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PtII based organometallic photosensitizers (PSs) have emerged as novel potent photodynamic inactivation (PDI) reagents through their enhanced intersystem crossing (ISC) processes. Currently, few PtII PSs have been investigated as antibacterial materials, with relatively poor performances reported and with structure-activity relationships not well described. Herein, a pair of configurational isomers are reported of Bis-BODIPY (4,4-difluoro-boradizaindacene) embedded PtII PSs. The cis-isomer (cis-BBP) displayed enhanced 1O2 generation and better bacterial membrane anchoring capability as compared to the trans-isomer (trans-BBP). The effective PDI concentrations (efficiency > 99.9%) for cis-BBP in Acinetobacter baumannii (multi-drug resistant (MDR)) and Staphylococcus aureus are 400 nM (12 J cm−2) and 100 nM (18 J cm−2), respectively; corresponding concentrations and light doses for trans-BBP in the two bacteria are 2.50 µM (30 J cm−2) and 1.50 µM (18 J cm−2), respectively. The 50% and 90% minimum inhibitory concentration (MIC50 and MIC90) ratio of trans-BBP to cis-BBP is 22.22 and 24.02 in A. baumannii (MDR); 21.29 and 22.36 in methicillin resistant S. aureus (MRSA), respectively. Furthermore, cis-BBP displays superior in vivo antibacterial performance, with acceptable dark and photoinduced cytotoxicity. These results demonstrate cis-BBP is a robust light-assisted antibacterial reagent at sub-micromolecular concentrations. More importantly, configuration of PtII PSs should be an important issue to be considered in further PDI reagents design.

Background: Tularemia is an important re-emerging disease with a multimodal transmission-pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden.

Methods: Data from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011-2021 were collected through review of electronic medical records and participant questionnaires; with 415 out of 784 accepting participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or PCR). A multivariable logistic regression model was used to investigate variables associated with re-treatment.

Results: Median age of participants was 54 years (IQR 41.5-65) and 49.2% were female. While ulceroglandular tularemia was the predominant form (n=215, 65.7%), there were several cases of pulmonary tularemia (n=40; 12.2%). Inflammatory markers were largely non-specific, with monocytosis frequently observed (n=36/75; 48%). Tularemia was often misdiagnosed upon presentation (n=158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics, and 102 (31.2%) re-treated. Persistent lymphadenopathy was infrequent (n=22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with re-treatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR 3.25-20.75] vs. 7 [IQR 4-11.25] days; adjusted p=0.076), and doxycycline-based treatment regimen (vs. ciprofloxacin; adjusted p=0.084), although not significant after correction for multiple comparisons.

Conclusion: We comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis and timely commencement of treatment for an appropriate duration.

Background: Young women and adolescent girls (15-30years) are disproportionately affected by discrimination, sexual violence, unplanned pregnancy, and gender-based violence; even more so when they are at the intersection of multiple stigmatized identities. Nevertheless, sexual and reproductive health rights (SRH-R) services are often inaccessible due to costs, as well as lack of awareness and sensitivity by service providers. This study explored the impact of the COVID-19 pandemic and how civil society organizations and communities adapted to provide SRHR services to young women in Lebanon, Guatemala, Mozambique, Uganda and Nigeria.

Methods: Data was collected electronically by a team of 11 young female researchers and advocates from 5 different countries using the KoboCollect toolkit between October and December, 2022. A mixed methods approach with surveys and interviews was used to investigate the lived experiences and perspectives of 227 young women identified primarily from existing networks and through chain-referral sampling. Targeted populations were young women and girls: living with HIV; identifying as lesbian, bisexual, transgender, and/or intersex (LBTI); affected by displacement; and/or living with disabilities. Both in-person and virtual interviews due to COVID-19 disruptions were conducted.

Results: Several respondents (35%) were directly involved in implementing SRHR advocacy actions in their communities. A third (33%) of respondents described barriers inaccessing SRHR services, including stigmatization for being sexually active. In particular, young women with disabilities and young LBTI women faced discriminatory attitudes from health care professionals. The fear of contracting COVID-19 coupled with lockdown measures (including lack of transportation and diversion of resources) kept young women away from seeking SRHR services and left nearly half (46%) feeling the pandemic worsened accessing healthcare. Difficulty access-ing contraceptives during the pandemic and associated unplanned pregnancies was identified as a key barrier among 65% of respondents. Notably, sensitive counselling and cervical cancer screening was the least accessed SRHR services in all the included countries.

Conclusions: Our findings show that there is an ongoing need for joint initiatives to address a range of issues surrounding the current advocacy efforts around SRHR in order to attain high standards of health, and ensure equality, non-discrimination, privacy, and confidentiality for young women and girls.