoeba keratitis

Results
Most cases occurred in the Americas (44.1%), followed by Europe (22.4%) and the least number of cases were contracted in the Eastern Mediterranean (5.3%) region (Figure 1). 76/170 cases of AK showed partial response to the treatment and 12/170 remained unchanged (Figure 2). Table 1 shows the most commonly used medications and their respective outcomes. Figure 4 represents the correlation between type of contact lens used and severity of disease presentation for the 90 cases where this information was available.
Most commonly used medications and their respective outcomes

Conclusion
Although majority of the patients responded to treatment, most did not fully recover, and 4 patients died. This underscores the significant morbidity caused by this disease. We noticed diagnostic delays due to misdiagnoses as fungal or viral eye infections. Improved diagnosis will be vital to improving outcomes. Outcomes appeared to be better with combination therapies that included Chlorhexidine, Propamidine and PHMB. This finding supports the inclusion of these drugs in a standardized regimen for treatment of AK. Conversely, Miltefosine produced mixed results and should be excluded. It also appears that severity of AK may be related to contact lens use and soft contact lenses may be associated with higher severity of AK. We speculate that higher incidences in the Americas and Europe may also be related to higher lens usage. Our aim is to further investigate these correlations through a full manuscript.
Lens use V/S No Lens use and severity in presenting symptoms

Disclosures
All Authors: No reported disclosures
P-180. Enhancing Mortality Surveillance: Insights from Excess Deaths Analysis during the COVID-19 Pandemic
Authors: Skocibusic Sinisa , Cilovic Lagarija Seila 
Published: January 2025

Abstract

Background
The global repercussions of the COVID-19 pandemic extend beyond reported fatalities, imprinting a lasting effect on global health. The COVID-19 pandemic has presented substantial issues, encompassing not only direct infections but also excess mortality. The death rates in the Federation of Bosnia and Herzegovina (FB&H) have been significantly affected by the pandemic, leading to a need for a thorough analysis of the elements that contribute to this phenomenon.
Mortality in Federation of Bosnia and Herzegovina age 15 - 44

Methods
The objective of this study was to quantitatively assess the rise in overall excess mortality rates in the FB&H region for the years 2020, 2021, and 2022. We employed data from the FB&H mortality record, along with population statistics and official COVID-19 death counts, to emphasize the often underestimated number of deaths. Our objective was to offer a thorough comprehension of the actual scale of the pandemic.
Mortality in Federation of Bosnia and Herzegovina age above 65

Results
During the initial three years of the pandemic, FB&H encountered three separate instances of heightened mortality from any cause, accounting for 18 % of the overall excess mortality during the period of 2020–2022. The biggest burden was recorded among adults aged 45–74, with 22.4% falling within the 45–64 age group, 22.1% within the 65–74 age group, and 19.4% within the 75–84 age group. Children under 15 years old did not exhibit any excess mortality.

Conclusion
COVID-19-related mortality in FB&H are significantly underreported, especially among younger persons. This statement highlights the pressing necessity to enhance civil registration and vital statistics, while pushing for the implementation of comprehensive surveillance systems for all causes of mortality. These measures are of utmost importance in improving the surveillance of forthcoming pandemics and effectively addressing other significant public health occurrences.

Disclosures
Sinisa Skocibusic, Medicopharmacia: Travel grant to ECCMIDs
P-181. Limited oxygen therapy capacity against COVID-19 and the public health response in Zambia 2021
Authors: Sivile Suilanji , Imamura Takeaki , Imamura Tadatsugu , Msanzya Zulu Paul , Zyambo Masuzyo , Ntambwe Papytcho , Spuka Ndaba , Chomba Julien , Enane Anita , Sikanga O T IP O , Hamalala Alphonsina , Innocent Hamuganyu , Chanda Christopher , Mulenga Lloyd 
Published: January 2025

Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic revealed the limited capacity of intensive oxygen therapy in Zambia, especially in provincial medical facilities.
Zambia COVID-19 treatment centers with newly installed HFNC and NPPV devices in 2021

Methods
The Ministry of Health (MoH) conducted a clinical chart review of COVID-19 cases admitted to 11 COVID-19 treatment centers across Zambia to evaluate oxygen therapy practices and clinical outcomes. Then, MoH launched a multidisciplinary capacity-building project targeting four national COVID-19 treatment centers in the provinces aiming to deploy high-flow nasal cannula (HFNC) and non-invasive positive pressure ventilation (NPPV) coupled with training for healthcare workers. The chart review and the reporting of the project were approved by National Health Research Authority, Zambia (NHRA000006/15/10/2021, NHRA00003/25/04/2022), and Tohoku University, Japan (2021-1-983, 2022-1-287).

Results
Among 1,687 cases of severe/critical COVID-19, 84 cases (5%) were treated without oxygen, 687 (41%) were administered with oxygen only via nasal cannula, 759 (45%) via conventional masks, and 157 cases (9%) received intensive oxygen therapy, including HFNC, NPPV, and invasive mechanical ventilation. Compared to the capital Lusaka, COVID-19 cases treated in the provinces were more likely to receive oxygen administration only via nasal cannula and less likely to receive intensive oxygen therapy. To strengthen the intensive oxygen therapy capacity in the provinces, MoH installed HFNC and NPPV devices in four provincial medical facilities equipped with oxygen plants and piping in October and November 2021. MoH also provided a five-day training program for healthcare workers focusing on clinical knowledge/skills of HFNC and NPPV in COVID-19 and infection prevention and control in aerosol-generating procedures.

Conclusion
Our study identified the inequity of intensive oxygen therapy capacity between Lusaka and the provinces in Zambia and the need for further strengthening. A multidisciplinary approach coordinating national experts was practical in rapidly deploying HFNC and NPPV amid the COVID-19 pandemic.

Disclosures
All Authors: No reported disclosures
P-185. Seroprevalence and Clinical Spectrum of Toxocara Infections: A Retrospective Study from a Tertiary Care Center in Lebanon
Authors: El Ayoubi L’Emir Wassim , El Meski Nour , Hassani Samar , Bidikian Nayda , Bou Khalil Jad , Kanj Souha S 
Published: January 2025

Abstract

Background
Toxocara is a prevalent zoonotic disease worldwide. It exhibits a broad spectrum of clinical manifestations, ranging from asymptomatic cases to severe conditions like myelitis and, in rare instances, fatal outcomes such as aortic thrombosis. Despite its prevalence, studies focusing on the seroprevalence, clinical manifestations, and laboratory findings of Toxocara in the MENA region are limited, highlighting a significant gap in research.

Methods
This is a retrospective, single-center cohort study conducted at the American University of Beirut Medical Center. The charts of 227 patients who were tested for Toxocara via ELISA IgG, presenting either as inpatients or outpatients from January 2002 to September 2022, were examined.

Results
The majority of the patients were middle-aged, generally exhibiting few co-morbidities as evidenced by 75% (75/100) of the study population being classified as “mild” on the Charlson co-morbidity index and only 16% (16/100) being immunosuppressed. 95.3% (61/64) of the patients were residents of Lebanon, most of whom were living in either Beirut or Mount Lebanon (22/59 (37.3%) and 20/59 (33.9%), respectively). 78.5% (62/79) of the patients presented with symptoms, and 67.7% (42/62) primarily complained of neurologic symptoms, mostly tingling or weakness in the extremities (37/43 (86%)). Asymptomatic patients were typically investigated for incidental eosinophilia (15/17 (88.2%)). Except for a lower overall age (44 vs 55, p=0.005), no statistically significant variable was detected between symptomatic and asymptomatic patients in terms of demographic characteristics. Among patients with Toxocara myelitis, most of the MRIs examined revealed enhancing (7/8 (87.5%)) longitudinal lesions (6/10 (60%)), mainly involving the thoracic levels of the spine (4/10 (40%)).

Conclusion
According to our center's experience, most patient who presented were symptomatic, mainly complaining of neurologic symptoms, with those diagnosed with Toxocara myelitis mainly showing longitudinal enhancing lesions involving the thoracic levels. Further studies are crucial to ascertain the actual prevalence and clinical presentations of Toxocara in the region.

Disclosures
All Authors: No reported disclosures
P-186. Trends in Antimicrobial Resistance Among Adults Across 6 Hospitals in Argentina, Brazil, and Chile, 2018-2022
Authors: Siza Charlene R , Mahon Garrett W , Patel Twisha S , Garzon Maria I , Boszczowski Icaro , Munita José M , Lessa Fernanda C , Chiarastelli Salomao Matias , Marssola Giovanna , Tavares Bruno , Verónica Hernandez Daniela , Peters Anne S , Spencer Maria , McGovern Olivia L 
Published: January 2025

Abstract

Background
In 2019, an estimated 1.27 million deaths were attributed to bacterial antimicrobial resistance (AR) globally. During the Coronavirus Disease 2019 (COVID-19) Pandemic, additional strain was placed on healthcare systems that may have led to further increases in AR. We evaluated AR prevalence before and after the onset of COVID-19 in 6 healthcare facilities (HCF) in South America.

Methods
We conducted an ecological evaluation of HCF-wide AR prevalence in 4 private and 2 public HCFs in Argentina, Brazil, and Chile; 2 HCFs per country. We calculated percentage of non-susceptible (NS) or resistant (R) to select antibiotics among clinical isolates of Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus spp., and Enterobacterales cultured from adult acute care inpatients. We compared percentage-NS or -R between the periods pre- (March 2018–February 2020) and post- (March 2020–February 2022) onset of the COVID-19 pandemic. Chi-square or Fisher’s exact tests were used with statistical significance set at a two-tailed p&lt; 0.05.

Results
When comparing 2020-2022 to 2018-2020, 2/6 hospitals showed statistically significant increases (+14.1–19.2%) in carbapenem-NS A. baumannii. For carbapenem-NS P. aeruginosa, 1/6 hospitals showed a significant increase (+76.6%) and 1/6 showed a significant decrease (-52.4%). For carbapenem-NS Enterobacterales, 2/6 hospitals had significant increases (+50.7–236.2%) and 1 exhibited a significant decrease (-91.7%). For vancomycin-R Enterococcus spp., 2/6 hospitals had significant increases (+43.9–400.0%) and 2/6 hospitals had significant decreases (-49.0-60.7%). For Enterobacterales-R to 3rd generation cephalosporins, 2/6 hospitals showed significant increases (+16.0–110.9%) and 1/6 hospitals had a significant decrease (-40.4%) (Table).

Conclusion
Among the isolates from our study hospitals, we noted not only significant increases but also significant decreases across multiple AR profiles associated with multi-drug resistance. These data suggest that the pandemic may have led to changes in resistance among both gram-negative and gram-positive bacteria. Given the variability in these changes, further evaluation of infection rates would be valuable to confirm these findings.

Disclosures
José M Munita, MD, MSD: Grant/Research Support|Pfizer: Grant/Research Support
P-241. Epidemiology of ventilator-associated pneumonia among patients requiring extracorporeal membrane oxygenation (ECMO): a retrospective cohort study
Authors: Nowak Caden , Albin Owen 
Published: January 2025

Abstract

Background
Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality among critically ill patients requiring extracorporeal membrane oxygenation (ECMO), yet the epidemiology of VAP in this patient cohort remains uncertain, particularly following the COVID-19 pandemic. The aim of this study is to characterize the epidemiology and microbiologic causes of VAP in patients requiring ECMO at a tertiary care academic referral center following COVID-19 (2020-23). Here, we present preliminary study data for the year 2020.Figure 1.Histogram showing number of VAP episodes per patient among 14 ECMO patients who experienced VAP.

Methods
Retrospective cohort study of adult patients (age ≥ 18) hospitalized at Michigan Medicine University Hospital in calendar year 2020 who required use of ECMO (venoarterial or venovenous) during hospitalization. Patient demographic characteristics, medical comorbidities, and microbiologic data were abstracted from the electronic medical record via a structured query. VAP was defined as occurrence of a positive quantitative respiratory culture obtained via distal lung sampling.Figure 2.Pathogens isolated from 30 positive quantitative respiratory cultures obtained in 14 ECMO patients in 2020.

Results
102 adult patients required use of ECMO in 2020. The mean patient age was 50.3 (SD 14.3) years of age. 61 (59%) of patients were male. 64% of patients were Caucasian, and 21% were African-American. Relevant patient comorbidities included congestive heart failure (67%), liver disease (44%), chronic pulmonary disease (43%), and diabetes (36%). 14 (14%) of patients experienced VAP. Of these patients who experienced VAP, 8 (57%) experienced &gt;1 episode of VAP (Figure 1), and 7 (50%) died prior to hospital discharge. Figure 2 illustrates the microbiologic causes of VAP in this patient cohort.

Conclusion
In a tertiary referral academic medical center, a minority of ECMO patients experienced the vast majority of VAP cases and suffered high rates of in-hospital mortality. Enterobacteriales and Staphylococcus aureus were responsible for the majority of VAP cases among patients requiring ECMO. Future work will extend these analyses through the year 2023 and capture antimicrobial use rates.

Disclosures
All Authors: No reported disclosures
P-253. Impact of Restroom Disinfecting/Cleaning Frequency and Product Selection on Risk of Infection
Authors: Gerba Charles P 
Published: January 2025

Abstract

Background
Restrooms are associated with transmission of bacterial and viral illnesses. Disinfecting pathogen-contaminated surfaces represents an intervention for reducing transmission risk. This study assessed whether cleaning/disinfecting frequency affects bacterial pathogen contamination in American patient rooms, long term care facilities and households with ≥ four occupants.

Methods
During the control phase, toilet surfaces (toilet bowl, water, and rim) were cleaned using a 9.5% w/w hydrochloric acid product only. During the intervention phase, multiple restroom surfaces (vanity/sink, toilet surfaces, floor, doorknob including toilet bowl) were cleaned/disinfected with disinfecting/cleaning products selected for the specific surfaces. Surface samples were collected and tested for heterotrophic and coliform bacteria after 1, 2, 3, or 7 days, with sampling being randomized during the week. The ratio of E. coli to norovirus in feces from an infected person was then used to perform a quantitative microbial risk assessment.

Results
The greatest numbers of bacteria were recovered on surfaces after three days. The largest reduction in bacterial recovery occurred during a three-day (∼twice-a-week) cleaning cycle, resulting in statistically significant reductions in recovery of heterotrophic bacteria (P = 0.00898) and Escherichia coli (P = 0.01).

Conclusion
Quantitative microbial risk assessments of commonly touched surfaces suggests that risk of infection by norovirus (highly contagious, excreted in high numbers, low human infectious dose) may be reduced by 91.5% using a three-day (twice-a-week) restroom cleaning/disinfection cycle.

Disclosures
Charles P. Gerba, PhD, Rickitt Benckiser: Grant/Research Support
P-254. The Effect of Disinfection with 222-nm Ultraviolet C on Surfaces Contaminated with Clostridioides difficile and Vancomycin-resistant Enterococci in the Bathrooms of Isolation Patients
Authors: Kitagawa Hiroki , Tadera Kayoko , Omori Keitaro , Nomura Toshihito , Shigemoto Norifumi , Ohge Hiroki 
Published: January 2025

Abstract

Background
Contaminated environmental surfaces are important sources of transmission for healthcare-associated pathogens, including Clostridioides difficile (CD) and vancomycin-resistant enterococci (VRE). Toilet surfaces are easily contaminated by pathogens excreted in stools. In this study, we investigated the efficacy of a 222-nm ultraviolet C (UVC) disinfection device, Care222®, for removing bacterial contamination in the bathrooms of isolated patients.

Methods
This study was conducted in the rooms of five patients diagnosed with C. difficile infection and in the rooms of five patients colonized with VRE. The Care222® device is mounted on a mobile cart and fixed at a 45-degree downward angle. The Care222® emission window was placed 1 m from the farthest end of the toilet seat and at a height of 1.1 m from the floor. At this position, UVC irradiation was performed for 45 min at a total 222-nm UVC fluence of 27 mJ/cm2. Before and after UVC irradiation, samples were collected from the toilet seat and control panel of the electric warm-water bidet toilet seat, in each room, and colony-forming units (CFUs) were determined.

Results
Disinfection with 222-nm UVC resulted in a significant decrease in the number of CD CFUs compared to the number of CFUs before disinfection (Median CFUs (range), 8 (0–51) vs. 1 (0-5), P=0.004). It also resulted in a significant decrease in the number of VRE CFUs compared to the number of CFUs before disinfection (Median CFUs (range), 7 (1–32) vs. 1 (0-3), P=0.001).

Conclusion
The disinfection with the 222-nm UVC device significantly reduced CD and VRE surface contamination in the bathrooms of isolated patients. Further studies are required to investigate the effectiveness of 222-nm UVC disinfection for reducing environmental pathogen contamination.

Disclosures
All Authors: No reported disclosures