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BMC Infectious Diseases, 24.04.2024
Tilføjet 24.04.2024
Abstract Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, necessitating the administration of polymyxin E (colistin) as a last-line antibiotic. Meanwhile, the mortality rate associated with colistin-resistant K. pneumoniae infections is seriously increasing. On the other hand, importance of administration of carbapenems in promoting colistin resistance in K. pneumoniae is unknown. Case presentation We report a case of K. pneumoniae-related pyogenic liver abscess in which susceptible K. pneumoniae transformed into carbapenem- and colistin-resistant K. pneumoniae during treatment with imipenem. The case of pyogenic liver abscess was a 50-year-old man with diabetes and liver transplant who was admitted to Abu Ali Sina Hospital in Shiraz. The K. pneumoniae isolate responsible for community-acquired pyogenic liver abscess was isolated and identified. The K. pneumoniae isolate was sensitive to all tested antibiotics except ampicillin in the antimicrobial susceptibility test and was identified as a non-K1/K2 classical K. pneumoniae (cKp) strain. Multilocus sequence typing (MLST) identified the isolate as sequence type 54 (ST54). Based on the patient’s request, he was discharged to continue treatment at another center. After two months, he was readmitted due to fever and progressive constitutional symptoms. During treatment with imipenem, the strain acquired blaOXA−48 and showed resistance to carbapenems and was identified as a multidrug resistant (MDR) strain. The minimum inhibitory concentration (MIC) test for colistin was performed by broth microdilution method and the strain was sensitive to colistin (MIC
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.04.2024
Tilføjet 24.04.2024
Abstract Background The problem of resistance to beta-lactam antibiotics, which is caused by ESBL and AmpC β-lactamases, is getting worse globally. Infections caused by bacterial isolates harboring these enzymes are difficult to treat with carbapenems being the sole effective treatment option for such infections. The objective of this study was to determine the frequency of ESBLs and AmpC-producing Gram-negative bacilli isolated from clinical specimens and to evaluate the sensitivity of cefepime-tazobactam combination against them. Methods This is an observational cross-sectional study carried out on 100 Gram-negative bacilli at Theodor Bilharz Research Institute Hospital during the period from February 2015 to January 2016. ESBL production was screened by using the disc diffusion test followed by confirmation by the combined disc confirmatory test, the screening for AmpC production was conducted using the cefoxitin disc test, which was subsequently confirmed by the AmpC disc test. Isolates confirmed positive for ESBL and/ or AmpC production were investigated for their susceptibility to antibiotics. Results Among 100 Gram-negative bacilli, 44 isolates were confirmed as ESBL producers by the combined disc confirmatory test out of 56 isolates that tested positive for ESBL production through the disc diffusion test. The presence of AmpC production was assessed using the cefoxitin disc test, 32 isolates were screened to be AmpC producers, and the AmpC disc test confirmed AmpC production in 9 isolates of them. Using the Mast® D68C set, 32 isolates were ESBL producers, 3 were AmpC producers, and 4 isolates were ESBL/AmpC co-producers. The highest sensitivity was to cefepime-tazobactam (91.48%) followed by the carbapenems. Conclusion Cefepime-tazobactam showed remarkable activity against ESBL and/or AmpC-producing Gram-negative bacilli and may be considered as a therapeutic alternative to carbapenems.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.04.2024
Tilføjet 24.04.2024
Abstract Background Influenza-like illness (ILI) imposes a significant burden on patients, employers and society. However, there is no analysis and prediction at the hospital level in Chongqing. We aimed to characterize the seasonality of ILI, examine age heterogeneity in visits, and predict ILI peaks and assess whether they affect hospital operations. Methods The multiplicative decomposition model was employed to decompose the trend and seasonality of ILI, and the Seasonal Auto-Regressive Integrated Moving Average with exogenous factors (SARIMAX) model was used for the trend and short-term prediction of ILI. We used Grid Search and Akaike information criterion (AIC) to calibrate and verify the optimal hyperparameters, and verified the residuals of the multiplicative decomposition and SARIMAX model, which are both white noise. Results During the 12-year study period, ILI showed a continuous upward trend, peaking in winter (Dec. - Jan.) and a small spike in May-June in the 2–4-year-old high-risk group for severe disease. The mean length of stay (LOS) in ILI peaked around summer (about Aug.), and the LOS in the 0–1 and ≥ 65 years old severely high-risk group was more irregular than the others. We found some anomalies in the predictive analysis of the test set, which were basically consistent with the dynamic zero-COVID policy at the time. Conclusion The ILI patient visits showed a clear cyclical and seasonal pattern. ILI prevention and control activities can be conducted seasonally on an annual basis, and age heterogeneity should be considered in the health resource planning. Targeted immunization policies are essential to mitigate potential pandemic threats. The SARIMAX model has good short-term forecasting ability and accuracy. It can help explore the epidemiological characteristics of ILI and provide an early warning and decision-making basis for the allocation of medical resources related to ILI visits.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.04.2024
Tilføjet 24.04.2024
Abstract Background Vaccination is effective in preventing viral respiratory infectious diseases through protective antibodies and the gut microbiome has been proven to regulate human immunity. This study explores the causal correlations between gut microbial features and serum-specific antiviral immunoglobulin G (IgG) levels. Methods We conduct a two-sample bidirectional Mendelian randomization (MR) analysis using genome-wide association study (GWAS) summary data to explore the causal relationships between 412 gut microbial features and four antiviral IgG (for influenza A, measles, rubella, and mumps) levels. To make the results more reliable, we used four robust methods and performed comprehensive sensitivity analyses. Results The MR analyses revealed 26, 13, 20, and 18 causal associations of the gut microbial features influencing four IgG levels separately. Interestingly, ten microbial features, like genus Collinsella, species Bifidobacterium longum, and the biosynthesis of L-alanine have shown the capacity to regulate multiple IgG levels with consistent direction (rise or fall). The reverse MR analysis suggested several potential causal associations of IgG levels affecting microbial features. Conclusions The human immune response against viral respiratory infectious diseases could be modulated by changing the abundance of gut microbes, which provided new approaches for the intervention of viral respiratory infections.
Læs mere Tjek på PubMedGuowei WangLianmei ZhongManxia WangJuan ZhouShuting LiuWang MiaoLeilei LiYonghong LiuShougang GuoHaining LiXiaoming WangLiuqing XieMin XieShihong FuTingting XuanFan LiTingting YangLufei ShaoMingfang ShiXiaocong LiXiaoling LiLi GaoShaopeng ZhaiJia DingTianhong WangDayong LiuGuosheng MaJiang WuDongjun WanJunlin GuoXinbo ZhangJinxia WuYinxu WangAnsong JinLei MaHuan YangXuexian HeXiaona MaHuijuan LiuBoya MaNingai YangXiaolin HouTing XuCheng-feng QinHuanyu WangPeng XieZhenhai Wanga The First Clinical Medical School, Ningxia Medical University, Yinchuan, People’s Republic of Chinab Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of Chinac Department of Neurology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of Chinad Guangzhou Women and Children’s Medical Center, Guangzhou, People’s Republic of Chinae Ningxia Medical University, Yinchuan, People’s Republic of Chinaf Neuro-Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of Chinag West China Hospital of Sichuan University, Chengdu, People’s Republic of Chinah Department of Neurology, Xijing Hospital, The Air Force Medical University, Xi’an, People’s Republic of Chinai Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of Chinaj Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of Chinak The Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of Chinal Meishan People’s Hospital, Meishan, People’s Republic of Chinam Chengdu Seventh People’s Hospital, Chengdu, People’s Republic of Chinan National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinao Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of Chinap Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, People’s Republic of Chinaq Department of Pediatrics, Yibin Hospital, Children's Hospital of Chongqing Medical University, Yibin, People’s Republic of Chinar Baoji Central Hospital, Baoji, People’s Republic of Chinas The First People’s Hospital of Tianshui, Tianshui, People’s Republic of Chinat The First Hospital of Lanzhou University, Lanzhou, People’s Republic of Chinau The Affiliated Hospital of Gansu Medical College, Pingliang, People’s Republic of Chinav Gansu Provincial People’s Hospital, Lanzhou, People’s Republic of Chinaw The First People’s Hospital of Longnan, Longnan, People’s Republic of Chinax The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou, People’s Republic of Chinay Qingyang People's Hospital, Qingyang, People’s Republic of Chinaz The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of Chinaaa Emergency Center, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of Chinaab Cerebrospinal Fluid Laboratory, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of Chinaac Department of Infectious Diseases, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of Chinaad General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of Chinaae State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of Chinaaf NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, Chongqing, People’s Republic of Chinaag Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
Emerg Microbes Infect, 23.04.2024
Tilføjet 23.04.2024
Mei Sun, Zhe Zhang, Jingjing Zhang, Juewei Zhang, Zhuqiang Jia, Lin Zhao, Xin Han, Xiaohong Sun, Junwei Zong, Ying Zhu, Shouyu Wang
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Mei Sun, Zhe Zhang, Jingjing Zhang, Juewei Zhang, Zhuqiang Jia, Lin Zhao, Xin Han, Xiaohong Sun, Junwei Zong, Ying Zhu, Shouyu Wang Background Previous observational studies have demonstrated a connection between the risk of Type 2 diabetes mellitus (T2DM) and gastrointestinal problems brought on by Helicobacter pylori (H. pylori) infection. However, little is understood about how these factors impact on T2DM. Method This study used data from the GWAS database on H. pylori antibodies, gastroduodenal ulcers, chronic gastritis, gastric cancer, T2DM and information on potential mediators: obesity, glycosylated hemoglobin (HbA1c) and blood glucose levels. Using univariate Mendelian randomization (MR) and multivariate MR (MVMR) analyses to evaluate the relationship between H. pylori and associated gastrointestinal diseases with the risk of developing of T2DM and explore the presence of mediators to ascertain the probable mechanisms. Results Genetic evidence suggests that H. pylori IgG antibody (P = 0.006, b = 0.0945, OR = 1.0995, 95% CI = 1.023–1.176), H. pylori GroEL antibody (P = 0.028, OR = 1.033, 95% CI = 1.004–1.064), gastroduodenal ulcers (P = 0.019, OR = 1.036, 95% CI = 1.006–1.068) and chronic gastritis (P = 0.005, OR = 1.042, 95% CI = 1.012–1.074) are all linked to an increased risk of T2DM, additionally, H. pylori IgG antibody is associated with obesity (P = 0.034, OR = 1.03, 95% CI = 1.002–1.055). The results of MVMR showed that the pathogenic relationship between H. pylori GroEL antibody and gastroduodenal ulcer in T2DM is mediated by blood glucose level and obesity, respectively. Conclusion Our study found that H. pylori IgG antibody, H. pylori GroEL antibody, gastroduodenal ulcer and chronic gastritis are all related to t T2DM, and blood glucose level and obesity mediate the development of H. pylori GroEL antibody and gastroduodenal ulcer on T2DM, respectively. These findings may inform new prevention and intervention strategies for T2DM.
Læs mere Tjek på PubMedLu Liu, Shuang He, Lin Jia, Hua Yao, Dan Zhou, Xiaobin Guo, Lei Miao
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Lu Liu, Shuang He, Lin Jia, Hua Yao, Dan Zhou, Xiaobin Guo, Lei Miao Objective The Toll-like receptor (TLR) 4-mediated nuclear factor kappa B (NF-κB) signaling pathway regulates the production of inflammatory factors and plays a key role in the pathogenesis of gouty arthritis. The aim of the present study was to investigate the link among TLR4 gene polymorphisms at various loci, protein expression, and gouty arthritis susceptibility. Methods Between 2016 and 2021, a case-control study was used to collect a total of 1207 study subjects, including 317 male patients with gouty arthritis (gout group) and 890 healthy males (control group). The association between gout susceptibility and different genetic models was analyzed by typing three loci of the TLR4 gene (rs2149356, rs2737191, and rs10759932) using a multiplex point mutation rapid assay, and the association between protein expression and gout was confirmed by measuring TLR4 protein concentrations using enzyme-linked immunosorbent assays (ELISAs). Results In a codominant models AA and AG, the rs2737191 polymorphism in the gout group increased the risk of gout compared to the AA genotype (OR = 2.249, 95%CI 1.010~5.008), and the risk of gout was higher for those carrying the G allele compared to the A allele (OR = 2.227, 95%CI 1.006~4.932). TLR4 protein expression was different between the two groups with different locus genotypes. The differences in TLR4 protein expression between the gout group and control group were statistically significant between the following genotypes: the GG and GT genotypes of the rs2149356 polymorphism; the AA and AG genotypes of the rs2737191 polymorphism; and the TT and TC genotypes of the rs10759932 polymorphism(P
Læs mere Tjek på PubMedHuayong Huang, Qiaoling Chang, Yanhui Zhou, Li Liao
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Huayong Huang, Qiaoling Chang, Yanhui Zhou, Li Liao Background Central catheter bloodstream infections (CRBSI) is a major cause of healthcare-associated infections. However, few factors are generally accepted and some studies have conflicting finding about some factors, possibly caused by limitation associated with an individual study. This study was to identify risk factors for CRBSI in intensive care units. Methods We searched the PubMed, Cochrane Library, Web of science and EMBASE databases and the 4 top Chinese-language databases, including WanFang data, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM) as of July 2023. Case control and cohort studies were included. Two authors independently screened the literature and evaluated the quality of the studies using the Newcastle-Ottawa scale (NOS). The pooled effect size was estimated using the odds ratio (OR), and the corresponding 95% confidence interval (CI) was calculated. The Cochrane Q (χ2) and I2 tests were used to assess heterogeneity among studies, and each risk factor was tested for its robustness using fixed- or random-effects models. Findings A total of 32 studies enrolled, among which eleven factors were identified, they were divided into two categories: modifiable and unmodifiable factors. Modifiable factors: duration of catheterization (≥ 5d) (OR: 2.07, 95%CI: 1.41–3.03), duration of catheterization (≥ 7d) (OR: 3.62, 95%CI: 2.65–4.97), duration of catheterization (≥ 14d)(OR: 4.85, 95%CI: 3.35–7.01), total parenteral nutrition (OR: 2.27,95%CI: 1.56–3.29), use of multiple-lumen catheters(OR: 3.41, 95%CI: 2.27–5.11), times of tube indwelling (OR: 3.50, 95%CI: 2.93–4.17), length of ICU stay (OR: 4.05, 95%CI: 2.41–6.80), the position of indwelling(OR: 2.41, 95%CI: 2.03–2.85); Unmodifiable factors: APACHEII scores (OR: 1.84, 95%CI: 1.54–2.20), Age≥ 60 years old (OR: 2.19, 95%CI: 1.76–2.73), the extensive use of antibiotic (OR: 3.54, 95%CI: 1.65–7.61), Diabetes mellitus (OR: 3.06, 95%CI: 2.56–3.66), Immunosuppression (OR: 2.87, 95%CI: 2.08–3.95). Conclusions Effective interventions targeting the above modifiable factors may reduce the risk of developing CRBSI in ICU and improve the clinical outcome of patients. Further prospective studies are needed to confirm these findings.
Læs mere Tjek på PubMedJuliana Elvira Herdy Guerra Avila, Levy Aniceto Santana, Denise Rabelo Suzuki, Vinícius Zacarias Maldaner da Silva, Marcio Luís Duarte, Aline Mizusaki Imoto, Fábio Ferreira Amorim
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Juliana Elvira Herdy Guerra Avila, Levy Aniceto Santana, Denise Rabelo Suzuki, Vinícius Zacarias Maldaner da Silva, Marcio Luís Duarte, Aline Mizusaki Imoto, Fábio Ferreira Amorim Introduction Burns are tissue traumas caused by energy transfer and occur with a variable inflammatory response. The consequences of burns represent a public health problem worldwide. Inhalation injury (II) is a severity factor when associated with burn, leading to a worse prognosis. Its treatment is complex and often involves invasive mechanical ventilation (IMV). The primary purpose of this study will be to assess the evidence regarding the frequency and mortality of II in burn patients. The secondary purposes will be to assess the evidence regarding the association between IIs and respiratory complications (pneumonia, airway obstruction, acute respiratory failure, acute respiratory distress syndrome), need for IMV and complications in other organ systems, and highlight factors associated with IIs in burn patients and prognostic factors associated with acute respiratory failure, need for IMV and mortality of II in burn patients. Methods This is a systematic literature review and meta-analysis, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). PubMed/MEDLINE, Embase, LILACS/VHL, Scopus, Web of Science, and CINAHL databases will be consulted without language restrictions and publication date. Studies presenting incomplete data and patients under 19 years of age will be excluded. Data will be synthesized through continuous (mean and standard deviation) and dichotomous (relative risk) variables and the total number of participants. The means, sample sizes, standard deviations from the mean, and relative risks will be entered into the Review Manager web analysis software (The Cochrane Collaboration). Discussion Despite the extensive experience managing IIs in burn patients, they still represent an important cause of morbidity and mortality. Diagnosis and accurate measurement of its damage are complex, and therapies are essentially based on supportive measures. Considering the challenge, their impact, and their potential severity, IIs represent a promising area for research, needing further studies to understand and contribute to its better evolution.The protocol of this review is registered on the International prospective register of systematic reviews platform of the Center for Revisions and Disclosure of the University of York, United Kingdom (https://www.crd.york.ac.uk/prospero), under number RD42022343944.
Læs mere Tjek på PubMedDaniel E. Jacobsen, Makaela M. Montoya, Trent R. Llewellyn, Kaitlyn Martinez, Kristen M. Wilding, Kiersten D. Lenz, Carrie A. Manore, Jessica Z. Kubicek-Sutherland, Harshini Mukundan
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Daniel E. Jacobsen, Makaela M. Montoya, Trent R. Llewellyn, Kaitlyn Martinez, Kristen M. Wilding, Kiersten D. Lenz, Carrie A. Manore, Jessica Z. Kubicek-Sutherland, Harshini Mukundan Universal and early recognition of pathogens occurs through recognition of evolutionarily conserved pathogen associated molecular patterns (PAMPs) by innate immune receptors and the consequent secretion of cytokines and chemokines. The intrinsic complexity of innate immune signaling and associated signal transduction challenges our ability to obtain physiologically relevant, reproducible and accurate data from experimental systems. One of the reasons for the discrepancy in observed data is the choice of measurement strategy. Immune signaling is regulated by the interplay between pathogen-derived molecules with host cells resulting in cellular expression changes. However, these cellular processes are often studied by the independent assessment of either the transcriptome or the proteome. Correlation between transcription and protein analysis is lacking in a variety of studies. In order to methodically evaluate the correlation between transcription and protein expression profiles associated with innate immune signaling, we measured cytokine and chemokine levels following exposure of human cells to the PAMP lipopolysaccharide (LPS) from the Gram-negative pathogen Pseudomonas aeruginosa. Expression of 84 messenger RNA (mRNA) transcripts and 69 proteins, including 35 overlapping targets, were measured in human lung epithelial cells. We evaluated 50 biological replicates to determine reproducibility of outcomes. Following pairwise normalization, 16 mRNA transcripts and 6 proteins were significantly upregulated following LPS exposure, while only five (CCL2, CSF3, CXCL5, CXCL8/IL8, and IL6) were upregulated in both transcriptomic and proteomic analysis. This lack of correlation between transcription and protein expression data may contribute to the discrepancy in the immune profiles reported in various studies. The use of multiomic assessments to achieve a systems-level understanding of immune signaling processes can result in the identification of host biomarker profiles for a variety of infectious diseases and facilitate countermeasure design and development.
Læs mere Tjek på PubMedSara Coelho Rangel, Michelly Damasceno da Silva, Décio Gilberto Natrielli Filho, Samuel Nascimento Santos, Jonatas Bussador do Amaral, Jefferson Russo Victor, Kevin Cezar Nascimento Silva, Izabela Dorota Tuleta, Carolina Nunes França, Marina Tiemi Shio, Lucas Melo Neves, André Luis Lacerda Bachi and Luiz Henrique da Silva Nali
Retrovirology, 23.04.2024
Tilføjet 23.04.2024
Bipolar disorder (BD) and schizophrenia (SZ) are the two main mental disorders with unknown etiology that significantly impact individuals’ quality of life. The potential pro-inflammatory role in their pathoge...
Læs mere Tjek på PubMedMalaria Journal, 23.04.2024
Tilføjet 23.04.2024
Journal of Medical Virology, 23.04.2024
Tilføjet 23.04.2024
Infection, 23.04.2024
Tilføjet 23.04.2024
Abstract Purpose Antibodies against SARS-CoV-2 spike (anti-S) may confer protection against symptomatic COVID-19. Whether their level predicts progression among those with COVID-19 pneumonia remains unclear. Methods We conducted a retrospective cohort study to assess predictors of anti-S levels and whether anti-S titer is associated with death or mechanical ventilation (MV). Adults hospitalized for COVID-19 pneumonia between July 2021 and July 2022 were enrolled if anti-S had been measured within 72 h of admission. Predictors of anti-S level were explored using multivariable quantile regression. The association between anti-S levels and 30-day death/MV was investigated via multivariable logistic regression. Analyses were stratified by vaccine status. Results The median anti-S level was 1370 BAU/ml in 328 vaccinated and 15.5 BAU/ml in 206 unvaccinated individuals. Among the vaccinated, shorter symptom duration (p = 0.001), hematological malignancies (p = 0.002), and immunosuppressive therapy (p = 0.004) were associated with lower anti-S levels. In the unvaccinated group, symptom duration was the only predictor of anti-S levels (p
Læs mere Tjek på PubMedInfection, 23.04.2024
Tilføjet 23.04.2024
Abstract Purpose A German multicentre study BLOOMY was the first to use machine learning approach to develop mortality prediction scores for bloodstream infection (BSI) patients, but the scores have not been assessed in other cohorts. Our aim was to assess how the BLOOMY 14-day and 6-month scores estimate mortality in our cohort of 497 cases with BSI. Methods Clinical data, laboratory data, and patient outcome were gathered retrospectively from patient records. The scores were calculated as presented in the BLOOMY study with the exception in the day of the evaluation. Results In our cohort, BLOOMY 14-day score estimated death by day 14 with an area under curve (AUC) of 0.87 (95% Confidence Interval 0.80–0.94). Using ≥ 6 points as a cutoff, sensitivity was 68.8%, specificity 88.1%, positive predictive value (PPV) 39.3%, and negative predictive value (NPV) 96.2%. These results were similar in the original BLOOMY cohort and outweighed both quick Sepsis-Related Organ Failure Assessment (AUC 0.76) and Pitt Bacteraemia Score (AUC 0.79) in our cohort. BLOOMY 6-month score to estimate 6-month mortality had an AUC of 0.79 (0.73–0.85). Using ≥ 6 points as a cutoff, sensitivity was 98.3%, specificity 10.7%, PPV 25.7%, and NPV 95.2%. AUCs of 6-month score to estimate 1-year and 5-year mortality were 0.80 (0.74–0.85) and 0.77 (0.73–0.82), respectively. Conclusion The BLOOMY 14-day and 6-month scores performed well in the estimations of mortality in our cohort and exceeded some established scores, but their adoption in clinical work remains to be seen.
Læs mere Tjek på PubMedInfection, 23.04.2024
Tilføjet 23.04.2024
Abstract Purpose Physicians may administer Nirmatrelvir-ritonavir to patients who have been symptomatic for more than 5 days. There is currently no clear evidence to support this approach. Methods A real-world study was conducted to investigate the potential relationship between the administration of Nirmatrelvir-ritonavir and the rates of intubation or in-hospital mortality among COVID-19 patients who experienced symptoms for more than 5 days. The end point was a composite event of intubation or in-hospital mortality. The outcomes between those patients who received Nirmatrelvir-ritonavir and those who did not were compared. Results A total of 847 patients were included in the analysis. Among them, 312 patients (36.84%) received Nirmatrelvir-ritonavir. Within the entire population, 86 patients (10.15%) experienced intubation or in-hospital mortality. The main analysis indicated that there was a significant association between the application of Nirmatrelvir-ritonavir and intubation or in-hospital mortality, with an odds ratio of 0.50 (95% confidence interval, 0.28 to 0.87; P = 0.0153) using inverse probability of treatment weighting. The finding was consistent with multiple sensitivity analyses. Conclusions The application of Nirmatrelvir-ritonavir was associated with a significantly reduced risk of intubation or death in hospitalized COVID-19 patients who experienced symptoms for more than 5 days as compared to those who did not receive the treatment.
Læs mere Tjek på PubMedCélia BernardYi LiuGérald Larrouy-MaumusChristophe GuilhotKaymeuang CamChristian Chalut1Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, Université Toulouse III - Paul Sabatier (UT3), Toulouse, France2Faculty of Natural Sciences, Department of Life Sciences, Centre for Bacterial Resistance Biology, Imperial College London, London, United Kingdom, Sean Wasserman
Antimicrobial Agents And Chemotherapy, 23.04.2024
Tilføjet 23.04.2024
Patricia Monzó-Gallo, Carlos Lopera, Ana M Badía-Tejero, Marina Machado, Julio García-Rodríguez, Pablo Vidal-Cortés, Esperanza Merino, Jorge Calderón, Jesús Fortún, Zaira R. Palacios-Baena, Javier Pemán, Joan Roig Sanchis, Manuela Aguilar-Guisado, Carlota Gudiol, Juan C Ramos, Isabel Sánchez-Romero, Pilar Martin-Davila, Luis E. López-Cortés, Miguel Salavert, Isabel Ruiz-Camps, Mariana Chumbita, Tommaso Francesco Aiello, Olivier Peyrony, Pedro Puerta-Alcalde, Alex Soriano, Francesc Marco, Carolina Garcia-Vidal
International Journal of Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
There is a notable change in the profile of patients with invasive fungal infections (IFI): there has been a progressive rise of such infections in non-neutropenic population (i.e., COVID-19, influenza, biologic agents, corticosteroids, cancer, chronic obstructive pulmonary disorder [COPD] or cirrhosis) [1–3]. However, information concerning the management of non-neutropenic patients with IFI remains limited. Caution should be exercised before these patients are treated like those who are neutropenic, given a considerable variability in pathogenesis and clinical manifestations of IFI [4].
Læs mere Tjek på PubMedThomas Theo rehm, Maja Reimann, Niklas Köhler, Christoph Lange
Clinical Microbiology and Infection, 23.04.2024
Tilføjet 23.04.2024
Tuberculosis (TB) is a common complication associated with treatment with tumor necrosis factor (TNF) antagonists and Janus kinase (JAK) inhibitors. However, there is uncertainty about the risk of TB relapse in patients with TB and comorbidities requiring treatment with these agents.
Læs mere Tjek på PubMedYibeltal, K., Workneh, F., Melesse, H., Wolde, H., Kidane, W. T., Berhane, Y., Herzig van Wees, S.
BMJ Open, 23.04.2024
Tilføjet 23.04.2024
ObjectiveThis study explored faith leaders’ perspectives on the COVID-19 vaccine and their role in building COVID-19 vaccine trust in Addis Ababa, Ethiopia. DesignA qualitative study with in-depth interviews and thematic analysis was conducted. ParticipantsTwenty-one faith leaders from the seven religious groups represented in the Inter-Religious Council of Ethiopia participated in the study. SettingThe study was conducted in Addis Ababa, Ethiopia. ResultsThe thematic analysis revealed three themes. First, faith leaders were aware of the risks of the COVID-19 pandemic, although most ascribed a spiritual meaning to the advent of the pandemic. The pandemic seriously affected the faith communities, inflicting financial losses. Second, faith leaders were essential allies during the pandemic by effectively collaborating with government and health professionals in COVID-19 prevention activities and public health interventions using spiritual reasoning. They were actively informing the community about the importance of the COVID-19 vaccine, where many faith leaders were publicly vaccinated to build trust in the vaccine and act as role models. Third, despite this, they faced multiple questions from the congregation about the vaccine, including rumours. ConclusionsThis research showed that faith leaders played crucial roles in encouraging vaccine use but were limited in their persuasion power because of intense rumours and misinformation. Empowering faith leaders with the latest vaccine evidence needs to be prioritised in the future.
Læs mere Tjek på PubMedThomas-Rüddel, D., Bauer, M., Moita, L. F., Helbig, C., Schlattmann, P., Ehler, J., Rahmel, T., Meybohm, P., Gründling, M., Schenk, H., Köcher, T., Brunkhorst, F. M., Gräler, M., Heger, A.-J., Weis, S., EPOS-1 study group, SepNetCriticalCare TrialsGroup, Bloos, Dlubatz, Hagel, Hammersen, Lehmann, Leonhardt, Markgraf, Michael, Rissner, Röstel, Roth, Schumacher, Schwarze, Städtler, Vivas-Varela, Fuchs, Greinacher, Kuhn, Hagedorn, Unterberg, Wittkowski, Rumpf, Haas, Helmer, Hottenrott, Kranke, Kranke, Neuf, Reppchen, Röder, Schmidt
BMJ Open, 23.04.2024
Tilføjet 23.04.2024
IntroductionSepsis remains the major cause of death among hospitalised patients in intensive care. While targeting sepsis-causing pathogens with source control or antimicrobials has had a dramatic impact on morbidity and mortality of sepsis patients, this strategy remains insufficient for about one-third of the affected individuals who succumb. Pharmacological targeting of mechanisms that reduce sepsis-defining organ dysfunction may be beneficial. When given at low doses, the anthracycline epirubicin promotes tissue damage control and lessens the severity of sepsis independently of the host–pathogen load by conferring disease tolerance to infection. Since epirubicin at higher doses can be myelotoxic, a first dose–response trial is necessary to assess the potential harm of this drug in this new indication. Methods and analysisEpirubicin for the Treatment of Sepsis and Septic Shock-1 is a randomised, double-blind, placebo-controlled phase 2 dose-escalation phase IIa clinical trial to assess the safety of epirubicin as an adjunctive in patients with sepsis. The primary endpoint is the 14-day myelotoxicity. Secondary and explorative outcomes include 30-day and 90-day mortality, organ dysfunction, pharmacokinetic/pharmacodynamic (PK/PD) and cytokine release. Patients will be randomised in three consecutive phases. For each study phase, patients are randomised to one of the two study arms (epirubicin or placebo) in a 4:1 ratio. Approximately 45 patients will be recruited. Patients in the epirubicin group will receive a single dose of epirubicin (3.75, 7.5 or 15 mg/m2 depending on the study phase. After each study phase, a data and safety monitoring board will recommend continuation or premature stopping of the trial. The primary analyses for each dose level will report the proportion of myelotoxicity together with a 95% CI. A potential dose-toxicity association will be analysed using a logistic regression model with dose as a covariate. All further analyses will be descriptive. Ethics and disseminationThe protocol is approved by the German Federal Institute for Drugs and Medical Devices. The results will be submitted for publication in peer-reviewed journals. Trial registration number NCT05033808.
Læs mere Tjek på PubMedSilverthorne, C. A., Jones, B., Brooke, M., Coates, L. C., Orme, J., Robson, J. C., Tillett, W., Dures, E.
BMJ Open, 23.04.2024
Tilføjet 23.04.2024
ObjectiveMany clinically extremely vulnerable rheumatology patients have only recently ceased shielding from COVID-19, while some continue to minimise in-person contact. The objective of this study was to understand the impact of shielding and associated support needs in patients with rheumatic conditions and to understand how rheumatology teams can meet these needs both currently and in future pandemics. Design, participants and settingThe study was conducted in the Southwest of England using a case-study design. The participants were 15 patients with rheumatic conditions who were advised to shield and/or chose to shield at any time during the COVID-19 pandemic. MethodsQualitative data collected via telephone and online semi-structured interviews and analysed using reflexive thematic analysis. ResultsFifteen interviews were conducted. Three main themes represent the data: ‘Just shove them over there in the corner’ captures changes in patients’ self-perception. They felt different to most other people, vulnerable and left behind. The initial sense of shock was followed by a sense of loss as changes became long term. ‘A long and lonely road’ captures patients’ psychological isolation due to a perceived lack of understanding and support. This included having to prove their health status and justify their shielding behaviours, which impacted their relationships. At times, they felt abandoned by their healthcare providers. ‘You can’t just flip a switch’ captures the difficulty of getting back to pre-pandemic normal after shielding. Patients did not recognise themselves physically and mentally. They wanted to collaborate with health professionals and identified the need for specific guidance to support their recovery. ConclusionPatients are dealing with lasting physical and mental effects from shielding and consequences of delayed healthcare. Health professionals need time and resources to ask about patients’ well-being, identify their health needs and refer/signpost to appropriate sources of support.
Læs mere Tjek på PubMedMay, F., Ginige, S., Firman, E., Li, Y. S., Soonarane, Y. K., Smoll, N., Hunter, I., Pery, B., Macfarlane, B., Bladen, T., Allen, T., Green, T., Walker, J., Slinko, V., Stickley, M., Khandaker, G., Anuradha, S., Wattiaux, A.
BMJ Open, 23.04.2024
Tilføjet 23.04.2024
ObjectiveThe 2022 Australian winter was the first time that COVID-19, influenza and respiratory syncytial virus (RSV) were circulating in the population together, after two winters of physical distancing, quarantine and borders closed to international travellers. We developed a novel surveillance system to estimate the incidence of COVID-19, influenza and RSV in three regions of Queensland, Australia. DesignWe implemented a longitudinal testing-based sentinel surveillance programme. Participants were provided with self-collection nasal swabs to be dropped off at a safe location at their workplace each week. Swabs were tested for SARS-CoV-2 by PCR. Symptomatic participants attended COVID-19 respiratory clinics to be tested by multiplex PCR for SARS-CoV-2, influenza A and B and RSV. Rapid antigen test (RAT) results reported by participants were included in the analysis. Setting and participantsBetween 4 April 2022 and 3 October 2022, 578 adults were recruited via their workplace. Due to rolling recruitment, withdrawals and completion due to positive COVID-19 results, the maximum number enrolled in any week was 423 people. ResultsA total of 4290 tests were included. Participation rates varied across the period ranging from 25.9% to 72.1% of enrolled participants. The total positivity of COVID-19 was 3.3%, with few influenza or RSV cases detected. Widespread use of RAT may have resulted in few symptomatic participants attending respiratory clinics. The weekly positivity rate of SARS-CoV-2 detected during the programme correlated with the incidence of notified cases in the corresponding communities. ConclusionThis testing-based surveillance programme could estimate disease trends and be a useful tool in settings where testing is less common or accessible. Difficulties with recruitment meant the study was underpowered. The frontline sentinel nature of workplaces meant participants were not representative of the general population but were high-risk groups providing early warning of disease.
Læs mere Tjek på PubMedCole, S. W., Glick, J. L., Campoamor, N. B., Sanchez, T. H., Sarkar, S., Vannappagari, V., Rinehart, A., Rawlings, K., Sullivan, P. S., Bridges, J. F. P.
BMJ Open, 23.04.2024
Tilføjet 23.04.2024
IntroductionCabotegravir long-acting injectable HIV pre-exposure prophylaxis (LA-PrEP) was shown to be safe and effective in multiple clinical trials. Increasing uptake and persistence among populations with elevated risk for HIV acquisition, especially among men who have sex with men (MSM), is critical to HIV prevention. ObjectiveThis analysis aims to understand potential users’ preferences for LA-PrEP, with audience segmentation. DesignWillingness to use and preferences for LA-PrEP were measured in HIV-negative, sexually active MSM in the 2020 American Men’s Internet Survey. Respondents answered a discrete choice experiment with paired profiles of hypothetical LA-PrEP characteristics with an opt-out option (no LA-PrEP). Conditional and mixed logit models were run; the final model was a dummy-coded mixed logit that interacted with the opt-out. SettingUS national online sample. ResultsAmong 2506 MSM respondents, most (75%) indicated a willingness to use LA-PrEP versus daily oral PrEP versus no PrEP. Respondents were averse to side effects and increasing costs and preferred increasing levels of protection. Respondents preferred a 2-hour time to obtain LA-PrEP vs 1 hour, with a strong aversion to 3 hours. Overall, there was an aversion to opting out of LA-PrEP, with variations: those with only one partner, no/other insurance or who were Black, Indigenous or People of Colour were significantly less likely to prefer LA-PrEP, while those who were Hispanic/Latino, college educated and
Læs mere Tjek på PubMedTianyang MaoJooyoung KimMario A. Peña-HernándezGabrielee ValleMiyu MoriyamaSophia LuytenIsabel M. OttMaria Luisa Gomez-CalvoJeff R GehlhausenEmily BakerBenjamin IsraelowMartin SladeLokesh SharmaWei LiuChangwan RyuAsawari KordeChris J. LeeValter Silva MonteiroCarolina LucasHuiping DongYi YangSmita GopinathCraig B. WilenNoah PalmCharles S. Dela CruzAkiko IwasakiaDepartment of Immunobiology, Yale University School of Medicine, New Haven, CT 06510bDepartment of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT 06510cDivision of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh PA 15213dDepartment of Microbial Pathogenesis, Yale University School of Medicine, New Haven CT 06510eDepartment of Dermatology, Yale University School of Medicine, New Haven, CT 06510fDepartment of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06510gDepartment of Internal Medicine, Section of Occupational Medicine, Yale University School of Medicine, New Haven, CT 06510hDepartment of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115iDepartment of Laboratory Medicine, Yale University School of Medicine, New Haven, CT 06510jVeterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15240kCenter for Infection and Immunity, Yale University School of Medicine, New Haven, CT 06510lHHMI, Chevy Chase, MD 20815, Chantal B. F. VogelsAnne M. HahnNicholas F. G. ChenMallery BrebanTobias R KochChrispin ChaguzaIrina TikhonovaChristopher CastaldiShrikant ManeBony De KumarDavid FergusonNicholas KerantzasDavid PeaperMarie L LandryWade SchulzNathan Grubaugh
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 23.04.2024
Tilføjet 23.04.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 18, April 2024.
Læs mere Tjek på PubMedStephanie E AnderM Guston ParksBennett J DavenportFrances S LiAngela Bosco-LauthKathryn S CarpentierChengqun SunCormac J LucasWilliam B KlimstraGregory D EbelThomas E Morrison, Hidde Ploegh
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 23.04.2024
Tilføjet 23.04.2024
FEMS Microbiology Reviews, 23.04.2024
Tilføjet 23.04.2024
Abstract The number of research papers published on the involvement of the oral microbiota in systemic diseases has grown exponentially over the last four years clearly demonstrating the growing interest in this field. Indeed, accumulating evidence highlights the central role of ectopic colonization by oral bacteria in numerous non-communicable diseases including inflammatory bowel diseases (IBDs), undernutrition, pre-term birth, neurological diseases, liver diseases, lung diseases, heart diseases or colonic cancer. There is thus much interest in understanding the molecular mechanisms that lead to the colonization and maintenance of ectopic oral bacteria. The aim of this review is to summarize and conceptualize the current knowledge about ectopic colonization by oral bacteria, highlight wherever possible the underlying molecular mechanisms and describe its implication in health and disease. The focus lies on the newly discovered molecular mechanisms, showcasing shared pathophysiological mechanisms across different body sites and syndromes and highlighting open questions in the field regarding the pathway from oral microbiota dysbiosis to non-communicable diseases.
Læs mere Tjek på PubMedSarah Nascimento Silva, Glaucia Cota, Kathiaja Miranda Souza, Marina Gonçalves de Freitas, Janaína de Pina de Carvalho, Endi Lanza Galvão
Tropical Medicine & International Health, 23.04.2024
Tilføjet 23.04.2024
BMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background This cross-sectional study investigates infection prevention and control (IPC) competencies among healthcare professionals in northwest China, examining the influence of demographic factors, job titles, education, work experience, and hospital levels. Methods Data from 874 respondents across 47 hospitals were collected through surveys assessing 16 major IPC domains. Statistical analyses, including Mann-Whitney tests, were employed to compare competencies across variables. Results Significant differences were identified based on gender, job titles, education, work experience, and hospital levels. Females demonstrated higher IPC competencies, while senior positions exhibited superior performance. Higher educational attainment and prolonged work experience positively correlated with enhanced competencies. Variances across hospital levels underscored context-specific competencies. Conclusion Demographic factors and professional variables significantly shape IPC competencies. Tailored training, considering gender differences and job roles, is crucial. Higher education and prolonged work experience positively impact proficiency. Context-specific interventions are essential for diverse hospital settings, informing strategies to enhance IPC skills and mitigate healthcare-associated infections effectively.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Group B streptococci (Streptococcus agalactiae) (GBS) is a rare cause of prosthetic joint infection (PJI) occurring in patients with comorbidities and seems to be associated with a poor outcome. Depiction of GBS PJI is scarce in the literature. Methods A retrospective survey in 2 referral centers for bone joint infections was done Patients with a history of PJI associated with GBS between 2014 and 2019 were included. A descriptive analysis of treatment failure was done. Risk factors of treatment failure were assessed. Results We included 61 patients. Among them, 41 had monomicrobial (67%) infections. The median duration of follow-up was 2 years (interquartile range 2.35) Hypertension, obesity, and diabetes mellitus were the most reported comorbidities (49%, 50%, and 36% respectively). Death was observed in 6 individuals (10%) during the initial management. The rate of success was 63% (26/41). Removal of the material was not associated with remission (p = 0.5). We did not find a specific antibiotic regimen associated with a better outcome. Conclusion The results show that S. agalactiae PJIs are associated with high rates of comorbidities and a high treatment failure rate with no optimal treatment so far.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background There are few thorough studies assessing predictors of severe encephalitis, despite the poor prognosis and high mortality associated with severe encephalitis. The study aims to evaluate the clinical predictors of mortality and poor outcomes at hospital discharge in patients with severe infectious encephalitis in intensive care units. Method In two Chinese hospitals, a retrospective cohort study comprising 209 patients in intensive care units suffering from severe infectious encephalitis was carried out. Univariate and multivariate logistic regression analyses were used to identify the factors predicting mortality in all patients and poor outcomes in all survivors with severe infectious encephalitis. Results In our cohort of 209 patients with severe encephalitis, 22 patients died, yielding a mortality rate of 10.5%. Cerebrospinal fluid pressure ≥ 400mmH2O (OR = 7.43), abnormal imaging (OR = 3.51), abnormal electroencephalogram (OR = 7.14), and number of rescues (OR = 1.12) were significantly associated with an increased risk of mortality in severe infectious encephalitis patients. Among the 187 survivors, 122 (65.2%) had favorable outcomes, defined as the modified Rankine Scale (mRS) score (0 ~ 3), and 65(34.8%) had poor outcomes (mRS scores 4 ~ 5). Age (OR = 1.02), number of rescues (OR = 1.43), and tubercular infection (OR = 10.77) were independent factors associated with poor outcomes at discharge in all survivors with severe infectious encephalitis. Conclusions Multiple clinical, radiologic, and electrophysiological variables are independent predictive indicators for mortality and poor outcomes in patients with severe encephalitis in intensive care units. Identifying these outcome predictors early in patients with severe encephalitis may enable the implementation of appropriate medical treatment and help reduce mortality rates.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Adenovirus (ADV) is a prevalent infective virus in children, accounting for around 5–10% of all cases of acute respiratory illnesses and 4–15% of pneumonia cases in children younger than five years old. Without treatment, severe ADV pneumonia could result in fatality rates of over 50% in cases of emerging strains or disseminated disease. This study aims to uncover the relationship of clinical indicators with primary ADV infection severity, regarding duration of hospitalization and liver injury. Methods In this retrospective study, we collected and analyzed the medical records of 1151 in-patients who met the inclusion and exclusion criteria. According to duration of hospitalization, all patients were divided into three groups. Then the difference and correlation of clinical indicators with ADV infection were analyzed, and the relationship among liver injury, immune cells and cytokines was evaluated. Results The study revealed that patients with a duration of hospitalization exceeding 14 days had the highest percentage of abnormalities across most indicators. This was in contrast to the patients with a hospitalization duration of either less than or equal to 7 days or between 7 and 14 days. Furthermore, correlation analysis indicated that a longer duration of body temperature of ≥ 39°C, bilateral lung lobes infiltration detected by X ray, abnormal levels of AST, PaO2, and SPO2, and a lower age were all predictive of longer hospital stays. Furthermore, an elevated AST level and reduced liver synthesis capacity were related with a longer hospital stay and higher ADV copy number. Additionally, AST/ALT was correlated positively with IFN-γ level and IFN-γ level was only correlated positively with CD4+ T cells. Conclusions The study provided a set of predicting indicators for longer duration of hospitalization, which responded for primary severe ADV infection, and elucidated the possible reason for prolonged duration of hospitalization attributing to liver injury via higher ADV copy number, IFN-γ and CD4+ T cells, which suggested the importance of IFN-γ level and liver function monitoring for the patients with primary severe ADV infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Necrotising fasciitis (NF) is a life-threatening soft-tissue infection that rapidly destroys the epidermis, subcutaneous tissue, and fascia. Despite their low virulence, Lactobacillus spp. can cause NF, and because of its rare incidence, there is limited information about its molecular and clinicopathological characteristics. We report a rare case of NF in a patient with type 2 diabetes mellitus diagnosed on admission and severe obesity due to infection with two types of Lactobacillus spp. that manifested in extensive necrosis. Case presentation A 48-year-old woman was referred to our hospital with a complaint of difficulty walking due to severe bilateral thigh pain. She presented with mild erythema, swelling, and severe skin pain extending from the pubic region to the groin. The patient was morbidly obese, had renal dysfunction, and had diabetes mellitus diagnosed on admission.; her LRINEC (Laboratory Risk Indicator for Necrotising Fasciitis) score was 9, indicating a high risk of NF. An exploratory surgical incision was made, and NF was diagnosed based on fascial necrosis. Emergent surgical debridement was performed, and cultures of the tissue culture and aspirated fluid/pus revealed two types of Lactobacillus spp.: Lactobacillus salivarius and L. iners. The patient was admitted to the intensive care unit (ICU), where antibiotics were administered and respiratory and circulatory management was performed. Diabetic ketoacidosis was detected, which was treated by controlling the blood glucose level stringently via intravenous insulin infusion. The patient underwent a second debridement on day 11 and a skin suture and skin grafting on day 36. The patient progressed well, was transferred from the ICU to the general ward on day 41, and was discharged unassisted on day 73. Conclusions Lactobacillus spp. are rarely pathogenic to healthy individuals and can scarcely trigger NF. However, these bacteria can cause rare infections such as NF in immunocompromised individuals, such as those with diabetes and obesity, and an early diagnosis of NF is imperative; surgical intervention may be required for the prevention of extensive necrosis. The LRINEC score may be useful for the early diagnosis of NF, even for less pathogenic bacteria such as Lactobacillus.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Cat scratch disease (CSD) is caused by Bartonella henselae (B. henselae) and presents as lymphadenopathy following close contact with cats. However, in context of the global COVID-19 pandemic, clinical manifestations of CSD may vary, posing new challenges for healthcare professionals. Here we describe a case of a 54-year-old male with painful left upper arm mass, which gradually resolved until he was infected with COVID-19. The mass then rapidly progressed before admission. Meanwhile, pulmonary symptoms including pleural effusion emerged simultaneously. The cause was undetermined with routine blood culture and pathological test until the next generation sequencing (NGS) confirmed the presence of B. henselae. We believe this case is the first to report localized aggravation of CSD after COVID-19 infection and hopefully, offers treatment experience for clinicians worldwide.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that uses angiotensin converting enzyme 2 (ACE2), a pivotal member of the renin–angiotensin system (RAS), as its cell-entry receptor. Another member of the RAS, angiotensin II (Ang II), is the major biologically active component in this system. There is growing evidence suggesting that serum miRNAs could serve as prognostic biomarkers for SARS-CoV-2 infection and regulate ACE2 expression. Therefore, the aim of this study is to evaluate the changes in the serum levels of sACE2 and Ang II, as well as the expression level of miR-141-3p and miR-421 in SARS-CoV-2 positive and negative subjects. Methods In the present study, the serum levels of sACE2 and Ang II were measured in 94 SARS-CoV-2 positive patients and 94 SARS-CoV-2 negative subjects with some symptoms similar to those of SARS-CoV-2 positive patients using the ELISA method. In addition, the expression level of miR-141-3p and miR-421 as ACE2 regulators and biomarkers was evaluated using quantitative real-time PCR (qRT-PCR) method. Results The mean serum sACE2 concentration in the SARS-CoV-2-positive group was 3.268 ± 0.410 ng/ml, whereas in the SARS-CoV-2 negative group, it was 3.564 ± 0.437 ng/ml. Additionally, the mean serum Ang II level in the SARS-CoV-2 positive and negative groups were 60.67 ± 6.192 ng/L and 67.97 ± 6.837 ng/L, respectively. However, there was no significant difference in the serum levels of sACE2 (P value: 0.516) and Ang II (P value: 0.134) between the SARS-CoV-2 positive and negative groups. Meanwhile, our findings indicated that the expression levels of miR-141-3p and miR-421 in SARS-CoV-2 positive group were significantly lower and higher than SARS-CoV-2 negative group, respectively (P value
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact – although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) – PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. Methods From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. Results 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06–4.35]), family stigma (2.42 [1.65–3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. Conclusions In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Objective To compare the similarities and differences between patients with Coronavirus Disease 2019 (COVID-19) and those with other community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU), utilizing propensity score matching (PSM), regarding hospitalization expenses, treatment options, and prognostic outcomes, aiming to inform the diagnosis and treatment of COVID-19. Methods Patients admitted to the ICU of the Third People’s Hospital of Datong City, diagnosed with COVID-19 from December 2022 to February 2023, constituted the observation group, while those with other CAP admitted from January to November 2022 formed the control group. Basic information, clinical data at admission, and time from symptom onset to admission were matched using PSM. Results A total of 70 patients were included in the COVID-19 group and 119 in the CAP group. The patients were matched by the propensity matching method, and 37 patients were included in each of the last two groups. After matching, COVID-19 had a higher failure rate than CAP, but the difference was not statistically significant (73% vs. 51%, p = 0.055). The utilization rate of antiviral drugs (40% vs. 11%, p = 0.003), γ-globulin (19% vs. 0%, p = 0.011) and prone position ventilation (PPV) (27% vs. 0%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Severe acute respiratory infection (SARI), a significant global health concern, imposes a substantial disease burden. In China, there is inadequate data concerning the monitoring of respiratory pathogens, particularly bacteria, among patients with SARI. Therefore, this study aims to delineate the demographic, epidemiological, and aetiological characteristics of hospitalised SARI patients in Central China between 2018 and 2020. Methods Eligible patients with SARI admitted to the First Affiliated Hospital of Zhengzhou University between 1 January 2018 and 31 December 2020 were included in this retrospective study. Within the first 24 h of admission, respiratory (including sputum, nasal/throat swabs, bronchoalveolar lavage fluid, thoracocentesis fluid, etc.), urine, and peripheral blood specimens were collected for viral and bacterial testing. A multiplex real-time polymerase chain reaction (PCR) diagnostic approach was used to identify human influenza virus, respiratory syncytial virus, parainfluenza virus, adenovirus, human bocavirus, human coronavirus, human metapneumovirus, and rhinovirus. Bacterial cultures of respiratory specimens were performed with a particular focus on pathogenic microorganisms, including S. pneumoniae, S. aureus, K. pneumoniae, P. aeruginosa, Strep A, H. influenzae, A. baumannii, and E. coli. In cases where bacterial culture results were negative, nucleic acid extraction was performed for PCR to assay for the above-mentioned eight bacteria, as well as L. pneumophila and M. pneumoniae. Additionally, urine specimens were exclusively used to detect Legionella antigens. Furthermore, epidemiological, demographic, and clinical data were obtained from electronic medical records. Results The study encompassed 1266 patients, with a mean age of 54 years, among whom 61.6% (780/1266) were males, 61.4% (778/1266) were farmers, and 88.8% (1124/1266) sought medical treatment in 2020. Moreover, 80.3% (1017/1266) were housed in general wards. The most common respiratory symptoms included fever (86.8%, 1122/1266) and cough (77.8%, 986/1266). Chest imaging anomalies were detected in 62.6% (792/1266) of cases, and 58.1% (736/1266) exhibited at least one respiratory pathogen, with 28.5% (361/1266) having multiple infections. Additionally, 95.7% (1212/1266) of the patients were from Henan Province, with the highest proportion (38.3%, 486/1266) falling in the 61–80 years age bracket, predominantly (79.8%, 1010/1266) seeking medical aid in summer and autumn. Bacterial detection rate (39.0%, 495/1266) was higher than viral detection rate (36.9%, 468/1266), with the primary pathogens being influenza virus (13.8%, 175/1266), K. pneumoniae (10.0%, 127/1266), S. pneumoniae (10.0%, 127/1266), adenovirus (8.2%, 105/1266), P. aeruginosa (8.2%, 105/1266), M. pneumoniae (7.8%, 100/1266), and respiratory syncytial virus (7.7%, 98/1266). During spring and winter, there was a significant prevalence of influenza virus and human coronavirus, contrasting with the dominance of parainfluenza viruses in summer and autumn. Respiratory syncytial virus and rhinovirus exhibited higher prevalence across spring, summer, and winter. P. aeruginosa, K. pneumoniae, and M. pneumoniae were identified at similar rates throughout all seasons without distinct spikes in prevalence. However, S. pneumoniae showed a distinctive pattern with a prevalence that doubled during summer and winter. Moreover, the positive detection rates of various other viruses and bacteria were lower, displaying a comparatively erratic prevalence trend. Among patients admitted to the intensive care unit, the predominant nosocomial bacteria were K. pneumoniae (17.2%, 43/249), A. baumannii (13.6%, 34/249), and P. aeruginosa (12.4%, 31/249). Conversely, in patients from general wards, predominant pathogens included influenza virus (14.8%, 151/1017), S. pneumoniae (10.4%, 106/1017), and adenovirus (9.3%, 95/1017). Additionally, paediatric patients exhibited significantly higher positive detection rates for influenza virus (23.9%, 11/46) and M. pneumoniae (32.6%, 15/46) compared to adults and the elderly. Furthermore, adenovirus (10.0%, 67/669) and rhinovirus (6.4%, 43/669) were the primary pathogens in adults, while K. pneumoniae (11.8%, 65/551) and A. baumannii (7.1%, 39/551) prevailed among the elderly, indicating significant differences among the three age groups. Discussion In Central China, among patients with SARI, the prevailing viruses included influenza virus, adenovirus, and respiratory syncytial virus. Among bacteria, K. pneumoniae, S. pneumoniae, P. aeruginosa, and M. pneumoniae were frequently identified, with multiple infections being very common. Additionally, there were substantial variations in the pathogen spectrum compositions concerning wards and age groups among patients. Consequently, this study holds promise in offering insights to the government for developing strategies aimed at preventing and managing respiratory infectious diseases effectively.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background The impact of the constantly evolving severe acute respiratory syndrome coronavirus 2 on the effectiveness of early coronavirus disease 2019 (COVID-19) treatments is unclear. Here, we report characteristics and acute clinical outcomes of patients with COVID-19 treated with a monoclonal antibody (mAb; presumed to be sotrovimab) across six distinct periods covering the emergence and predominance of Omicron subvariants (BA.1, BA.2, and BA.5) in England. Methods Retrospective cohort study using data from the Hospital Episode Statistics database from January 1–July 31, 2022. Included patients received a mAb delivered by a National Health Service (NHS) hospital as a day-case, for which the primary diagnosis was COVID-19. Patients were presumed to have received sotrovimab based on NHS data showing that 99.98% of COVID-19-mAb-treated individuals received sotrovimab during the study period. COVID-19-attributable hospitalizations were reported overall and across six distinct periods of Omicron subvariant prevalence. Subgroup analyses were conducted in patients with severe renal disease and active cancer. Results Among a total of 10,096 patients, 1.0% (n = 96) had a COVID-19-attributable hospitalization, 4.6% (n = 465) had a hospital visit due to any cause, and 0.3% (n = 27) died due to any cause during the acute period. COVID-19-attributable hospitalization rates were consistent among subgroups, and no significant differences were observed across periods of Omicron subvariant predominance. Conclusions Levels of COVID-19-attributable hospitalizations and deaths were low in mAb-treated patients and among subgroups. Similar hospitalization rates were observed whilst Omicron BA.1, BA.2, and BA.5 were predominant, despite reported reductions in in vitro neutralization activity of sotrovimab against BA.2 and BA.5.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background COVID-19 has been shown to increase the risk of extracorporeal coagulation during hemodialysis in patients, but the underlying mechanism remains unclear. This study aimed to investigate the effect and mechanism of COVID-19 on the risk of extracorporeal coagulation in patients with chronic kidney disease undergoing hemodialysis. Methods A retrospective analysis of the extracorporeal coagulation status of 339 hemodialysis patients at our center before and after COVID-19 infection was performed, including subgroup analyses. Post-infection blood composition was analyzed by protein spectrometry and ELISA. Results Compared to the pre-COVID-19 infection period, COVID-19-induced extracorporeal coagulation predominantly occurred in patients with severe/critical symptoms. Further proteomic analysis demonstrated that in patients with severe/critical symptoms, the coagulation cascade reaction, platelet activation, inflammation, and oxidative stress-related pathways were significantly amplified compared to those in patients with no/mild symptoms. Notably, the vWF/FBLN5 pathway, which is associated with inflammation, vascular injury, and coagulation, was significantly upregulated. Conclusions Patients with severe/critical COVID-19 symptoms are at a higher risk of extracorporeal coagulation during hemodialysis, which is associated with the upregulation of the vWF/FBLN5 signaling pathway. These findings highlight the importance of early anticoagulant therapy initiation in COVID-19 patients with severe/critical symptoms, particularly those undergoing hemodialysis. Additionally, vWF/FBLN5 upregulation may be a novel mechanism for virus-associated thrombosis/coagulation.
Læs mere Tjek på PubMedSylvia Warren
Lancet Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
In a month when France has enshrined abortion as a constitutional legal right and the state of Arizona, USA, has voted to reinstate a law banning all abortions from conception unless it is necessary to save the life of the pregnant person, it is easy to consider abortion access primarily a matter of legislation, rather than as the necessary health-care procedure it should be. And lack of abortion access can favour illegal practices that expose women to unhygienic conditions and infections.
Læs mere Tjek på PubMedHollie Sherwood-Martin
Lancet Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
In response to the UN\'s seventeen SDG agenda for 2030, which fosters research focused on global targets addressing some of society\'s biggest challenges, an accompanying body of work, a SDG programme, has been launched by Springer Nature. The programme encompasses work from researchers over a variety of fields, highlighting issues with enormous social impacts and global threats such as climate action, poverty, gender equality, access to food and clean water, and general health and well-being. Emma Shuvai Chikovore and Radhamany Sooryamoorthy\'s book Family influence on adolescent sexual behaviour in South Africa falls into the latter category, providing research on a subject and in a country which has been overlooked in prior sub-Saharan health studies pertaining to sexual health and gender equality.
Læs mere Tjek på PubMedEd Holt
Lancet Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Czech Republic is experiencing the largest outbreak of pertussis in more than 60 years, with suboptimal vaccine coverage and waning immunity partly to blame. Ed Holt reports.
Læs mere Tjek på PubMedWenting Zuo, Di He, Chaoyang Liang, Shiyu Du, Zhan Hua, Qiangqiang Nie, Xiaofeng Zhou, Meng Yang, Haidong Tan, Jiuyang Xu, Yanbing Yu, Yuliang Zhan, Ying Zhang, Xiaoying Gu, Weijie Zhu, Hui Zhang, Hongyan Li, Weiliang Sun, Mingzhi Sun, Xiaolei Liu, Liguo Liu, Chuanzhen Cao, Rui Li, Jing Li, Yun Zhang, Yuting Zhang, Jing Guo, Ling Zhao, Chuan-Peng Zhang, Hongyu Liu, Shiyao Wang, Fei Xiao, Yeming Wang, Zai Wang, Haibo Li, Bin Cao
Lancet Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Our findings suggest that residual SARS-CoV-2 can persist in patients who have recovered from mild COVID-19 and that there is a significant association between viral persistence and long COVID symptoms. Further research is needed to verify a mechanistic link and identify potential targets to improve long COVID symptoms.
Læs mere Tjek på PubMedDeidre Wilkins, Yuan Yuan, Yue Chang, Anastasia A. Aksyuk, Beatriz Seoane Núñez, Ulrika Wählby-Hamrén, Tianhui Zhang, Michael E. Abram, Amanda Leach, Tonya Villafana, Mark T. Esser
Nature, 23.04.2024
Tilføjet 23.04.2024
Molly Cliff, Paul Welaga, Nuredin Mohammed, Patrick Ansah, Robert S. Heyderman, Caroline Trotter, Brenda Kwambana-Adams
Nature, 23.04.2024
Tilføjet 23.04.2024
Tessa Acar, Sandra Moreau, Marie-Françoise Jardinaud, Gabriella Houdinet, Felicia Maviane-Macia, Frédéric De Meyer, Bart Hoste, Olivier Leroux, Olivier Coen, Aurélie Le Ru, Nemo Peeters, Aurelien Carlier
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Tessa Acar, Sandra Moreau, Marie-Françoise Jardinaud, Gabriella Houdinet, Felicia Maviane-Macia, Frédéric De Meyer, Bart Hoste, Olivier Leroux, Olivier Coen, Aurélie Le Ru, Nemo Peeters, Aurelien Carlier Hereditary, or vertically-transmitted, symbioses affect a large number of animal species and some plants. The precise mechanisms underlying transmission of functions of these associations are often difficult to describe, due to the difficulty in separating the symbiotic partners. This is especially the case for plant-bacteria hereditary symbioses, which lack experimentally tractable model systems. Here, we demonstrate the potential of the leaf symbiosis between the wild yam Dioscorea sansibarensis and the bacterium Orrella dioscoreae (O. dioscoreae) as a model system for hereditary symbiosis. O. dioscoreae is easy to grow and genetically manipulate, which is unusual for hereditary symbionts. These properties allowed us to design an effective antimicrobial treatment to rid plants of bacteria and generate whole aposymbiotic plants, which can later be re-inoculated with bacterial cultures. Aposymbiotic plants did not differ morphologically from symbiotic plants and the leaf forerunner tip containing the symbiotic glands formed normally even in the absence of bacteria, but microscopic differences between symbiotic and aposymbiotic glands highlight the influence of bacteria on the development of trichomes and secretion of mucilage. This is to our knowledge the first leaf symbiosis where both host and symbiont can be grown separately and where the symbiont can be genetically altered and reintroduced to the host.
Læs mere Tjek på PubMedXinyi Zhou, Tengda Huang, Hongyuan Pan, Ao Du, Tian Wu, Jiang Lan, Yujia Song, Yue Lv, Fang He, Kefei Yuan
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Xinyi Zhou, Tengda Huang, Hongyuan Pan, Ao Du, Tian Wu, Jiang Lan, Yujia Song, Yue Lv, Fang He, Kefei Yuan Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of coronavirus disease 2019 (COVID-19), has infected millions of individuals worldwide, which poses a severe threat to human health. COVID-19 is a systemic ailment affecting various tissues and organs, including the lungs and liver. Intrahepatic cholangiocarcinoma (ICC) is one of the most common liver cancer, and cancer patients are particularly at high risk of SARS-CoV-2 infection. Nonetheless, few studies have investigated the impact of COVID-19 on ICC patients. Methods With the methods of systems biology and bioinformatics, this study explored the link between COVID-19 and ICC, and searched for potential therapeutic drugs. Results This study identified a total of 70 common differentially expressed genes (DEGs) shared by both diseases, shedding light on their shared functionalities. Enrichment analysis pinpointed metabolism and immunity as the primary areas influenced by these common genes. Subsequently, through protein-protein interaction (PPI) network analysis, we identified SCD, ACSL5, ACAT2, HSD17B4, ALDOA, ACSS1, ACADSB, CYP51A1, PSAT1, and HKDC1 as hub genes. Additionally, 44 transcription factors (TFs) and 112 microRNAs (miRNAs) were forecasted to regulate the hub genes. Most importantly, several drug candidates (Periodate-oxidized adenosine, Desipramine, Quercetin, Perfluoroheptanoic acid, Tetrandrine, Pentadecafluorooctanoic acid, Benzo[a]pyrene, SARIN, Dorzolamide, 8-Bromo-cAMP) may prove effective in treating ICC and COVID-19. Conclusion This study is expected to provide valuable references and potential drugs for future research and treatment of COVID-19 and ICC.
Læs mere Tjek på PubMedPacifique Karekezi, Jean Damascene Nzabakiriraho, Ezra Gayawan
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Pacifique Karekezi, Jean Damascene Nzabakiriraho, Ezra Gayawan In sub-Saharan Africa, malaria and anemia contribute substantially to the high burden of morbidity and mortality among under-five children. In Rwanda, both diseases have remained public health challenge over the years in spite of the numerous intervention programs and policies put in place. This study aimed at understanding the geographical variations between the joint and specific risks of both diseases in the country while quantifying the effects of some socio-demographic and climatic factors. Using data extracted from Rwanda Demographic and Health Survey, a shared component model was conceived and inference was based on integrated nested Laplace approximation. The study findings revealed similar spatial patterns for the risk of malaria and the shared risks of both diseases, thus confirming the strong link between malaria and anaemia. The spatial patterns revealed that the risks for contracting both diseases are higher among children living in the districts of Rutsiro, Nyabihu, Rusizi, Ruhango, and Gisagara. The risks for both diseases are significantly associated with type of place of residence, sex of household head, ownership of bed net, wealth index and mother’s educational attainment. Temperature and precipitation also have substantial association with both diseases. When developing malaria intervention programs and policies, it is important to take into account climatic and environmental variability in Rwanda. Also, potential intervention initiatives focusing on the lowest wealth index, children of uneducated mothers, and high risky regions need to be reinforced.
Læs mere Tjek på PubMedPatricia Martins, Richardson Warley Siqueira Luzia, Jair Alves Pereira Filho, Kelly Silva Welsh, Cíntia Fuzikawa, Rodrigo Nicolato, Márcia Mascarenhas Alemão, Márcio Augusto Gonçalves, José Carlos Cavalheiro, Ianny Dumont Ávila, Ricardo Teixeira Veiga
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Patricia Martins, Richardson Warley Siqueira Luzia, Jair Alves Pereira Filho, Kelly Silva Welsh, Cíntia Fuzikawa, Rodrigo Nicolato, Márcia Mascarenhas Alemão, Márcio Augusto Gonçalves, José Carlos Cavalheiro, Ianny Dumont Ávila, Ricardo Teixeira Veiga Burnout is most commonly defined as a syndrome characterized by emotional exhaustion, cynicism, and ineffectiveness, which occurs in response to chronic stressors at work. It can adversely affect health workers’ physical and mental health, and the quality of care provided. The COVID-19 pandemic increased stressors and could impact burnout prevalence in this group. There is a lack of information regarding the prevalence of burnout among hospital health workers in Brazil. A newer definition of burnout has been proposed that considers three different clinical profiles: the frenetic, underchallenged and worn-out subtypes. This differentiation could lead to interventions tailored for each subtype. The present study aimed to estimate the prevalence of burnout, its subtypes, and associated factors in workers of a public hospital network in Brazil, during the pandemic. A total of 143 randomly selected participants answered an online form that included sociodemographic and occupational items, and the Burnout Clinical Subtypes Questionnaire, a summarized version. This questionnaire evaluates three burnout dimensions (overload, lack of development, neglect) that can be used to discriminate the three burnout subtypes (frenetic, underchallenged, worn-out, respectively); higher scores indicate higher burnout levels. The prevalence of burnout was high (53.85%), similar to other studies during the pandemic. The most common subtypes were ‘frenetic’ (34.97%), characterized by increased efforts to meet work demands, to the point of neglecting personal needs, and ‘lack of development’ (23.78%), characterized by a sense that work is uninteresting and does not contribute to personal development, and a perfunctory behavior towards tasks. Age was associated with burnout: workers with less than 51 years presented higher levels of burnout. These findings indicate the need for effective interventions to prevent and/or treat burnout. The assessment of burnout subtypes can allow managers to better understand the processes affecting employees, and inform actions to improve workforce health.
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