Recent years have witnessed the rise of artificial intelligence (AI) in antimicrobial resistance (AMR) management, implying a positive signal in the fight against antibiotic-resistant microbes. The impact of AI starts with data collection and preparation for deploying AI-driven systems, which can lay the foundation for some effective infection control strategies. Primary applications of AI include identifying potential antimicrobial molecules, rapidly testing antimicrobial susceptibility, and optimizing antibiotic combinations. Aside from their outstanding effectiveness, these applications also express high potential in narrowing the burden gap of AMR among different settings around the world. Despite these benefits, the interpretability of AI-based systems or models remains vague. Attempts to address this issue had led to two novel explanation techniques, but none have shown enough robustness or comprehensiveness to be widely applied in AI and AMR control. A multidisciplinary collaboration between the medical field and advanced technology is therefore needed to partially manage this situation and improve the AI systems’ performance and their effectiveness against drug-resistant pathogens, in addition to multiple equity actions for mitigating the failure risks of AI due to a global-scale equity gap.

The increasing concerns over emerging infectious diseases and potential pandemics led to the formation of One Health, a collaborative, multidisciplinary approach to address the risks from human–animal–ecosystem interactions. This multi-sectoral approach is specifically important in Australia, a biodiverse country with unique flora, fauna, and many infectious diseases, including leptospirosis. Leptospirosis is a relatively rare but potentially fatal zoonosis, with an attributed mortality of around 60,000 deaths per year worldwide. In recent years, sporadic cases and alarming outbreaks of leptospirosis have been notified in many states and territories of Australia, noteworthily in 2018 and 2019. The sudden outbreaks in these two years have raised a question about the possibility of a more severe menace or a potential threat to both humans and animals. Amid the fight against leptospirosis, One Health has been shown to be an excellent and ideal framework, especially in Australia, the country that has taken the lead in zoonosis control using this approach. In this review, the focus will be put on the effectiveness and ethics of One Health in leptospirosis control under the Australian setting to further advocate the implementation of this framework for many other infectious diseases.

Oral anticoagulants for venous thromboembolism are not thoroughly managed in ambulatory settings in low-/middle-income countries, primarily because of patients' neglect of medication knowledge and adherence. This study was conducted to investigate patient knowledge, adherence, and the associated factors at a Vietnamese tertiary hospital, serving as a reference for educational programs in other local and regional health care facilities. A randomly recruited cross-sectional study was conducted on patients using vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC). The primary and secondary outcomes were the knowledge score (in percent) and adherence to oral anticoagulants. Student's t-tests or chi-squared tests were used to compare the crude differences in mean or proportion between patients taking VKA and DOAC. Regression models were conducted to adjust the potential confounders and determine factors associated with patient knowledge and adherence. A total of 199 patients were included. After adjusting for potential confounders, patients receiving a DOAC had similar knowledge scores and levels of adherence compared with those taking VKA, with both groups being suboptimal. Previous counseling was associated with higher knowledge. Better medication knowledge, female sex, and no history of venous thromboembolism were associated with better adherence. Good knowledge and adherence of oral anticoagulant-taking patients remain limited in Southeast Asian clinical practice. Further studies in similar settings should examine the associations between these factors and the effectiveness of the regimens. More effective measures targeting patient knowledge and adherence should be implemented to optimize anticoagulation therapy, improve the patients' outcomes, and mitigate the associated adverse effects.

Background: Knowledge, attitude, and practice of Adverse Drug Reactions (ADRs) and ADRs reporting among healthcare workers were related to the quality and ADRs reporting rate. The aim of this study was to evaluate the effectiveness of the multifaceted interventions on knowledge, attitude, and practice (KAP) of healthcare workers and to compare the proportion of spontaneous ADRs reports at the study center, before and after instituting multifaceted interventions.Methods: A comparative intervention study was conducted among healthcare workers at the hospital. The participants were asked to complete a questionnaire before and after instituting the multifaceted interventions to assess the KAP of ADRs and their reporting. The impact of the multifaceted interventions was assessed by comparing their correct responses to the KAP questions and the proportion of spontaneous ADRs reports before and after the interventions. The pre- and post-intervention scores for KAP questions were compared usingMcNemar test by R Language.Results: 388 healthcare workers completed the study. The proportion of participants qualified for ADRs reporting increased significantly, from 73.5% (pre–intervention) to 99.2% (post–intervention) for knowledge scores, from 70.6% to 91.8% for attitude scores, and from 81.4% to 97.2% for practice scores (p < 0.001). Similarly, the number of spontaneous ADRs reports increased by 31% after 3 months of interventions.Conclusion: Multifaceted interventions instituted at the study center improved the knowledge, attitude, and practice of health workers towards ADRs and spontaneous reporting. It would be beneficial to implement such interventions in other hospitals in Vietnam.

Evidence on the prevalence of HLA-B*58:01 genotyping and its association with allopurinol-induced severe cutaneous adverse reactions (SCARs) is lacking, especially in low-resource settings. We addressed these gaps by conducting comprehensive and race/ethnic origin-specific evaluations. We conducted a systematic search from inception to 31 December 2022 using databases (PubMed, Embase, and medRxiv), Google (for Vietnamese articles), and manual searching. We included original studies that investigated the association between HLA-B*58:01 genotyping and allopurinol-induced SCARs. We excluded studies on: (1) animals; (2) pharmacokinetics/pharmacodynamics; (3) genetic markers or genetic testing methods; (4) single group; and (5) cost-effectiveness of screening. Risk of bias was assessed using Newcastle–Ottawa Scale. We used random-effects model to report the summary estimates and 95% confidence interval (95% CI) in the meta-analysis. We included 13,719 patients from 24 case–control studies. The prevalences of HLA-B*58:01 genotyping (overall 5.8%; 95% CI 2.9% to 11.5%; I² = 98%) varied by races (Asian [7.7%; 95% CI 3.4% to 16.8%; I² = 98%] and White in Eastern/Western Europe [2.3%; 95% CI 1.2% to 4.3%; I² = 86%]) and ethnic origins (East and Central Asia [5.5%; 95% CI 1.5% to 17.8%; I² = 98%] and South and Southeast Asia [12.9%; 95% CI 9.5% to 17.3%; I² = 79%]). HLA-B*58:01 genotyping was associated with substantially increasing risk of allopurinol-induced SCARs (odds ratio 117.6; 95% CI 70.3 to 196.8; I² = 45%) regardless of the subgroups. We found a higher prevalence of HLA-B*58:01 genotyping in some Asian populations compared with the Whites. There is evidence to confirm a strong association between this allele and allopurinol-induced SCARs.

Candida auris (C. auris), a globally emerging pathogen, has posed a significant threat to hospitalized individuals during the COVID-19 in Vietnam. This case series reported (1) common patterns in five patients with non-multidrug-resistant C. auris infections (multiple comorbidities, severe-to-critical illness, use of broad-spectrum antibiotics, or history of surgery/invasive procedures) and (2) high rate of C. auris-associated mortality in this medical setting (four deaths out of five cases). Further studies are needed to (1) identify risk factors for C. auris infections and mortality and (2) investigate the effects of screening and preventive measures for C. auris, especially in low-resource settings.