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BMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background In recent years, Raoultella ornithinolytica (R. ornithinolytica) have attracted clinical attention as a new type of pathogen. A wide range of infections with these germs is reported, and commonly found in urinary tract infections, respiratory infections, and bacteremia. Case presentation We report the case of an elderly woman with liver abscess, choledocholithiasis and cholangitis, who developed gastric fistula and abdominal abscess after underwent choledocholithotomy, and R. ornithinolytica were isolated from the abdominal drainage fluid. The patient was treated with meropenem and levofloxacin and had a good outcome. Conclusions To the best of our knowledge, case of isolating R. ornithinolytica from a patient with non-viscerally abdominal abscess was extremely rare. We share a case of a woman with non-viscerally abdominal abscess secondary to postoperative gastric fistula, R. ornithinolytica was isolated from the patient’s pus, and the pathogenic bacteria may originate from the gastrointestinal tract. Based on this case, We should be cautious that invasive treatment may greatly increase the probability of infection with this pathogenic bacterium.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract This comprehensive retrospective data-linkage study aimed at evaluating the impact of Direct-Acting Antivirals (DAAs) on Hepatitis C Virus (HCV) testing, treatment trends, and access to care in Tuscany over six years following their introduction. Utilizing administrative healthcare records, our work reveals a substantial increase in HCV tests in 2017, attributed to the decision to provide universal access to treatment. However, despite efforts to eradicate chronic HCV through a government-led plan, the target of treating 6,221 patients annually was not met, and services contracted after 2018, exacerbated by the COVID-19 pandemic. Key findings indicate a higher prevalence of HCV screening among females in the 33–53 age group, influenced by pregnancy-related recommendations, while diagnostic tests and treatment uptake were more common among males. Problematic substance users constituted a significant proportion of those tested and treated, emphasizing their priority in HCV screening. Our paper underscores the need for decentralized HCV models and alternative testing strategies, such as point-of-care assays, especially in populations accessing harm reduction services, communities, and prisons. The study acknowledges limitations in relying solely on administrative records, advocating for improved data access and timely linkages to accurately monitor HCV care cascades and inform regional plans. Despite challenges, the paper demonstrates the value of administrative record linkages in understanding the access to care pathway for hard-to-reach populations. The findings emphasize the importance of the national HCV elimination strategy and the need for enhanced data collection to assess progress accurately, providing insights for future regional and national interventions.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background The COVID-19 pandemic has caused significant disruptions to everyday life and has had social, political, and financial consequences that will persist for years. Several initiatives with intensive use of technology were quickly developed in this scenario. However, technologies that enhance epidemiological surveillance in contexts with low testing capacity and healthcare resources are scarce. Therefore, this study aims to address this gap by developing a data science model that uses routinely generated healthcare encounter records to detect possible new outbreaks early in real-time. Methods We defined an epidemiological indicator that is a proxy for suspected cases of COVID-19 using the health records of Emergency Care Unit (ECU) patients and text mining techniques. The open-field dataset comprises 2,760,862 medical records from nine ECUs, where each record has information about the patient’s age, reported symptoms, and the time and date of admission. We also used a dataset where 1,026,804 cases of COVID-19 were officially confirmed. The records range from January 2020 to May 2022. Sample cross-correlation between two finite stochastic time series was used to evaluate the models. Results For patients with age 18 years, we find time-lag () = 72 days and cross-correlation () ~ 0.82, = 25 days and ~ 0.93, and = 17 days and ~ 0.88 for the first, second, and third waves, respectively. Conclusions In conclusion, the developed model can aid in the early detection of signs of possible new COVID-19 outbreaks, weeks before traditional surveillance systems, thereby anticipating in initiating preventive and control actions in public health with a higher likelihood of success.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Pancreaticoduodenectomy (PD) is a complex procedure and easily accompanied by healthcare-associated infections (HAIs). This study aimed to assess the impact of PBD on postoperative infections and clinical outcomes in PD patients. Methods The retrospective cohort study were conducted in a tertiary hospital from January 2013 to December 2022. Clinical and epidemiological data were collected from HAIs surveillance system and analyzed. Results Among 2842 patients who underwent PD, 247 (8.7%) were diagnosed with HAIs, with surgical site infection being the most frequent type (n = 177, 71.7%). A total of 369 pathogenic strains were detected, with Klebsiella pneumoniae having the highest proportion, followed by Enterococcu and Escherichia coli. Although no significant association were observed generally between PBD and postoperative HAIs, subgroup analysis revealed that PBD was associated with postoperative HAIs in patients undergoing robotic PD (aRR = 2.174; 95% CI:1.011–4.674; P = 0.047). Prolonging the interval between PBD and PD could reduce postoperative HAIs in patients with cholangiocarcinoma (≥4 week: aRR = 0.292, 95% CI 0.100–0.853; P = 0.024) and robotic PD (≤2 week: aRR = 3.058, 95% CI 1.178–7.940; P = 0.022). PBD was also found to increase transfer of patients to ICU (aRR = 1.351; 95% CI 1.119–1.632; P = 0.002), extended length of stay (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background HIV virological failure is one of the main problems in HIV-infected patients, and identifying the main predictors of such treatment failure may help in combating HIV/AIDS. Methodology This cross-sectional study included 1800 HIV-infected patients with either virological failure or treatment response. HIV viral load, CD4 count, and other tests were performed. Statistical analysis was used to determine the predictors of virological failure. Results Clinical stage, treatment with reverse transcriptase inhibitors (RTIs), under therapy for three years or more, suboptimal adherence to antiretroviral treatment (ART), age > 40 years, CD4 count
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Since the early 1970s, cholera outbreaks have been a major public health burden in the Democratic Republic of Congo (DRC). Cholera cases have been reported in a quasi-continuous manner in certain lakeside areas in the Great Lakes Region. As these cholera-endemic health zones constitute a starting point for outbreaks and diffusion towards other at-risk areas, they play a major role in cholera dynamics in the country. Monitoring the spatiotemporal dynamics of cholera hotspots and adjusting interventions accordingly thus reduces the disease burden in an efficient and cost-effective manner. Methods A literature review was conducted to describe the spatiotemporal dynamics of cholera in the DRC at the province level from 1973 to 1999. We then identified and classified cholera hotspots at the provincial and health zone levels from 2003 to 2022 and described the spatiotemporal evolution of hotspots. We also applied and compared three different classification methods to ensure that cholera hotspots are identified and classified according to the DRC context. Results According to all three methods, high-priority hotspots were concentrated in the eastern Great Lakes Region. Overall, hotspots largely remained unchanged over the course of the study period, although slight improvements were observed in some eastern hotspots, while other non-endemic areas in the west experienced an increase in cholera outbreaks. The Global Task Force on Cholera Control (GTFCC) and the Department of Ecology and Infectious Disease Control (DEIDC) methods largely yielded similar results for the high-risk hotspots. However, the medium-priority hotspots identified by the GTFCC method were further sub-classified by the DEIDC method, thereby providing a more detailed ranking for priority targeting. Conclusions Overall, the findings of this comprehensive study shed light on the dynamics of cholera hotspots in the DRC from 1973 to 2022. These results may serve as an evidence-based foundation for public health officials and policymakers to improve the implementation of the Multisectoral Cholera Elimination Plan, guiding targeted interventions and resource allocation to mitigate the impact of cholera in vulnerable communities.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background There are abundant studies on COVID-19 but few on its impact on hepatitis E. We aimed to assess the effect of the COVID-19 countermeasures on the pattern of hepatitis E incidence and explore the application of time series models in analyzing this pattern. Methods Our pivotal idea was to fit a pre-COVID-19 model with data from before the COVID-19 outbreak and use the deviation between forecast values and actual values to reflect the effect of COVID-19 countermeasures. We analyzed the pattern of hepatitis E incidence in China from 2013 to 2018. We evaluated the fitting and forecasting capability of 3 methods before the COVID-19 outbreak. Furthermore, we employed these methods to construct pre-COVID-19 incidence models and compare post-COVID-19 forecasts with reality. Results Before the COVID-19 outbreak, the Chinese hepatitis E incidence pattern was overall stationary and seasonal, with a peak in March, a trough in October, and higher levels in winter and spring than in summer and autumn, annually. Nevertheless, post-COVID-19 forecasts from pre-COVID-19 models were extremely different from reality in sectional periods but congruous in others. Conclusions Since the COVID-19 pandemic, the Chinese hepatitis E incidence pattern has altered substantially, and the incidence has greatly decreased. The effect of the COVID-19 countermeasures on the pattern of hepatitis E incidence was temporary. The incidence of hepatitis E was anticipated to gradually revert to its pre-COVID-19 pattern.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background The burden of cervical cancer in Ghana is high due to a lack of a national screening and vaccination program. Geographical variations in high-risk Human Papilloma Virus incidence and type should be considered for vaccine improvement and screening in LMICs. Methods A descriptive, multi-center cross-sectional study with purposive sampling of cases with cervical cancer diagnosed from January 2012 through to December 2018 was employed relying on archived Formalin Fixed Paraffin Embedded (FFPE) tissues from four (4) Teaching Hospitals. Cervical cancers were assessed for histopathological features following WHO guidelines. In addition, the novel Tumour Budding and Nest Size Grade (TBNS) for SCC, SILVA pattern of invasion for EAC and Tumour Infiltrating Lymphocytes (TILs) were assessed. High Risk HPV testing was performed using an isothermal, multiplex nucleic acid amplification method from ATILA biosystem (Mountain View California, USA). The FFPE blocks were tested for 15 hrHPV genotypes. Results were analyzed using SPSS v.26.0, with descriptive statistics and cross-tabulation and chi-square tests done with significance established at p
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background This real-world study assessed the epidemiology and clinical complications of Clostridioides difficile infections (CDIs) and recurrences (rCDIs) in hospital and community settings in Germany from 2015 − 2019. Methods An observational retrospective cohort study was conducted among adult patients diagnosed with CDI in hospital and community settings using statutory health insurance claims data from the BKK database. A cross-sectional approach was used to estimate the annual incidence rate of CDI and rCDI episodes per 100,000 insurants. Patients’ demographic and clinical characteristics were described at the time of first CDI episode. Kaplan-Meier method was used to estimate the time to rCDIs and time to complications (colonic perforation, colectomy, loop ileostomy, toxic megacolon, ulcerative colitis, peritonitis, and sepsis). A Cox model was used to assess the risk of developing complications, with the number of rCDIs as a time-dependent covariate. Results A total of 15,402 CDI episodes were recorded among 11,884 patients. The overall incidence of CDI episodes declined by 38% from 2015 to 2019. Most patients (77%) were aged ≥ 65 years. Around 19% of CDI patients experienced at least one rCDI. The median time between index CDI episode to a rCDI was 20 days. The most frequent complication within 12-months of follow-up after the index CDI episode was sepsis (7.57%), followed by colectomy (3.20%). The rate of complications increased with the number of rCDIs. The risk of any complication increased by 31% with each subsequent rCDI (adjusted hazard ratio [HR]: 1.31, 95% confidence interval: 1.17;1.46). Conclusions CDI remains a public health concern in Germany despite a decline in the incidence over recent years. A substantial proportion of CDI patients experience rCDIs, which increase the risk of severe clinical complications. The results highlight an increasing need of improved therapeutic management of CDI, particularly efforts to prevent rCDI.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background The prevalence and distinction between first Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reinfection with the Omicron variant among healthcare workers (HCWs) remain unclear. Methods A cross-sectional study was conducted at a hospital in Southern China. The study included 262 HCWs who were infected with SARS-CoV-2 between April and June 2023, with 101 cases of first infection and 161 ones of reinfection. Student’s t-test, Analysis of Variance (ANOVA), and Mann-Whitney U tests were used based on the distribution of quantitative variables. Pearson’s chi-square and Fisher’s exact tests were used based on the expected frequencies of categorical variables. Results The reinfection rate among HCWs was 11.5% (161/1406). The majority of the infected HCWs were female (212/262, 80.9%, first infection vs. reinfection: 76.2% vs. 83.9%). The nursing staff, had the highest percentage of SARS-CoV-2 infection (42.0%), especially of its reinfection (47.8%). Out of the 262 infected individuals, 257 had received SARS-CoV-2 vaccination, primarily inactivated vaccines (243/257, 91.1%). The first infection group, which received four doses (24, 23.8%), was significantly higher than that in the reinfection group (6, 3.7%) (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Purpose This study aims to evaluate the effectiveness of mitigation strategies and analyze the impact of human behavior on the transmission of Mpox. The results can provide guidance to public health authorities on comprehensive prevention and control for the new Mpox virus strain in the Democratic Republic of Congo as of December 2023. Methods We develop a two-layer Watts-Strogatz network model. The basic reproduction number is calculated using the next-generation matrix approach. Markov chain Monte Carlo (MCMC) optimization algorithm is used to fit Mpox cases in Canada into the network model. Numerical simulations are used to assess the impact of mitigation strategies and human behavior on the final epidemic size. Results Our results show that the contact transmission rate of low-risk groups and susceptible humans increases when the contact transmission rate of high-risk groups and susceptible humans is controlled as the Mpox epidemic spreads. The contact transmission rate of high-risk groups after May 18, 2022, is approximately 20% lower than that before May 18, 2022. Our findings indicate a positive correlation between the basic reproduction number and the level of heterogeneity in human contacts, with the basic reproduction number estimated at 2.3475 (95% CI: 0.0749–6.9084). Reducing the average number of sexual contacts to two per week effectively reduces the reproduction number to below one. Conclusion We need to pay attention to the re-emergence of the epidemics caused by low-risk groups when an outbreak dominated by high-risk groups is under control. Numerical simulations show that reducing the average number of sexual contacts to two per week is effective in slowing down the rapid spread of the epidemic. Our findings offer guidance for the public health authorities of the Democratic Republic of Congo in developing effective mitigation strategies.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Introduction Skin diseases such as impetigo pose a significant public health challenge in low resource settings. Despite this, there is a dearth of epidemiological data on the prevalence of this condition in Ghana. Methods We conducted a cross sectional study in three settings in Ghana: community members in East Mamprusi district in the North East region, a secondary school in Sekyere East district, and inmates of the Kumasi central prisons both in the Ashanti region. Following a period of training, we performed a standardised skin examination on each participant to assess for scabies and impetigo. We calculated the prevalence of each skin condition and investigated determinants of impetigo. Results/ findings Of the 1327 participants [males 64.1% and median age 22 (16–29) years], 746 (56.2%) had scabies and 186 (14%) had impetigo which was usually very mild or mild in severity. Most participants with impetigo also had scabies (161/186, 86.6%). Having an itch [RR 6.05 (95% CI 2.53–14.47)], presence of scabies burrows [RR 1.99 (95% CI 1.54–2.59)], clinical scabies [RR 3.15 (2.11–4.72)] or being in preschool [RR 4.56 (1.78–11.67)] increased the risk for impetigo. A combination of the presence of clinical scabies, age, sex and itch most accurately predicted the odds of having impetigo. Conclusions There is substantial burden of impetigo and scabies in Ghana. There is a need to institute measures to improve detection and control of these common dermatoses as part of Universal Health Coverage package to reduce the scourge of the diseases in this setting.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Introduction Leprosy is a chronic granulomatous infectious disease, mainly affecting the skin and peripheral nerves, caused by the obligate intracellular bacteria Mycobacterium leprae. The disease has been discussed in several review articles in recent research, but as far as we know, only a few have addressed the effects of leprosy on nails, especially those who examine the dermoscopic features of nails in leprosy patients. Purposes We aimed to document nail changes in leprosy patients and identify any particular findings through dermoscopic examination. Method This was an observational study conducted in the Dermatology and Venereology Clinic of Hasan Sadikin Hospital, West Java, Indonesia, from March 2023 through May 2023. All patients have established cases of leprosy, and the diagnosis is based on clinical and bacteriological examinations. Recruitment was done through total sampling. Dermoscopic examination of all fingernails and toenails was performed at 10x magnification using a handheld dermatoscope (Heine DELTA 20 T Dermatoscope) in polarized mode without the linkage fluid to document the dermoscopic features. Result Of a total of 19 patients, 15 had nail changes due to leprosy. Out of 15 patients, 13 patients were male. Patients below 25 years old had more nail changes. Most of the patients had a duration of disease greater than two years. Both fingers and toes were involved in nine patients. In this study, the most common dermoscopic feature found was the longitudinal ridge. Other dermoscopic features found in this study were transverse lines, onycholysis, longitudinal melanonychia, leukonychia, subungual hemorrhage, subungual hyperkeratosis, anonychia, and onychorrexis. Conclusion Nail changes are found in leprosy patients and have a wide variety of clinical appearances. A dermoscopy should be performed to assess nail changes in leprosy.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Timely and accurate identification of pathogens is crucial for appropriate treatment and prognosis of infectious diseases. As an increasingly popular pathogen detection method, the performance of metagenomic next-generation sequencing (mNGS) in detecting pathogens in febrile patients with suspected infection requires further exploration. Methods This study included 368 febrile patients with suspected infections who were admitted to the Infectious Disease Department of Qilu Hospital, Shandong University between January 5, 2021 and April 14, 2023. Both mNGS testing and conventional culture were performed in all patients. Clinical data of enrolled patients were collected, and the diagnostic performances of mNGS and culture were compared. Results Of the 368 enrolled patients, 231 were finally diagnosed with infection and 137 were with diseases other than infection. The sensitivity (58.01% vs. 21.65%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Pakistan witnessed five waves of COVID-19 infections during the pandemic. Punjab, the largest province of Pakistan, remained the epicentre due to a high infection rate. Administrative data for five waves of the pandemic was analyzed to determine the rate of infections and the significance of pharmacological and non-pharmacological interventions on the severity and duration of infection. Methodology COVID-19 data from March 2020 to May 2023 was obtained from the Provincial Public Health Reference Laboratory (PPHRL), Punjab AIDS Control Program, Lahore. The data included samples from index cases, contacts, and recovered patients. A total of 36,252,48 cases were screened for COVID-19, and 90,923 (2.50%) were detected positive by RT-PCR, accounting for 5.69% of the cases reported positive throughout the country. Results Among the positive cases, 50.86% (n = 46,244) cases were new cases (registered for the first time), 40.41% (n = 36751) were the contact cases traced from the newly identified cases and 8.62% (n = 7842) repeated cases. The positivity rates among index cases were reported to be 2.37%, 2.34%, 4.61%, 2.09%, and 1.19%, respectively, for the five respective COVID-19 pandemic waves. Distribution by gender indicated that 64% of males and 35% of females were infected during the pandemic. The age factor demonstrated the most susceptibility to infection in women aged 19-29 years, whereas most males between the ages of 29-39 had an infection. Susceptibility to COVID-19 infection was observed to be equally likely between males and females; however, clinical outcomes indicated that infections in males were more severe and often resulted in fatalities as compared to those in females. This trend was also reflected in the viral titer as measured by the Ct values, where 40% of males had Ct values < 25 (an indicator of high viral titers) compared to 30% of females with Ct values < 25. Conclusion Overall, our data indicated that infection rates remained stable throughout the pandemic except for 3rd wave, which showed a higher incidence of infection rate of 4%. Additionally, data showed a positive impact of masking, social distancing, and immunization, as indicated by the shorter window of high infection rates.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Men who have sex with men (MSM) are a key population group disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. In Rwanda, the HIV epidemic remains a significant public health concern, and understanding the burden of HIV and hepatitis B and C coinfections among MSM is crucial for designing effective prevention and control strategies. This study aims to determine the prevalence of HIV, hepatitis B, and hepatitis C infections among MSM in Rwanda and identify correlates associated with HIV infection within this population. Methods We used respondent-driven sampling (RDS) to recruit participants between November and December 2021. A face-to-face, structured questionnaire was administered. Testing for HIV infection followed the national algorithm using two rapid tests: Alere Combo and STAT PAK as the first and second screening tests, respectively. Hepatitis B surface antigen (HBsAg) and anti-HCV tests were performed. All statistics were adjusted for RDS design, and a multivariable logistic regression model was constructed to identify factors associated with HIV infection. Results The prevalence of HIV among MSM was 6·9% (95% CI: 5·5–8·6), and among HIV-positive MSM, 12·9% (95% CI: 5·5–27·3) were recently infected. The prevalence of hepatitis B and C was 4·2% (95% CI: 3·0–5·7) and 0·7% (95% CI: 0·4–1·2), respectively. HIV and hepatitis B virus coinfection was 0·5% (95% CI: 0·2–1·1), whereas HIV and hepatitis C coinfection was 0·1% (95% CI: 0·0–0·5), and no coinfection for all three viruses was observed. MSM groups with an increased risk of HIV infection included those who ever suffered violence or abuse because of having sex with other men (AOR: 3·42; 95% CI: 1·87–6·25), those who refused to answer the question asking about ‘ever been paid money, goods, or services for sex’ (AOR: 10·4; 95% CI: 3·30–32·84), and those not consistently using condoms (AOR: 3·15; 95% CI: 1·31–7·60). Conclusion The findings suggest more targeted prevention and treatment approaches and underscore the importance of addressing structural and behavioral factors contributing to HIV vulnerability, setting interventions to reduce violence and abuse against MSM, promoting safe and consensual sexual practices, and expanding access to HIV prevention tools such as condoms and preexposure prophylaxis (PrEP).
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background This study explores regional variations in COVID-19 hospitalization rates, in-hospital mortality, and acute kidney injury (AKI) in England. We investigated the influence of population demographic characteristics, viral strain changes, and therapeutic advances on clinical outcomes. Methods Using hospital episode statistics, we conducted a retrospective cohort study with 749,844 admissions in 337,029 adult patients with laboratory-confirmed COVID-19 infection (March 1, 2020, to March 31, 2021). Multivariable logistic regression identified factors predicting AKI and mortality in COVID-19 hospitalized patients. Results London had the highest number of COVID-19 admissions (131,338, 18%), followed by the North-west region (122,683, 16%). The North-west had the highest population incidence of COVID-19 hospital admissions (21,167 per million population, pmp), while the South-west had the lowest (9,292 admissions pmp). Patients in London were relatively younger (67.0 ± 17.7 years) than those in the East of England (72.2 ± 16.8 years). The shortest length of stay was in the North-east (12.2 ± 14.9 days), while the longest was in the North-west (15.2 ± 17.9 days). All eight regions had higher odds of death compared to London, ranging from OR 1.04 (95% CI 1.00, 1.07) in the South-west to OR 1.24 (95% CI 1.21, 1.28) in the North-west. Older age, Asian ethnicity, emergency admission, transfers from other hospitals, AKI presence, ITU admission, social deprivation, and comorbidity were associated with higher odds of death. AKI incidence was 30.3%, and all regions had lower odds of developing AKI compared to London. Increasing age, mixed and black ethnicity, emergency admission, transfers from other providers, ITU care, and different levels of comorbidity were associated with higher odds of developing AKI. Conclusions London exhibited higher hospital admission numbers and AKI incidence, but lower odds of death compared to other regions in England. Trial registration Registered on National Library of Medicine website (www.clinicaltrials.gov) with registration number NCT04579562 on 8/10/2020.
Læs mere Tjek på PubMedBate, Sebastian; Stokes, Victoria; Greenlee, Hannah; Goh, Kwee Yen; Whiting, Graham; Kitchen, Gareth; Martin, Glen P.; Parker, Alexander J.; Wilson, Anthony; on behalf of the MRI Critical Care Data Group
Critical Care Explorations, 30.03.2024
Tilføjet 30.03.2024
OBJECTIVES (BACKGROUND): To externally validate clinical prediction models that aim to predict progression to invasive ventilation or death on the ICU in patients admitted with confirmed COVID-19 pneumonitis. DESIGN: Single-center retrospective external validation study. DATA SOURCES: Routinely collected healthcare data in the ICU electronic patient record. Curated data recorded for each ICU admission for the purposes of the U.K. Intensive Care National Audit and Research Centre (ICNARC). SETTING: The ICU at Manchester Royal Infirmary, Manchester, United Kingdom. PATIENTS: Three hundred forty-nine patients admitted to ICU with confirmed COVID-19 Pneumonitis, older than 18 years, from March 1, 2020, to February 28, 2022. Three hundred two met the inclusion criteria for at least one model. Fifty-five of the 349 patients were admitted before the widespread adoption of dexamethasone for the treatment of severe COVID-19 (pre-dexamethasone patients). OUTCOMES: Ability to be externally validated, discriminate, and calibrate. METHODS: Articles meeting the inclusion criteria were identified, and those that gave sufficient details on predictors used and methods to generate predictions were tested in our cohort of patients, which matched the original publications’ inclusion/exclusion criteria and endpoint. RESULTS: Thirteen clinical prediction articles were identified. There was insufficient information available to validate models in five of the articles; a further three contained predictors that were not routinely measured in our ICU cohort and were not validated; three had performance that was substantially lower than previously published (range C-statistic = 0.483–0.605 in pre-dexamethasone patients and C = 0.494–0.564 among all patients). One model retained its discriminative ability in our cohort compared with previously published results (C = 0.672 and 0.686), and one retained performance among pre-dexamethasone patients but was poor in all patients (C = 0.793 and 0.596). One model could be calibrated but with poor performance. CONCLUSIONS: Our findings, albeit from a single center, suggest that the published performance of COVID-19 prediction models may not be replicated when translated to other institutions. In light of this, we would encourage bedside intensivists to reflect on the role of clinical prediction models in their own clinical decision-making.
Læs mere Tjek på PubMedLakshmipathy, Damini; Ye, Xiaoyi; Kuti, Joseph L.; Nicolau, David P.; Asempa, Tomefa E.
Critical Care Explorations, 30.03.2024
Tilføjet 30.03.2024
OBJECTIVES: In 2020, cefiderocol became the first Food and Drug Administration-approved medication with continuous renal replacement therapy (CRRT) dosing recommendations based on effluent flow rates (QE). We aimed to evaluate the magnitude and frequency of factors that may influence these recommendations, that is, QE intrapatient variability and residual renal function. DESIGN: Retrospective observational cohort study. SETTING: ICUs within Hartford Hospital (890-bed, acute-care hospital) in Connecticut from 2017 to 2023. PATIENTS: Adult ICU patients receiving CRRT for greater than 72 hours. MEASUREMENTS AND MAIN RESULTS: CRRT settings including QE and urine output (UOP) were extracted from the time of CRRT initiation (0 hr) and trends were assessed. To assess the impact on antibiotic dosing, cefiderocol doses were assigned to 0 hour, 24 hours, 48 hours, and 72 hours QE values per product label, and the proportion of antibiotic dose changes required as a result of changes in inpatient’s QE was evaluated. Among the 380 ICU patients receiving CRRT for greater than 72 hours, the median (interquartile range) 0 hour QE was 2.96 (2.35–3.29) L/hr. Approximately 9 QE values were documented per patient per 24-hour window. QE changes of greater than 0.75 L/hr were observed in 21.6% of patients over the first 24 hours and in 7.9% (24–48 hr) and 5.8% (48–72 hr) of patients. Approximately 40% of patients had UOP greater than 500 mL at 24 hours post-CRRT initiation. Due to QE changes within 24 hours of CRRT initiation, a potential cefiderocol dose adjustment would have been warranted in 38% of patients (increase of 21.3%; decrease of 16.6%). QE changes were less common after 24 hours, warranting cefiderocol dose adjustments in less than 15% of patients. CONCLUSIONS: Results highlight the temporal and variable dynamics of QE and prevalence of residual renal function. Data also demonstrate a risk of antibiotic under-dosing in the first 24 hours of CRRT initiation due to increases in QE. For antibiotics with QE-based dosing recommendations, empiric dose escalation may be warranted in the first 24 hours of CRRT initiation.
Læs mere Tjek på PubMedPhilip A. KlenoticEdward W. Yu1Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA, Corrella S. Detweiler
Microbiology and Molecular Biology Reviews, 30.03.2024
Tilføjet 30.03.2024
Mario Pedraza-ReyesKaren Abundiz-YañezAlejandra Rangel-MendozaLissett E. MartínezRocío C. Barajas-OrnelasMayra Cuéllar-CruzHilda C. Leyva-SánchezVíctor M. Ayala-GarcíaLuz I. Valenzuela-GarcíaEduardo A. Robleto1Department of Biology, Division of Natural and Exact Sciences, University of Guanajuato, Guanajuato, Mexico2School of Life Sciences, University of Nevada, Las Vegas, Nevada, USA3Faculty of Chemical Sciences, Juarez University of Durango State, Durango, Mexico4Department of Sustainable Engineering, Advanced Materials Research Center (CIMAV), Arroyo Seco, Durango, Mexico, Corrella S. Detweiler
Microbiology and Molecular Biology Reviews, 30.03.2024
Tilføjet 30.03.2024
Xiping Zhu, Sheng Hong, Jiachen Bu, Yingping Liu, Can Liu, Runhan Li, Tiantian Zhang, Zhuqiang Zhang, Liping Li, Xuyu Zhou, Zhaolin Hua, Bing Zhu, Baidong Hou
Science Advances, 30.03.2024
Tilføjet 30.03.2024
Aurélie Boilard, Samuel J. Walker, Trond Klungseth Lødøen, Mona Henriksen, Liselotte M. Takken Beijersbergen, Bastiaan Star, Marius Robu, Christine Tøssebro, Cornelia Marie Albrektsen, Yvonne Soleng, Sverre Aksnes, Roger Jørgensen, Anne Karin Hufthammer, Thijs van Kolfschoten, Stein-Erik Lauritzen, Sanne Boessenkool
Science Advances, 30.03.2024
Tilføjet 30.03.2024
Chin Fen NeohSharon C-A ChenFanny LanternierShio Yen TioCatriona L. HallidaySarah E. KiddDavid C. M. KongWieland MeyerMartin HoeniglMonica A. Slavin1National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia2Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia3Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia4Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology, Westmead Hospital, Sydney, Australia5The University of Sydney, Sydney, Australia6Department of Infectious Diseases, Westmead Hospital, Sydney, Australia7Service de Maladies Infectieuses et Tropicales, Hôpital universitaire Necker-Enfants malades, Paris, France,8National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology research group, Mycology Department, Institut Pasteur, Université Paris Cité, Paris, France9National Mycology Reference Centre, SA Pathology, Adelaide, Australia10School of Biological Sciences, Faculty of Sciences, University of Adelaide, Adelaide, Australia11The National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infections and Immunity, Melbourne, Australia12Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia13School of Medicine, Deakin University, Waurn Ponds, Geelong, Australia14Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands15Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria16Translational Medical Mycology Research Group, ECMM Excellence Center for Clinical Mycology, Medical University of Graz, Graz, Austria, Graeme N. Forrest, Andoni Ramirez-Garcia
Clinical Microbiology Reviews, 30.03.2024
Tilføjet 30.03.2024
Hassan Abdi Hussein, Abdifetah Mohamed, Juhar Mohamed Ahmed
PLoS One Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
by Hassan Abdi Hussein, Abdifetah Mohamed, Juhar Mohamed Ahmed A cross-sectional study was conducted from May 2017 to March 2019. A participatory epidemiological appraisal was used to gain a rapid overview of the range of camel calf health problems and traditional management, a measure of the importance that people place on each of them, and to identify and prioritize economically important diseases in target zones. The most important constraints to camel production were identified to be the widespread prevalence of diseases such as camelpox, contagious ecthyma, calf scour, ticks, and nonspecific pneumonia; poor management and husbandry practices such as restrictive colostrum feeding, lack of concentrate and salt supplementation and inappropriate housing; shortage of feed; and scarce seasonal variation in water. Additionally, the livestock herders not only showed their knowledge of common camel calf diseases for affected organs and symptoms but also indicated the seasonality of disease occurrences with strong agreement (W = 0.899, P< 0.003) among the informants of all focus group discussions. The overall prevalence of mange, tick infestation, and bacteria-induced diarrhea in the study area was found to be 36.3%, 36%, and 74%, respectively. Sarcoptes scabie var. cameli was the only identified mite species from mange-infested calves, while Hyalomma, Rhipicephalus, and Amblyoma were the most commonly identified tick species. Similarly, the overall prevalence of diarrhea was 74% among this about 34.6% was caused by E. coli while 38.9% was affected by Salmonella and E. coli. Therefore, based on these findings, five diseases have been prioritized as the most significant calf diseases in the area (Camelpox, contagious ecthyma, and causes of pneumonia among camel calves). Improving veterinary health infrastructure and capacity, and increasing community awareness on camel health constraints are also recommended to enhance optimal camel calf rearing.
Læs mere Tjek på PubMedPalle Bager, Lars Bossen, Rasmus Gantzel, Henning Grønbæk
PLoS One Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
by Palle Bager, Lars Bossen, Rasmus Gantzel, Henning Grønbæk Background & aims Fatigue has high negative impact on many patients with primary biliary cholangitis (PBC) and treatment options are limited. Recently we showed favorable effects of four weeks of high-dose thiamine treatment on fatigue in patients with inflammatory bowel disease. We aimed to investigate the effect and safety of high-dose (600–1800 mg daily) oral thiamine treatment on chronic fatigue in patients with PBC. Methods Randomized, double-blinded, placebo-controlled crossover trial including patients with severe PBC-related fatigue. Participants were allocated 1:1 to either group 1) 4 weeks of high-dose thiamine, 4 weeks of washout, and 4 weeks of placebo; or group 2) 4 weeks of placebo, washout, and high-dose thiamine, respectively. Fatigue severity was quantified using the fatigue subscale of the PBC-40 questionnaire. The primary outcome was a fatigue reduction of ≥ 5 points after 4 weeks of high-dose thiamine treatment. Results We enrolled 36 patients; 34 completed the study. The overall mean reduction in fatigue was 5.0 points (95% CI: 2.5 to 7.5; p < 0.001) for the combined group 1 and group 2. Crossover analysis showed a mean increase in fatigue of 0.3 points (95% CI: -4.2 to 3.8) after high-dose thiamine treatment compared to a 1.4 points (95% CI: 6.2 to –3.4) mean reduction after placebo (p = 0.55). Only mild and transient adverse events were recorded. Conclusion Four weeks of high-dose oral thiamine treatment in patients with PBC was well tolerated and safe. However, high-dose thiamine was not superior to placebo in reducing PBC-related fatigue. Trial registration The trial was registered in the ClinicalTrials.gov (NCT04893993) and EudraCT (2020-004935-26).
Læs mere Tjek på PubMedTomoki Kuribara, Takeshi Unoki, Sachika Yamakita, Naoya Hashimoto, Yasuyo Yoshino, Hideaki Sakuramoto, Gen Aikawa, Saiko Okamoto
PLoS One Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
by Tomoki Kuribara, Takeshi Unoki, Sachika Yamakita, Naoya Hashimoto, Yasuyo Yoshino, Hideaki Sakuramoto, Gen Aikawa, Saiko Okamoto Oral care for critically ill patients helps provide comfort and prevent ventilator-associated pneumonia. However, a standardized protocol for oral care in intensive care units is currently unavailable. Thus, this study aimed to determine the overall oral care practices, including those for intubated patients, in Japanese intensive care units. We also discuss the differences in oral care methods between Japanese ICUs and ICUs in other countries. This study included all Japanese intensive care units meeting the authorities’ standard set criteria, with a minimum of 0.5 nurses per patient at all times and admission of adult patients requiring mechanical ventilation. An online survey was used to collect data. Survey responses were obtained from one representative nurse per intensive care unit. Frequency analysis was performed, and the percentage of each response was calculated. A total of 609 hospitals and 717 intensive care units nationwide participated; among these, responses were collected from 247 intensive care units (34.4%). Of these, 215 (87.0%) and 32 (13.0%) reported standardized and non-standardized oral care, respectively. Subsequently, the data from 215 intensive care units that provided standardized oral care were analyzed in detail. The most common frequency of practicing oral care was three times a day (68.8%). Moreover, many intensive care units provided care at unequal intervals (79.5%), mainly in the morning, daytime, and evening. Regarding oral care methods, 96 (44.7%) respondents used only a toothbrush, while 116 (54.0%) used both a toothbrush and a non-brushing method. The findings of our study reveal current oral care practices in ICUs in Japan. In particular, most ICUs provide oral care three times a day at unequal intervals, and almost all use toothbrushes as a common tool for oral care. The results suggest that some oral care practices in Japanese ICUs differ from those in ICUs in other countries.
Læs mere Tjek på PubMedDarcy C. Esiason, Nicole Ciesinski, Chelsi N. Nurse, Wendy Erler, Tom Hattrich, Ankita Deshpande, C. Virginia O’Hayer
PLoS One Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
by Darcy C. Esiason, Nicole Ciesinski, Chelsi N. Nurse, Wendy Erler, Tom Hattrich, Ankita Deshpande, C. Virginia O’Hayer Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed.
Læs mere Tjek på PubMedEmily F. Merritt, Joshua A. Kochanowsky, Perrine Hervé, Alison A. Watson, Anita A. Koshy
PLoS One Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
by Emily F. Merritt, Joshua A. Kochanowsky, Perrine Hervé, Alison A. Watson, Anita A. Koshy Toxoplasma gondii is an intracellular parasite that establishes a long-term infection in the brain of many warm-blooded hosts, including humans and rodents. Like all obligate intracellular microbes, Toxoplasma uses many effector proteins to manipulate the host cell to ensure parasite survival. While some of these effector proteins are universal to all Toxoplasma strains, some are polymorphic between Toxoplasma strains. One such polymorphic effector is GRA15. The gra15 allele carried by type II strains activates host NF-κB signaling, leading to the release of cytokines such as IL-12, TNF, and IL-1β from immune cells infected with type II parasites. Prior work also suggested that GRA15 promotes early host control of parasites in vivo, but the effect of GRA15 on parasite persistence in the brain and the peripheral immune response has not been well defined. For this reason, we sought to address this gap by generating a new IIΔgra15 strain and comparing outcomes at 3 weeks post infection between WT and IIΔgra15 infected mice. We found that the brain parasite burden and the number of macrophages/microglia and T cells in the brain did not differ between WT and IIΔgra15 infected mice. In addition, while IIΔgra15 infected mice had a lower number and frequency of splenic M1-like macrophages and frequency of PD-1+ CTLA-4+ CD4+ T cells and NK cells compared to WT infected mice, the IFN-γ+ CD4 and CD8 T cell populations were equivalent. In summary, our results suggest that in vivo GRA15 may have a subtle effect on the peripheral immune response, but this effect is not strong enough to alter brain parasite burden or parenchymal immune cell number at 3 weeks post infection.
Læs mere Tjek på PubMedMalaria Journal, 29.03.2024
Tilføjet 29.03.2024
Abstract Background Diversification of artemisinin-based combination therapy (ACT) is suggested as one of the strategies that can be used to contain artemisinin resistance. Artesunate-amodiaquine (ASAQ) is one of the artemisinin-based combinations that can be used in the diversification strategy as an alternative first-line treatment for uncomplicated malaria in mainland Tanzania. There is however limited data on the efficacy of ASAQ in mainland Tanzania. This study assessed the efficacy of ASAQ for treatment of uncomplicated Plasmodium falciparum malaria in selected sentinel sites for therapeutic efficacy studies in mainland Tanzania. Methods Between December 2018 and March 2020, children aged between 6 months and 10 years, attending at Nagaga, Mkuzi, and Mlimba primary health facilities, and with suspected uncomplicated malaria infection were screened for eligibility to participate in the study. Malaria infection was screened using microscopy. Children with uncomplicated P. falciparum monoinfection and who fulfilled all other inclusion criteria, and had none of the exclusion criteria, according to the World Health Organization (WHO) guidelines, were treated with ASAQ. Follow-up visits were scheduled on days 0, 1, 2, 3, 7, 14, 21, and 28 or on any day of recurrent infection for clinical and laboratory assessment. Polymerase chain reaction (PCR)-corrected cure rate on day 28 was the primary outcome. Results A total of 264 children, 88 in each of the three study sites (Mlimba, Mkuzi and Nagaga health facilities) were enrolled and treated with ASAQ. The ASAQ PCR-corrected cure rate was 100% at all the three study sites. None of the participants had early treatment failure or late clinical failure. Furthermore, none of the participants had a serious adverse event. Conclusion ASAQ was highly efficacious for the treatment of uncomplicated P. falciparum malaria in mainland Tanzania, therefore, it can be deployed as an alternative first-line treatment for uncomplicated malaria as part of diversification strategy to contain the spread of partial artemisinin resistance in the country.
Læs mere Tjek på PubMedStig Ree Krüger, Espen Rigby Norvard, Kjersti Wik Larssen, Ursa Maierhofer, Helene Hestmann, Thomas Papathomas
International Journal of Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
A 58-year-old male with no travel history was admitted to the medical emergency department with a 6-month history of weight loss, pruritus and reduced appetite, deteriorating with one week of loose stools and nausea. Blood tests indicated a slightly elevated CRP as well as low-grade anemia, eosinophilia, and hyponatremia. A CT scan of the abdomen (Figure 1a) revealed generalized lymphadenopathy. A lymph node biopsy displayed granulomatoid accumulations of variably foamy macrophages containing PAS- and GMS-positive rods (Figure 1b-d).
Læs mere Tjek på PubMedPol Campos-Mercade, Florian H. Schneider
Clinical Microbiology and Infection, 29.03.2024
Tilføjet 29.03.2024
Ensuring widespread vaccination is essential in mitigating the public health impacts of many infectious diseases. Despite the proven effectiveness of vaccination, achieving high vaccination coverage remains a challenge. To increase vaccination rates, public institutions, non-profit organizations, and companies often consider incentivization strategies, including offering monetary rewards conditional on vaccination. For example, in many low-income countries, parents are incentivized to adhere to the complete vaccination schedule for their children [1, 2].
Læs mere Tjek på PubMedKevin B. Laupland, Felicity Edwards, Zoe Dettrick, Patrick N.A. Harris
Clinical Microbiology and Infection, 29.03.2024
Tilføjet 29.03.2024
Studies examining time to positivity (TTP) of blood cultures as a risk factor for death have shown conflicting results. The study objective was to examine the effect of TTP on all cause-30-day case-fatality among a population-based cohort of patients with bloodstream infections (BSI).
Læs mere Tjek på PubMedOlivier Paccoud, Marie Desnos-Ollivier, Florence Persat, Magalie Demar, Karine Boukris-Sitbon, Anne-Pauline Bellanger, Julie Bonhomme, Christine Bonnal, Françoise Botterel, Marie-Elisabeth Bougnoux, Sophie Brun, Sophie Cassaing, Estelle Cateau, Taieb Chouaki, Muriel Cornet, Eric Dannaoui, Nicole Desbois-Nogard, Marie-Fleur Durieux, Loïc Favennec, Arnaud Fekkar, Frederic Gabriel, Jean-Pierre Gangneux, Juliette Guitard, Lilia Hasseine, Antoine Huguenin, Solène Le Gal, Valérie Letscher-Bru, Caroline Mahinc, Florent Morio, Muriel Nicolas, Philippe Poirier, Stéphane Ranque, Gabrielle Roosen, Célia Rouges, Anne-Laure Roux, Milène Sasso, Alexandre Alanio, Olivier Lortholary, Fanny Lanternier, for the French Mycoses Study Group
Clinical Microbiology and Infection, 29.03.2024
Tilføjet 29.03.2024
We aimed to describe features and outcomes of cryptococcosis among HIV-seronegative individuals in a large surveillance network for cryptococcosis in France.
Læs mere Tjek på PubMedSoheila Aghlmandi, Julia Bielicki, Heiner C. Bucher
Clinical Microbiology and Infection, 29.03.2024
Tilføjet 29.03.2024
There are fundamental differences between our cohort1 and the databases from Swiss primary care networks that are mentioned by Plüss-Suard C et al.2 In our study we used patient-level data covering roughly 50% of the Swiss population that was aggregated on a practice level, similar to our Benchmark II trial.3,4 We analyzed 2,945 general practices comprising 5,113 medium-to high-prescriber general practitioners (GPs) and pediatricians. Our study focused specifically on antibiotic prescriptions, and we considered any physician who had prescribed at least one antibiotic during a consultation in a specific year/month to construct the denominator for the calculation of antibiotic prescription rates.
Læs mere Tjek på PubMedGuido Granata, Eskild Petersen, Alessandro Capone, Daniele Donati, Benedetta Andriolo, Maya Gross, Stefania Cicalini, Nicola Petrosillo
Clinical Microbiology and Infection, 29.03.2024
Tilføjet 29.03.2024
Scant data are available on the link between armed conflicts and the development and spread of antimicrobial resistance.
Læs mere Tjek på PubMedBalal SadeghiMartin H. GroschupMartin EidenInstitute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
Virulence, 29.03.2024
Tilføjet 29.03.2024
Yong-Ye YangI-Ting TsaiChung-Hsu LaiChih-Ping ChenChia‐Chi ChenYin-Chou Hsua Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwanb School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwanc Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwand Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwane School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwanf School of Medicine for International Student, I-Shou University, Kaohsiung, Taiwang Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
Virulence, 29.03.2024
Tilføjet 29.03.2024
Milena Dropa, Jéssica Santiago Bispo da Silva, André Furugen César Andrade, Denis Hideki Nakasone, Marcos Paulo Vieira Cunha, Gesiane Ribeiro, Ronalda Silva de Araújo, Carlos Jesus Brandão, Barbara Ghiglione, Nilton Lincopan, Maria Inês Zanoli Sato, Terezinha Knöbl
Tropical Medicine & International Health, 29.03.2024
Tilføjet 29.03.2024
Fan Li, Jixu Li, Jingdong Song, De Li, Qikai Yin, Shihong Fu, Kai Nie, Qianqian Cui, Songtao Xu, Qiang Wei, Huanyu Wang
Journal of Medical Virology, 29.03.2024
Tilføjet 29.03.2024
Assim Verma, Ramesh Kumar Dedar, Ram Kumar, Yogesh Chander, Himanshu Kamboj, Garvit Kumar, Rekha Verma, Santosh Kumari, Shalini Sharma, Bhupendra N. Tripathi, Sanjay Barua, Naveen Kumar
Journal of Medical Virology, 29.03.2024
Tilføjet 29.03.2024