Molecular epidemiology of carbapenemase encoding genes in A. baumannii-calcoaceticus complex infections in children: a systematic review.

Background: Acinetobacter baumannii-calcoaeticus complex is the leader pathogen for the World Health Organization's list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in A. baumannii-calcoaceticus complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in A. baumannii-calcoaceticus complex infections in the pediatric population. Methods: Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in A. baumannii-calcoaceticus infections were included. Results: In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. A. baumannii-calcoaceticus was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, blaKPC displayed an overall prevalence of 1.2%, while class B blaNDM had a prevalence of 10.9%. Class D blaOXA-23-like reported a prevalence of 64%, blaOXA-48 and blaOXA-40 had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of blaOXA-23-like at 91.6%. Conclusion: Our work highlights the high prevalence of carbapenem-resistant A. baumannii-calcoaceticus and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.

Outcomes of transitional care programs on adolescent chronic inflammatory systemic diseases: systematic review and meta-analyses.

BACKGROUND: Patients with juvenile chronic inflammatory systemic diseases (jCID) are vulnerable to many circumstances when transitioning to adult-centered healthcare; this increases the burden of disease and worsen their quality of life. METHODS: MEDLINE, Embase, Web of Science and Scopus were searched from inception to March 16th, 2021. We included observational, randomized controlled trials and quasi-experimental studies that evaluated a transitional care program for adolescents and young adults with jCIDs. We extracted information regarding health-related quality of life, disease activity, drop-out rates, clinical attendance rates, hospital admission rates, disease-related knowledge, surgeries performed, drug toxicity and satisfaction rates. RESULTS: Fifteen studies met our inclusion criteria. The implementation of transition programs showed a reduction on hospital admission rates for those with transition program (OR 0.28; 95% CI 0.13 to 0.61; I 2 = 0%; p = 0.97), rates of surgeries performed (OR 0.26; 95% CI 0.12 to 0.59; I 2 = 0%; p = 0.50) and drop-out rates from the adult clinic (OR 0.23; 95% CI 0.12 to 0.46; I 2 = 0%; p = 0.88). No differences were found in other outcomes. CONCLUSION: The available body of evidence supports the implementation of transition programs as it could be a determining factor to prevent hospital admission rates, surgeries needed and adult clinic attendance rates.

Systematic review and meta-analysis of the clinical survival significance of Sialyl-Tn expression in histological tissues from cancer patients.

BACKGROUND: The expression of Sialyl-Tn (STn) has been associated with different mechanisms of cancer. Several studies using histological tissue samples from different types of cancer showed differences in the STn expression patterns, but few studies have explored the association between STn expression and decreased overall survival. Therefore, a comprehensive analysis of the clinical significance of STn in cancer patients was performed. METHODS: A systematic review and meta-analysis were done of scientific articles published and available from different sources, including MEDLINE/PubMed, Web of Science, Cochrane Library and LILACS. Odds ratio (OR) was represented by the number of deaths during follow-up in positive-STn versus negative-STn patients. OR from each study was pooled and the results were presented in a forest plot. RESULTS: Eleven articles were included in the systematic meta-analysis. The estimated OR of 3.26 (95% CI: 2.12-5.02) was obtained. Furthermore, subgroups studies of gastric cancer showed an OR of 3.74 (95% CI: 2.47-5.66) and other cancer types reported an OR of 2.92 (95% CI: 1.16-7.32). CONCLUSIONS: This study showed that survival time was significantly longer in patients with negative-STn tumors than in those with positive results.