Clinical Presentation and Outcomes Following Infection With Vibrio spp, Aeromonas spp, Chromobacterium violaceum, and Shewanella spp Water-Associated Organisms in Tropical Australia, 2015-2022.

Background: Water-associated bacterial infections cause a wide spectrum of disease. Although many of these infections are typically due to human host commensal Staphylococcal or Streptococcal spp, water exposure can result in infections with environmental gram negatives such as Vibrio spp, Aeromonas spp, Chromobacterium violaceum, and Shewanella spp (collectively VACS). Methods: We performed a retrospective analysis of the epidemiology, clinical presentation, and outcomes of deep and superficial infections associated with VACS organisms in our health service between 1 January 2015 and 31 December 2023. Results: We identified 317 patient episodes of infection with VACS organisms over this period. Of these, Aeromonas spp (63%) was the most common, followed by Vibrio spp (19%), Shewanella spp (13%), and C violaceum (5%). The majority were isolated from males (74.4%) and involved the lower limb (67.5%). Mild infections were more common than severe presentations, with only 15 (4.7%) admissions to the intensive care unit and 8 (2.5%) deaths. Colonization occurred in 6.9% of patients, in contrast to the perceived severity of some of these bacteria. Copathogens were common and included Staphylococcus aureus (48%) and enteric bacteria (57%). The majority of patients (60%) had no documented water exposure. Initial empiric antimicrobial therapy presumptively covered the susceptibilities of the isolated organisms in 47.3% of patients; however, a lack of VACS-covering empirical therapy was not associated with readmission. Conclusions: The isolation of a VACS organism in our setting was often not associated with documented water exposure, which has implications for empiric antimicrobial therapy. Severe disease and death were uncommon.

Infrequent small bowel intestinal bacterial overgrowth in malnourished Zambian children.

There is evidence that children with malnutrition have an increased frequency of small intestinal bacterial overgrowth (SIBO) due to impaired gastric acidity, impaired intestinal motility, and dysbiosis. Children with malnutrition respond to antibiotic therapy but it is not clear if this effect is mediated by treatment of SIBO. We set out to determine the frequency of SIBO in children of varying nutritional status in a poor community in Lusaka, Zambia. Hydrogen breath testing, following a dose of 1g/kg oral glucose, was used to determine the presence of SIBO amongst the study participants. Forty nine children, 45 of whom had varying degrees of malnutrition, completed a full series of observations at 15, 30 and 60 minutes. Four children (8%) had a rise of 10ppm from baseline, consistent with SIBO. No correlation with nutritional status was observed. In this small study of Zambian children, SIBO was infrequent and unrelated to nutritional status.

A systematic review of short and medium-term mental health outcomes in young people following sexual assault.

Objective: Sexual assault peaks in adolescence, yet sequelae at this age are not well understood. This systematic review aimed to describe mental health outcomes following sexual assault in young people. Method: Two reviewers independently searched databases, screening publications from 1990 to 2018. Inclusion criteria included: longitudinal studies, systematic reviews, and meta-analyses with ≥50% participants aged ten to 24 years; baseline mental health assessment prior to/or <8 weeks post-assault with follow-up ≥ 3 months after the initial assessment.Results: 5 124 titles and abstracts were screened, with 583 papers examined in full. Ten studies met inclusion criteria (sample size 31 to 191). Five studies examined rates of post-traumatic stress disorder (PTSD), reporting rates of up to 95% within one month and up to 60% at 12 months post-assault. Studies evaluating post-traumatic (n = 5) and anxiety (n = 3) symptom scores showed symptoms were highest in the immediate aftermath of the trauma, generally reducing over four to 12 months post-assault. Depressive symptomology appeared to vary between studies (n = 5). However, the majority showed symptoms decreasing over the same time period.Conclusions: Psychopathology is common following sexual assault in young people. Most studies observed reduced rates over time, but there is a paucity of longitudinal research. Psychopathology during the first year after sexual assault is an important treatment target to consider.