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38 emner vises.
Nanyan Jiang, Meiping Ye, Jingmin Yan, Chunjie Liao, Mengya Shang, Guixuan Wang, Ruirui Peng, Juan Wu, Tengfei Qi, Liyan Ni, Zhifang Guan, Wei Zhao, Pingyu Zhou
International Journal of Infectious Diseases, 14.03.2022
Tilføjet 14.03.2022
Peter V. Markov, Aris Katzourakis, Nikolaos I. Stilianakis
Nat Rev Microbiol, 14.03.2022
Tilføjet 14.03.2022
Nature Reviews Microbiology, Published online: 14 March 2022; doi:10.1038/s41579-022-00722-zThe comparatively milder infections with the Omicron variant and higher levels of population immunity have raised hopes for a weakening of the pandemic. We argue that the lower severity of Omicron is a coincidence and that ongoing rapid antigenic evolution is likely to produce new variants that may escape immunity and be more severe.
Læs mere Tjek på PubMedBrendan O'Kelly, Louise Vidal, Gordana Avramovic, John Broughan, Stephen Peter Connolly, Aoife G Cotter, Walter Cullen, Shannon Glaspy, Tina McHugh, James Woo, John S Lambert
International Journal of Infectious Diseases, 14.03.2022
Tilføjet 14.03.2022
Florin Elec, Jesper Magnusson, Alina Elec, Adriana Muntean, Oana Antal, Tudor Moisoiu, Cristina Cismaru, Mihaela Lupse, Mihai Oltean
International Journal of Infectious Diseases, 14.03.2022
Tilføjet 14.03.2022
: The aim of the study is to evaluate the impact of remdesivir on overall mortality, ICU mortality and renal functional outcome in hospitalized Covid 19 kidney transplant patients.
Læs mere Tjek på PubMedFrancine Ntoumi, Eskild Petersen, Peter Mwaba, Eleni Aklillu, Sayoki Mfinanga, Dorothy Yeboah-Manu, Markus Maeurer, Alimuddin Zumla
International Journal of Infectious Diseases, 14.03.2022
Tilføjet 14.03.2022
Samithamby Jeyaseelan, Hong Wei Chu, Scott K. Young, Mason W. Freeman, G. Scott Worthen aDivision of Respiratory Infections, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado, USA bDivision of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences, Aurora, Colorado, USA cHarvard Medical Schoolgrid.471403.5, Boston, Massachusetts, USA
Infection and Immunity, 14.03.2022
Tilføjet 14.03.2022
Catherine Arsenault, Anna Gage, Min Kyung Kim, Neena R. Kapoor, Patricia Akweongo, Freddie Amponsah, Amit Aryal, Daisuke Asai, John Koku Awoonor-Williams, Wondimu Ayele, Paula Bedregal, Svetlana V. Doubova, Mahesh Dulal, Dominic Dormenyo Gadeka, Georgiana Gordon-Strachan, Damen Haile Mariam, Dilipkumar Hensman, Jean Paul Joseph, Phanuwich Kaewkamjornchai, Munir Kassa Eshetu, Solomon Kassahun Gelaw, Shogo Kubota, Borwornsom Leerapan, Paula Margozzini, Anagaw Derseh Mebratie, Suresh Mehata, Mosa Moshabela, Londiwe Mthethwa, Adiam Nega, Juhwan Oh, Sookyung Park, Álvaro Passi-Solar, Ricardo Pérez-Cuevas, Alongkhone Phengsavanh, Tarylee Reddy, Thanitsara Rittiphairoj, Jaime C. Sapag, Roody Thermidor, Boikhutso Tlou, Francisco Valenzuela Guiñez, Sebastian Bauhoff, Margaret E. Kruk
Nature, 14.03.2022
Tilføjet 14.03.2022
Nature Medicine, Published online: 14 March 2022; doi:10.1038/s41591-022-01750-1An interrupted time series analysis of 31 healthcare services in ten low-income, middle-income and high-income countries demonstrates that the COVID-19 pandemic caused immediate, heterogeneous and prolonged disruptions in service delivery, highlighting the need for health system resilience in pandemic preparedness.
Læs mere Tjek på PubMedLi-Hua Li, Hsu-Feng Lu, Yi-Fu Liu, Yi-Tsung Lin, Tsuey-Ching Yang aDepartment of Pathology and Laboratory Medicine, Taipei Veterans General Hospitalgrid.278247.c, Taipei, Taiwan bSchool of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan cDepartment of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan dDepartment of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan eDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospitalgrid.278247.c, Taipei, Taiwan fSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Antimicrobial Agents And Chemotherapy, 14.03.2022
Tilføjet 14.03.2022
Serdal Arslan, Mehmet Bakir, Burcu Bayyurt, Eylem Itir Aydemir, Kenan Kinaci, Aynur Engin
Journal of Medical Virology, 14.03.2022
Tilføjet 14.03.2022
Monray E. Williams, Vurayai Ruhanya, Robert H. Paul, Jonathan C. Ipser, Dan J. Stein, John A. Joska, Petrus J.W. Naudé
Journal of Medical Virology, 14.03.2022
Tilføjet 14.03.2022
Shengle Qin, Runfeng Li, Zhaoguang Zheng, Xuxin Zeng, Yutao Wang, Xinhua Wang
Journal of Medical Virology, 14.03.2022
Tilføjet 14.03.2022
BMC Infectious Diseases, 13.03.2022
Tilføjet 13.03.2022
Abstract
Background
In older adult patients, bloodstream infections cause significant mortality. However, data on long-term prognosis in very elderly patients are scarce. This study aims to assess 1-year mortality from bacteraemia in very elderly patients.
Methods
Retrospective cohort study in inpatients aged 80 years or older and suspected of having sepsis. Patients with (n = 336) and without (n = 336) confirmed bacteraemia were matched for age, sex, and date of culture, and their characteristics were compared. All-cause mortality and risk of death were assessed using the adjusted hazard ratio (aHR).
Results
Compared to controls, cases showed a higher 1-year mortality (34.8% vs. 45.2%) and mortality rate (0.46 vs. 0.69 deaths per person-year). Multivariable analysis showed significant risk of 1-year mortality in patients with bacteraemia (aHR: 1.31, 95% confidence interval [CI] 1.03–1.67), quick Sepsis Related Organ Failure Assessment (qSOFA) score of 2 or more (aHR: 2.71, 95% CI 2.05–3.57), and age of 90 years or older (aHR 1.53, 95% CI 1.17–1.99).
Conclusions
In elderly patients suspected of sepsis, bacteraemia is associated with a poor prognosis and higher long-term mortality. Other factors related to excess mortality were age over 90 years and a qSOFA score of 2 or more.
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BMC Infectious Diseases, 13.03.2022
Tilføjet 13.03.2022
Abstract
Background
Enteric parasites are endemic in many of the countries from which refugees originate. Clinical guidelines vary in approaches to screening for and treating intestinal parasites in refugee receiving countries. This study aims to investigate the prevalence and species of intestinal parasites identified in stool ova and parasite (O&P) specimens in a sample of newly arrived refugees in Toronto, Canada.
Methods
We conducted a retrospective chart review of 1042 refugee patients rostered at a specialized primary care clinic in Toronto from December 2011 to September 2016. Patients who completed recommended stool O&P analyses were included. Basic sociodemographic and clinical variables and results of stool O&P were examined.
Results
419 patients (40.2%) had a stool O&P positive for any protozoan or helminth species. Sixty-nine patients (6.6%) had clinically significant parasite species (excluding B hominis, D fragilis, and E dispar, given their lower risk for causing symptoms/complications): 2.3% had clinically significant protozoans and 4.2% had helminths on stool analysis.
Conclusion
Given the relatively low prevalence of clinically significant parasites identified, our findings do not support universal screening for enteric parasites with stool O&P among refugee claimants/asylum seekers. However, stool analysis should be considered in certain clinical situations, as part of a more tailored approach.
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Pedro L. Alonso, Katherine L. O’Brien
New England Journal of Medicine, 12.03.2022
Tilføjet 13.03.2022
Stockman, Jeni; Friedman, Jonathan; Sundberg, Johnna; Harris, Emily
Journal of Acquired Immune Deficiency Syndromes, 9.03.2022
Tilføjet 13.03.2022
Background:
A core objective of HIV/AIDS programming is keeping clients on treatment to improve their health outcomes and to limit spread. Machine learning and artificial intelligence can combine client, temporal, and locational attributes to identify which clients are at greatest risk of loss to follow-up (LTFU) and enable health providers to direct support interventions accordingly.
Setting:
The analysis was part of a PEPFAR- and USAID-funded project, Data for Implementation, and applied to data from publicly available sources (health facility data, geospatial data, and satellite imagery) and de-identified electronic medical record data on ART clients in Nigeria and Mozambique.
Methods:
The project applied binary classification techniques using temporal cross-validation to predict the risk that patients would be LTFU. Classifiers included logistic regression, neural networks, and tree-based models.
Results:
Models showed strong predictive power in both settings. In Mozambique, the best performing model, a random forest, achieved an area under the precision-recall curve of 0.65 compared against an underlying LTFU rate of 23%. In Nigeria, the best performing model, a boosted tree, achieved an area under the precision-recall curve of 0.52 compared against an underlying LTFU rate of 27%.
Conclusion:
Machine-learned models outperformed current classification techniques and showed potential to better direct health worker resources towards patients at greatest risk of LTFU. Moreover, models performed equally across sex and age groups, supporting the model’s generalizability and wider application.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedImbert, Elizabeth; Hickey, Matthew D.; Del Rosario, Jan Bing; Conte, Madellena; Kerkoff, Andrew D.; Clemenzi-Allen, Angelo; Riley, Elise D; Havlir, Diane V.; Gandhi, Monica
Journal of Acquired Immune Deficiency Syndromes, 9.03.2022
Tilføjet 13.03.2022
Background/Setting:
In San Francisco, HIV viral suppression is 71% among housed individuals, but only 20% among unhoused individuals. We conducted a discrete choice experiment (DCE) at a San Francisco public HIV clinic to evaluate care preferences among people living with HIV (PLH) experiencing homelessness/unstable housing during the COVID-19 pandemic.
Methods:
From July-November 2020, we conducted a DCE among PLH experiencing homelessness/unstable housing who accessed care through a) an incentivized, drop-in program (“POP-UP”) or b) traditional primary care. We investigated five program features: single provider vs team of providers; visit incentives ($0, $10, $20); location (current site vs current+additional site); drop-in vs scheduled visits; in-person only vs optional telehealth visits; and navigator assistance. We estimated relative preferences using mixed-effects logistic regression and conducted latent class analysis to evaluate preference heterogeneity.
Results:
We enrolled 115 PLH experiencing homelessness/unstable housing, 40% of whom lived outdoors. The strongest preferences were for the same provider (β=0.94, 95%CI 0.48-1.41), visit incentives (β=0.56 per $5; 95%CI 0.47-0.66), and drop-in visits (β=0.47, 95%CI 0.12-0.82). Telehealth was not preferred. Latent class analysis revealed two distinct groups: 78 (68%) preferred a flexible care model; while 37 (32%) preferred a single provider.
Conclusion:
We identified heterogeneous care preferences among PLH experiencing homelessness/unstable housing during the COVID pandemic, with two-thirds preferring greater flexibility and one-third preferring provider continuity. Telehealth was not preferred, even with navigator facilitation. Including patient choice in service delivery design can improve care engagement, particularly for marginalized populations, and is an essential tool for ending the HIV epidemic.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRice, Brian; Machingura, Fortunate; Maringwa, Galven; Magutshwa, Sitholubuhle; Kujeke, Tatenda; Jamali, Gracious; Busza, Joanna; de Wit, Mariken; Fearon, Elizabeth; Hanisch, Dagmar; Yekeye, Raymond; Mugurungi, Owen; Hargreaves, James R; Cowan, Frances M
Journal of Acquired Immune Deficiency Syndromes, 9.03.2022
Tilføjet 13.03.2022
Background:
To reduce HIV incidence among adolescent girls who sell sex (AGSS) in Zimbabwe we need to better understand how vulnerabilities intersect with HIV infection, and how those living with HIV engage in care.
Methods:
In 2017, we conducted social mapping in four locations in Zimbabwe, and recruited girls aged 16 to 19 years who sell sex, using respondent driven sampling or census sampling methods. Participants completed a questionnaire and provided finger-prick blood samples for HIV antibody testing.
Results:
Of 605 AGSS recruited, 74.4% considered themselves sex workers, 24.4% reported experiencing violence in the past year, 91.7% were not in school, and 83.8% had less than a complete secondary education. Prevalence of HIV increasing steeply from 2.1% among those aged 16 years to 26.9% among those aged 19 years; overall 20.2% of AGSS were HIV positive. In multivariate analysis, age, education, marital status, and violence from a client were associated with HIV. Among the 605 AGSS, 86.3% had ever tested for HIV, with 64.1% having tested in the past six months. Among AGSS living with HIV, half (50.8%) were aware of their status, among whom 83.9% reported taking antiretroviral therapy.
Conclusion:
The steep rise in HIV prevalence between 16 and 19 years, suggests the window to engage with AGSS prior to HIV acquisition is short. To accelerate reductions in incidence among AGSS, intensified combination prevention strategies that address structural factors and tailor services to the needs of AGSS are required, particularly ensuring girls enrol and remain in school.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSsempijja, Victor; Nakigozi, Gertrude; Ssekubugu, Robert; Kagaayi, Joseph; Kigozi, Godfrey; Nalugoda, Fred; Nantume, Betty; Batte, James; Kigozi, Grace; Yeh, Ping Teresa; Nakawooya, Hadijja; Serwadda, David; Quinn, Thomas C.; Gray, Ronald H.; Wawer, Maria J.; Grabowski, Kate M.; Chang, Larry W.; van’t Hoog, Anja; Cobelens, Frank; Reynolds, Steven J.
Journal of Acquired Immune Deficiency Syndromes, 9.03.2022
Tilføjet 13.03.2022
Background:
The utility of using PrEP eligibility assessments to identify eligibility in general populations has not been well studied in sub-Saharan Africa. We used the Rakai Community Cohort Study to conduct a cross-sectional analysis to estimate PrEP eligibility and a cohort analysis to estimate HIV incidence associated with PrEP eligibility.
Methods:
Based on Uganda’s national PrEP eligibility tool, we defined eligibility as reporting at least one of the following HIV risks in the last 12 months: sexual intercourse with more than one partner of unknown HIV status; non-marital sex without a condom; sex in exchange for money, goods, or services; or genital ulcers. We used log-binomial and modified Poisson models to estimate prevalence ratios for PrEP eligibility and HIV incidence, respectively.
Findings:
We identified 12,764 participants among which to estimate PrEP eligibility prevalence, and 11,363 participants with 17,381 follow-up visits and 30,721 person-years (pys) of observation to estimate HIV incidence. Overall, 29% met at least one of the eligibility criteria. HIV incidence was significantly higher in PrEP-eligible versus non-PrEP-eligible participants (0·91/100 pys versus 0·41/100 pys; p<0·001), and independently higher in PrEP-eligible versus non-PrEP-eligible females (1·18/100 pys versus 0·50/100 pys; p<0·001). Among uncircumcised males, HIV incidence was significantly higher in PrEP-eligible versus non-PrEP-eligible (1·07/100 pys versus 0·27/100 pys; p=0·001), but there was no significant difference for circumcised males.
Interpretation:
Implementing PrEP as a standard HIV prevention tool in generalized HIV epidemics beyond currently recognized high-risk key populations could further reduce HIV acquisition and aid epidemic control efforts.
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedLori I. Robins, Andrew Clark, Philip R. Gafken, Samina Alam, Janice Milici, Reem Hassan, Che‐Yen Wang, Jeff Williams, Craig Meyers
Journal of Medical Virology, 12.03.2022
Tilføjet 13.03.2022
Hamad Dheir, Aysel Tocoglu, Hande Toptan, Musa Pinar, Taner Demirci, Mehmet Koroglu, Selcuk Yaylaci, Ahmed Bilal Genc, Ahmed Cihad Genc, Necattin Firat, Oguz Karabay, Savas Sipahi
Journal of Medical Virology, 12.03.2022
Tilføjet 13.03.2022
Malaria Journal, 12.03.2022
Tilføjet 13.03.2022
Abstract
Background
Resistance to anti-malarials is a serious threat to the efforts to control and eliminate malaria. Surveillance based on simple field protocols with centralized testing to detect molecular markers associated with anti-malarial drug resistance can be used to identify locations where further investigations are needed.
Methods
Dried blood spots were collected from 398 patients (age range 5–59 years, 99% male) with Plasmodium falciparum infections detected using rapid diagnostic tests over two rounds of sample collection conducted in 2016 and 2017 in Komé, South-West Chad. Specimens were genotyped using amplicon sequencing or qPCR for validated markers of anti-malarial resistance including partner drugs used in artemisinin-based combination therapy (ACT).
Results
No mutations in the pfk13 gene known to be associated with artemisinin resistance were found but a high proportion of parasites carried other mutations, specifically K189T (190/349, 54.4%, 95%CI 49.0–59.8%). Of 331 specimens successfully genotyped for pfmdr1 and pfcrt, 52% (95%CI 46.4–57.5%) carried the NFD-K haplotype, known to be associated with reduced susceptibility to lumefantrine. Only 20 of 336 (6.0%, 95%CI 3.7–9.0%) had parasites with the pfmdr1-N86Y polymorphism associated with increased treatment failures with amodiaquine. Nearly all parasites carried at least one mutation in pfdhfr and/or pfdhps genes but ‘sextuple’ mutations in pfdhfr—pfdhps including pfdhps -A581G were rare (8/336 overall, 2.4%, 95%CI 1.2–4.6%). Only one specimen containing parasites with pfmdr1 gene amplification was detected.
Conclusions
These results provide information on the likely high efficacy of artemisinin-based combinations commonly used in Chad, but suggest decreasing levels of sensitivity to lumefantrine and high levels of resistance to sulfadoxine-pyrimethamine used for seasonal malaria chemoprevention and intermittent preventive therapy in pregnancy. A majority of parasites had mutations in the pfk13 gene, none of which are known to be associated with artemisinin resistance. A therapeutic efficacy study needs to be conducted to confirm the efficacy of artemether-lumefantrine.
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Malaria Journal, 12.03.2022
Tilføjet 13.03.2022
Abstract
Background
Distribution of long-lasting insecticidal bed nets (LLINs) is one of the main control strategies for malaria. Improving malaria prevention programmes requires understanding usage patterns in households receiving LLINs, but there are limits to what standard cross-sectional surveys of self-reported LLIN use can provide. This study was designed to assess the performance of an accelerometer-based approach for measuring a range of LLIN use behaviours as a proof of concept for more granular LLIN-use monitoring over longer time periods.
Methods
This study was carried out under controlled conditions from May to July 2018 in Liverpool, UK. A single accelerometer was affixed to the side panel of an LLIN and participants carried out five LLIN use behaviours: (1) unfurling a net; (2) entering an unfurled net; (3) lying still as if sleeping; (4) exiting from under a net; and, (5) folding up a net. The randomForest package in R, a supervised non-linear classification algorithm, was used to train models on 20-s epochs of tagged accelerometer data. Models were compared in a validation dataset using overall accuracy, sensitivity and specificity, receiver operating curves and the area under the curve (AUC).
Results
The five-category model had overall accuracy of 82.9% in the validation dataset, a sensitivity of 0.681 for entering a net, 0.632 for exiting, 0.733 for net down, and 0.800 for net up. A simplified four-category model, combining entering/exiting a net into one category had accuracy of 94.8%, and increased sensitivity for net down (0.756) and net up (0.829). A further simplified three-category model, identifying sleeping, net up, and a combined net down/enter/exit category had accuracy of 96.2% (483/502), with an AUC of 0.997 for net down and 0.987 for net up. Models for detecting entering/exiting by adults were significantly more accurate than for children (87.8% vs 70.0%; p < 0.001) and had a higher AUC (p = 0.03).
Conclusions
Understanding how LLINs are used is crucial for planning malaria prevention programmes. Accelerometer-based systems provide a promising new methodology for studying LLIN use. Further work exploring accelerometer placement, frequency of measurements and other machine learning approaches could make these methods even more accurate in the future.
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Malaria Journal, 12.03.2022
Tilføjet 13.03.2022
Abstract
Background
Primaquine is a pro-drug and its active metabolite is potent against mature Plasmodium falciparum gametocytes. Primaquine is metabolized by a highly polymorphic cytochrome P450 2D6 (CYP2D6) enzyme. Mutations in the gene encoding this enzyme may lead to impaired primaquine activity. This study assessed if 0.25 mg/kg single-dose primaquine is safe and sufficient to reduce transmission of gametocytes in individuals with no, reduced, or increased CYP2D6 enzyme activity.
Methods
Between June 2019 and January 2020 children aged 1–10 years, attending at Yombo dispensary, Bagamoyo district, with confirmed microcopy-determined uncomplicated P. falciparum malaria were enrolled in the study. The enrolled patients were treated with a standard artemether-lumefantrine regimen plus 0.25 mg/kg single-dose primaquine and followed up for 28 days for clinical and laboratory assessment. Primaquine was administered with the first dose of artemether-lumefantrine. Safety assessment involved direct questioning and recording of the nature and incidence of clinical signs and symptoms, and measurement of haemoglobin (Hb) concentration. Blood samples collected from 100 patients were used for assessment of post-treatment infectiousness on day 7 using mosquito membrane feeding assays. Molecular methods were used to determine CYP2D6 and glucose-6-phosphate dehydrogenase (G6PD) status. The primary outcome was the safety of 0.25 mg/kg single-dose primaquine based on CYP2D6 status.
Results
In total, 157 children [median age 6.4 (Interquartile range 4.0–8.2) years] were recruited, of whom 21.0% (33/157) and 12.7% (20/157) had reduced CYP2D6 and deficient G6PD activity, respectively. Day 3 mean absolute Hb concentration reduction was 1.50 g/dL [95% confidence interval (CI) 1.10–1.90] and 1.51 g/dL (95% CI 1.31–1.71) in reduced and normal CYP2D6 patients, respectively (t = 0.012, p = 0.990). The day 3 mean absolute Hb concentration reduction in G6PD deficient, G6PD normal and heterozygous female was 1.82 g/dL (95% CI 1.32–2.32), 1.48 g/dL (95% CI 1.30–1.67) and 1.47 g/dL (95% CI 0.76–2.18), respectively (F = 0.838, p = 0.435). Sixteen percent (16/98) of the patients each infected at least one mosquito on day 7, and of these, 10.0% (2/20) and 17.9% (14/78) had reduced and normal CYP2D6 enzyme activity, respectively (x2 = 0.736, p = 0.513).
Conclusion
Single-dose 0.25 mg/kg primaquine was safe and sufficient for reducing transmission of P. falciparum gametocytes regardless of CYP2D6 or G6PD status.
Trial registration Study registration number: NCT03352843.
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BMC Infectious Diseases, 12.03.2022
Tilføjet 12.03.2022
Abstract
Backgrounds
Respiratory viruses are the main triggers of asthma. Coronavirus is shown to contribute to respiratory tract infections that can lead to prolonged cough and asthma.
Objectives
Present study aimed to determine the risk of developing Persistent cough and asthma-like symptoms in hospitalized children due to COVID-19.
Methods
This prospective study was carried out in a tertiary referral center. During the COVID-19 pandemic, 69 hospitalized pediatric patients admitted with COVID-19 were observed from February 2020 to January 2021. Clinical and laboratory data were recorded, and after discharge, patients were followed and visited for cough and asthma evaluation one, 2 and 6 months later. Patients with asthma-like diagnoses in follow up defined as asthma-like groups, and patients without any sign of asthma were categorized as the non-asthma group. Asthma-like co-morbids and risk factors were evaluated and compared between the two groups.
Results
In follow-up, most of the COVID-19 hospitalized patients (N = 42) (58.5%) were not affected by asthma-like symptoms. 60.9% of the COVID-19 patients were male. The asthma-like group cases had a significantly familial history of asthma (63.0%), past medical history of asthma (33.3%), and Allergic rhinitis (85.2%). Rates of signs and symptoms during hospitalization were significantly higher in patients with COVID-19 and past medical history of asthma.
Conclusions
We found an asthma-like prevalence of 41.5% in the cohort of COVID-19 hospitalized children. Family history of asthma and previous history of asthma and allergic rhinitis are risk factors for asthma-like after COVID-19 hospitalization. COVID-19 presentations are more severe in the asthma-like group.
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BMC Infectious Diseases, 12.03.2022
Tilføjet 12.03.2022
Abstract
Background
Mycobacterial time to positivity (TTP) in liquid culture media has predictive value for longer term outcomes in pulmonary tuberculosis, but has not been thoroughly studied in nontuberculous mycobacterial pulmonary disease. This study sought to evaluate for association between TTP and sputum culture conversion to negative in pulmonary disease caused by Mycobacterium avium complex (MAC).
Methods
Data from the CONVERT trial (NCT02344004) that evaluated efficacy of guideline-based-therapy with or without amikacin liposome inhalation suspension in adults with refractory MAC-PD (Mycobacterium avium complex pulmonary disease) were analyzed. We evaluated TTP measures for sputum obtained prior to study treatment initiation and at monthly visits, assessing reproducibility of measures as well as association of TTP with culture conversion on treatment.
Results
Data from 71 participants with at least one screening visit TTP value were analyzed. For participants who provided more than one sputum sample at a given visit, there was moderate between-sample reliability, with median intraclass correlation coefficient 0.62 (IQR 0.50, 0.70). Median TTP at screening was longer in those participants who subsequently achieved vs. did not achieve culture conversion (10.5 [IQR 9.4] days vs. 4.2 [IQR 2.8] days, p = 0.0002). Individuals with culture conversion by study treatment month 6 were more likely to have a screening TTP > 5 days compared to those who did not achieve culture conversion (OR 15.4, 95% CI 1.9, 716.7, p = 0.0037) and had increasing TTPs over time.
Conclusions
TTP prior to and on treatment is associated with microbiological treatment response in patients with MAC-PD.
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BMC Infectious Diseases, 12.03.2022
Tilføjet 12.03.2022
Abstract
Background
Colombia has been one of the Latin American countries seriously affected by the covid-19 pandemic. Risk factors for severe disease and death in COVID 19 have been described across the world. Here we report the outcomes, clinical characteristics and risk factors for invasive mechanical ventilation and in-hospital death in a tertiary center in Palmira, Colombia.
Methods
This was a retrospective cross-sectional study involving one single center in Palmira, Colombia. People hospitalized with severe and critical covid-19, during the first pandemic wave, were included. The clinical characteristics and risk factors for in-hospital mortality and invasive mechanical ventilation were mean to be stablished by using a logistic regression analysis.
Results
One hundred and fifty-eight patients were analyzed. Most patients were male (70%) with a mean age of 63 years, invasive mechanical ventilation was provided to 39%, in-hospital mortality was 36%, mainly caused by refractory hypoxemia and septic shock, admission to intensive care was as high as 65%. The logistic regression analysis showed that the risk factors for in-hospital mortality were elevated levels of lactic dehydrogenase and high-sensitivity troponin I, acute renal failure, COPD, and > 10 points on the MuLBSTA score. The risk factors for invasive mechanical ventilation were high levels of C-reactive protein and very low lymphocyte counts, a PaO2/FiO2 < 70 and some clinical scores like CURB65, NEWS 2, and PSI/PORT.
Conclusions
During the first pandemic wave in Colombia, for the experience of a tertiary center with a mainly elderly population, a high prevalence of severe ARDS was found, high requirement of intensive care, invasive ventilatory support, bacterial sepsis and an elevated mortality rate were found. The risk factors for in-hospital death and invasive mechanical ventilation were stablished.
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BMC Infectious Diseases, 12.03.2022
Tilføjet 12.03.2022
Abstract
Background
Effective treatment options for recurrent Clostridioides difficile infection (rCDI) are limited, with high recurrence rates associated with the current standard of care. Herein we report results from an open-label Phase 2 trial to evaluate the safety, efficacy, and durability of RBX2660—a standardized microbiota-based investigational live biotherapeutic—and a closely-matched historical control cohort.
Methods
This prospective, multicenter, open-label Phase 2 study enrolled patients who had experienced either ≥ 2 recurrences of CDI, treated by standard-of-care antibiotic therapy, after a primary CDI episode, or ≥ 2 episodes of severe CDI requiring hospitalization. Participants received up to 2 doses of RBX2660 rectally administered with doses 7 days apart. Treatment success was defined as the absence of CDI diarrhea without the need for retreatment for 8 weeks after completing study treatment. A historical control group with matched inclusion and exclusion criteria was identified from a retrospective chart review of participants treated with standard-of-care antibiotics for recurrent CDI who matched key criteria for the study. The primary objective was to compare treatment success of RBX2660 to the historical control group. A key secondary outcome was the safety profile of RBX2660, including adverse events and CDI occurrence through 24 months after treatment. In addition, fecal samples from RBX2660-treated participants were sequenced to evaluate microbiome composition and functional changes from before to after treatment.
Results
In this Phase 2 open-label clinical trial, RBX2660 demonstrated a 78.9% (112/142) treatment success rate compared to a 30.7% (23/75) for the historical control group (p < 0.0001; Chi-square test). Post-hoc analysis indicated that 91% (88/97) of evaluable RBX2660 responders remained CDI occurrence-free to 24 months after treatment demonstrating durability. RBX2660 was well-tolerated with mostly mild to moderate adverse events. The composition and diversity of RBX2660 responders’ fecal microbiome significantly changed from before to after treatment to become more similar to RBX2660, and these changes were durable to 24 months after treatment.
Conclusions
In this Phase 2 trial, RBX2660 was safe and effective for reducing rCDI recurrence as compared to a historical control group. Microbiome changes are consistent with restorative changes implicated in resisting C. difficile recurrence.
Clinical Trials Registration NCT02589847 (10/28/2015)
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Marta Giovanetti, Stefania Farcomeni, Leonardo Sernicola, Sara Virtuoso, Lucia Fontanelli Sulekova, Maria T. Maggiorella, Stefano Buttò, Gloria Taliani, Massimo Ciccozzi, Alessandra Borsetti
Journal of Medical Virology, 12.03.2022
Tilføjet 12.03.2022
Robin Arcani, Raphael Cauchois, Pierre Suchon, Rodolphe Jean, Pierre‐André Jarrot, Quentin Gomes De Pinho, Jean‐Baptiste Dalmas, Estelle Jean, Baptiste Andre, Véronique Veit, Marie Koubi, Gilles Kaplanski
Journal of Medical Virology, 12.03.2022
Tilføjet 12.03.2022
Li Shen, Minghao Sun, Shuxuan Song, Qingwu Hu, Nuoya Wang, Guangyu Ou, Zhaohui Guo, Du Jing, Zhongjun Shao, Yao Bai, Kun Liu
Journal of Medical Virology, 12.03.2022
Tilføjet 12.03.2022
Vivek P Chavda, Aayushi B. Patel, Darsh D. Vaghasiya
Journal of Medical Virology, 12.03.2022
Tilføjet 12.03.2022
Gregor John, Eric Mugnier, Etienne Pittet, Dominique Marianne Staehli, Olivier Clerc, Alain Foguena Kenfak, Andreas Konasch, Reto Lienhard, Daniel Genné
Clinical Microbiology and Infection, 11.03.2022
Tilføjet 12.03.2022
Milo Gatti, Matteo Rinaldi, Linda Bussini, Cecilia Bonazzetti, Renato Pascale, Zeno Pasquini, Francesca Faní, Mariana Nunes Pinho Guedes, Anna Maria Azzini, Elena Carrara, Zaira R. Palacios-Baena, Giulia Caponcello, Eduardo Reyna-Villasmil, Evelina Tacconelli, Jesús Rodríguez-Baño, Pierluigi Viale, Maddalena Giannella, ORCHESTRA study group
Clinical Microbiology and Infection, 11.03.2022
Tilføjet 12.03.2022
A significant increased risk of complications and mortality in immunocompromised patients affected by COVID-19 has been described. However, the impact of COVID-19 in solid organ transplant (SOT) recipients is an issue still on debate, due to conflicting evidence emerged from different observational studies.
Læs mere Tjek på PubMedChristina M Eckhardt, Max R O'Donnell
Lancet Infectious Diseases, 12.03.2022
Tilføjet 12.03.2022
In The Lancet Infectious Diseases, James Welker and colleagues1 report a randomised, double-blind, placebo-controlled, phase 3 study of intravenous CD24Fc (480 mg over 60 min on day 1) versus placebo in adults hospitalised with COVID-19 at nine medical centres in the USA. The primary endpoint was time to clinical improvement, defined as time elapsed between a baseline National Institute of Allergy and Infectious Diseases 8-point ordinal scale (NIAID-OS) score of 2–4 and a score of 5 or higher or hospital discharge.
Læs mere Tjek på PubMedJames Welker, Juan D Pulido, Andrew T Catanzaro, Carlos D Malvestutto, Zihai Li, Jonathan B Cohen, Eric D Whitman, Dana Byrne, Olivia K Giddings, Jordan E Lake, Joel V Chua, Ella Li, Jian Chen, Xiang Zhou, Kun He, Davis Gates, Amarjot Kaur, Jamie Chen, Hung-Yen Chou, Martin Devenport, Raymond Touomou, Shyamasundaran Kottilil, Yang Liu, Pan Zheng, SAC-COVID Study Team
Lancet Infectious Diseases, 12.03.2022
Tilføjet 12.03.2022
CD24Fc is generally well tolerated and accelerates clinical improvement of hospitalised patients with COVID-19 who are receiving oxygen support. These data suggest that targeting inflammation in response to tissue injuries might provide a therapeutic option for patients hospitalised with COVID-19.
Læs mere Tjek på PubMedJeong Min Lee, Junho Kwon, Soo Jeong Lee, Heejeong Jang, DoGyun Kim, Jeongeun Song, Kyoung Taek Kim
Science Advances, 11.03.2022
Tilføjet 12.03.2022
Science Advances, <a href='https://www.science.org/toc/sciadv/8/10'>Volume 8, Issue 10</a>, March 2022.
Læs mere Tjek på PubMedMarc Kschonsak, Matthew C. Johnson, Rachel Schelling, Evan M. Green, Lionel Rougé, Hoangdung Ho, Nidhi Patel, Cem Kilic, Edward Kraft, Christopher P. Arthur, Alexis L. Rohou, Laetitia Comps-Agrar, Nadia Martinez-Martin, Laurent Perez, Jian Payandeh, Claudio Ciferri
Science Advances, 11.03.2022
Tilføjet 12.03.2022
Science Advances, <a href='https://www.science.org/toc/sciadv/8/10'>Volume 8, Issue 10</a>, March 2022.
Læs mere Tjek på PubMedDaniel Wrapp, Xiaohua Ye, Zhiqiang Ku, Hang Su, Harrison G. Jones, Nianshuang Wang, Akaash K. Mishra, Daniel C. Freed, Fengsheng Li, Aimin Tang, Leike Li, Dabbu Kumar Jaijyan, Hua Zhu, Dai Wang, Tong-Ming Fu, Ningyan Zhang, Zhiqiang An, Jason S. McLellan
Science Advances, 11.03.2022
Tilføjet 12.03.2022
Science Advances, <a href='https://www.science.org/toc/sciadv/8/10'>Volume 8, Issue 10</a>, March 2022.
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