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Ingen søgeord valgt.
20 emner vises.
Jennifer Chua, Ethan Nguyenkhoa, Sherry Mou, Steven A. Tobery, Arthur M. Friedlander, David DeShazer aBacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA bHeadquarters, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA, Guy H. Palmer
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
Lindsey K. Schmidt, Caitlyn E. Orne, Teresa L. Shaffer, Shane M. Wilson, Nittaya Khakhum, Alfredo G. Torres, Paul J. Brett, Mary N. Burtnick aDepartment of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA bDepartment of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA cDepartment of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, Manuela Raffatellu
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
R. C. A. de Groot, H. Zhu, T. Hoogenboezem, A. C. J. M. de Bruijn, E. Eenjes, A. E. J. ’t Jong, A. I. Belo, S. C. Estevão, J. J. Bajramovic, R. J. Rottier, M. Kool, A. M. C. van Rossum, W. W. J. Unger aLaboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MCgrid.5645.2 University Medical Center Rotterdam–Sophia Children’s Hospital, Rotterdam, The Netherlands bDepartment of Pediatric Surgery and Department of Cell Biology, Erasmus MCgrid.5645.2 University Medical Center Rotterdam–Sophia Children’s Hospital, Rotterdam, The Netherlands cAlternatives Unit, Biomedical Primate Research Centregrid.11184.3d, Rijswijk, The Netherlands dDepartment of Pulmonary Medicine, Erasmus MCgrid.5645.2 University Medical Center Rotterdam, Rotterdam, The Netherlands eDepartment of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MCgrid.5645.2 University Medical Center Rotterdam–Sophia Children’s Hospital, Rotterdam, The Netherlands, Liise-anne Pirofski
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
Aubin Souche, Camille Kolenda, Jordan Teoli, Raymond Schuch, Tristan Ferry, Frédéric Laurent, Jérôme Josse aCIRI–Centre International de Recherche en Infectiologie, Inserm, U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France bLaboratoire de Bactériologie, Institut des Agents Infectieux, Hospices Civils de Lyongrid.413852.9, Lyon, France cContraFect Corporation, Yonkers, New York, USA dUniversité Claude Bernard Lyon 1, Lyon, France eCentre de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyongrid.413852.9, Lyon, France fService des Maladies Infectieuses, Hospices Civils de Lyongrid.413852.9, Lyon, France
Antimicrobial Agents And Chemotherapy, 11.07.2022
Tilføjet 11.07.2022
Xiangri Kong, Bingmei Wang, Xiaoyu Chen, Li Wang, Xingye Wang, Juan Hou, Lin Wei, Liyan Sui, Chi Zhang, Jiyu Guan, Yanhe Luan, Wei Wang, Wu Song, Yicheng Zhao aChangchun University of Chinese Medicinegrid.440665.5, Changchun, People’s Republic of China bKey Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, People’s Republic of China cCenter for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital Jilin University, Changchun, People’s Republic of China dAffiliated Hospital to Changchun University of Chinese Medicinegrid.440665.5, Changchun, People’s Republic of China
Antimicrobial Agents And Chemotherapy, 11.07.2022
Tilføjet 11.07.2022
Infection, 11.07.2022
Tilføjet 11.07.2022
Abstract
Background
Monkeypox is a zoonotic orthopoxvirus infection endemic in central and western Africa. In May 2022, human monkeypox infections including human-to-human transmission were reported in a multi-country outbreak in Europe and North America.
Case presentations
Here we present the first two cases of monkeypox infection in humans diagnosed in Germany. We present clinical and virological findings, including the detection of monkeypox virus DNA in blood and semen. The clinical presentation and medical history of our patients suggest close physical contact during sexual interactions as the route of infection.
Conclusion
Monkeypox requires rapid diagnosis and prompt public health response. The disease should be considered in the current situation especially the differential diagnosis of vesicular or pustular rash, particularly in patients with frequent sexual contacts. Most importantly, it is essential to raise awareness among all health professionals for the rapid and correct recognition and diagnosis of this disease, which is probably still underreported in Europe (Adler et al. in Lancet Infect Dis https://doi.org/10.1016/s1473-3099(22)00228-6, 2022).
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BMC Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
Abstract
Background
Tuberculosis (TB) is a leading cause of morbidity and mortality in children but epidemiological data are scarce, particularly for hard-to-reach populations. We aimed to identify the risk factors for unsuccessful outcome and TB mortality in migrant children at a supportive residential TB programme on the Thailand–Myanmar border.
Methods
We conducted retrospective analysis of routine programmatic data for children (aged ≤ 15 years old) with TB diagnosed either clinically or bacteriologically between 2013 and 2018. Treatment outcomes were described and risk factors for unsuccessful outcome and death were identified using multivariable logistic regression.
Results
Childhood TB accounted for a high proportion of all TB diagnoses at this TB programme (398/2304; 17.3%). Bacteriological testing was done on a quarter (24.9%) of the cohort and most children were diagnosed on clinical grounds (94.0%). Among those enrolled on treatment (n = 367), 90.5% completed treatment successfully. Unsuccessful treatment outcomes occurred in 42/398 (10.6%) children, comprising 26 (6.5%) lost to follow-up, one (0.3%) treatment failure and 15 (3.8%) deaths. In multivariable analysis, extra-pulmonary TB [adjusted OR (aOR) 3.56 (95% CI 1.12–10.98)], bacteriologically confirmed TB [aOR 6.07 (1.68–21.92)] and unknown HIV status [aOR 42.29 (10.00–178.78)] were independent risk factors for unsuccessful outcome. HIV-positive status [aOR 5.95 (1.67–21.22)] and bacteriological confirmation [aOR 9.31 (1.97–44.03)] were risk factors for death in the secondary analysis.
Conclusions
Children bear a substantial burden of TB disease within this migrant population. Treatment success rate exceeded the WHO End TB target of 90%, suggesting that similar vulnerable populations could benefit from the enhanced social support offered by this TB programme, but better child-friendly diagnostics are needed to improve the quality of diagnoses.
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Bogard, Sherri N.; Lee, James T.; Patel, Manish; Kempker, Russell R
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 11.07.2022
Background:
Although the price increase of pyrimethamine in 2015 received heavy media coverage, there is little data regarding specific implications to hospitals and the total costs of treating inpatients with toxoplasmosis encephalitis (TE).
Methods:
Utilizing average drug wholesale costs, we estimated the inpatient drug costs of TE drugs three years pre- and post- pyrimethamine price increase in August 2015. The drug regimens and total doses were determined through retrospective chart review of patients living with HIV who received treatment for toxoplasmosis encephalitis while inpatient during this period.
Results:
The three-year pre-increase TE drug costs for 66 admissions were estimated at $50,310 compared to a total drug cost of $1,026,006 for 61 admissions post-increase. Pyrimethamine made up 98% of the drug costs post-increase, compared to 57% pre-increase. Pyrimethamine-based regimens were the most frequently used throughout the study period.
Conclusions:
The price increase of pyrimethamine in 2015 led to a substantial and unnecessary financial burden to hospitals. This required healthcare systems to shift valuable resources in order to continue to provide medications to a vulnerable patient population. There has been more focus on providing high value care in recent years. Our study highlights the need for further examination of pharmaceutical companies’ arbitrary determination of medication costs and how they contribute to patient care.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChyten-Brennan, Jules; Patel, Viraj V.; Anastos, Kathryn; Hanna, David B.
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 11.07.2022
Background:
Transgender women (trans-women) are frequently conflated with cisgender sexual minority men (cis-SMM) in HIV research. We examined the impact of socioeconomic and health conditions, and gender-affirming hormones in comparing HIV-related outcomes between cis-SMM and trans-women.
Setting:
Large tertiary care health system in the Bronx, NY, USA.
Methods:
Retrospective cohort study of people with HIV receiving care in 2008-2017. We compared retention in care, antiretroviral therapy (ART) prescription, and viral suppression between cis-SMM and trans-women, using modified Poisson regression, adjusting for demographic and clinical factors. Trans-women were further stratified by receipt of estrogen prescription.
Results:
We included 166 trans-women (1.4%), 1,936 cis-SMM (17%), 4,715 other cisgender men (41%), and 4,745 cisgender women (41%). Trans-women were more likely to have public insurance (78% vs 65%) and mental health (49% vs 39%) or substance use (43% vs 33%) diagnoses than cis-SMM. Compared with cis-SMM, trans-women prescribed estrogen (67% of trans-women) were more likely to be retained (adjusted risk ratio [aRR] 1.15, 95% confidence interval [CI] 1.08-1.23), prescribed ART (aRR 1.06, CI 1.01-1.11), and virally suppressed (aRR 1.08, CI 1.01-1.16). Trans-women not prescribed estrogen were less likely to be retained (aRR 0.92, CI 0.83-1.02), prescribed ART (aRR 0.90, CI 0.82-0.98), or virally suppressed (aRR 0.85, CI 0.76-0.95).
Conclusions:
In the context of HIV, socioeconomic factors, comorbidities, and gender-affirming care distinguish trans-women from cis-SMM. Compared with cis-SMM, trans-women who were prescribed estrogen had better HIV care continuum outcomes; trans-women not prescribed estrogen had worse outcomes. These differences should be accounted for in HIV-related research.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
AbstractBackgroundScreen-and-treat strategies with sensitive diagnostic tests may reduce malaria-associated adverse pregnancy outcomes. We conducted a diagnostic accuracy study to evaluate new point-of-care tests to screen pregnant women for malaria at their first antenatal visit in western Kenya.MethodsConsecutively women were tested for Plasmodium infection by expert-microscopy, conventional rapid diagnostic test (cRDT), ultra-sensitive RDT (usRDT), and loop-mediated isothermal amplification (LAMP). Photo-induced electron-transfer polymerase-chain-reaction (PET-PCR) served as the reference standard. Diagnostic performance was calculated and modelled at low parasite densities.ResultsBetween May-September 2018, 172 out of 482 screened participants (35.7%) were PET-PCR positive. Relative to PET-PCR, expert-microscopy was least sensitive (40.1%, 95% CI 32.7-47.9), followed by cRDT (49.4%, 41.7-57.1), usRDT (54.7%, 46.9-62.2), and LAMP (68.6%, 61.1-75.5). Test sensitivities were comparable in febrile women (N = 90). Among afebrile women (N = 392), the geometric-mean parasite density was 29 parasites/µL and LAMP (sensitivity = 61.9%) and usRDT (43.2%) detected 1.74 (1.31-2.30) and 1.21 (0.88-2.21) more infections than cRDT (35.6%). Per our model, tests performed similarly at densities >200 parasites/µL. At 50 parasites/µL, the sensitivities were 45%, 56%, 62% and 74% with expert-microscopy, cRDT, usRDT, and LAMP, respectively.ConclusionsThis first-generation usRDT provided moderate improvement in detecting low-density infections in afebrile pregnant women compared to cRDTs.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 8.07.2022
Tilføjet 11.07.2022
AbstractBackgroundPoor sleep is associated with HIV, particularly among women with HIV (WWH), although mechanisms are unclear. We explored cross-sectional associations between sleep disruption and tryptophan-kynurenine (T/K) pathway activation, measured by the kynurenine-to-tryptophan ratio (K:T).MethodsHIV-uninfected women (HIV-) and WWH on stable antiretroviral therapy aged 35-70 were included. Sleep metrics were measured using wrist actigraphy. Plasma T/K pathway metabolites were measured using liquid chromatography-tandem mass spectrometry. Multivariate linear regression models examined relationships between K:T and actigraphy-based sleep metrics by HIV status.ResultsWWH (N = 153) and HIV- women (N = 151) were demographically similar. Among WWH, median CD4 was 751 cells/mm3; 92% had undetectable HIV RNA. Compared to HIV- women, WWH had higher K:T (p < 0.001) and kynurenine (p = 0.01) levels but similar tryptophan levels (p = 0.25). Higher K:T was associated with more wake bouts (p = 0.001), more time awake after sleep onset (p = 0.01) and lower sleep efficiency (p = 0.03) in WWH only.ConclusionsHIV infection was associated with T/K pathway activation; this activation was associated with poorer sleep efficiency and more fragmented sleep. While longitudinal studies are needed to elucidate the directionality of these associations, these findings may help identify treatments to reduce sleep disruption in WWH by targeting residual inflammation and T/K pathway activation.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 8.07.2022
Tilføjet 11.07.2022
FEMS Microbiology Reviews, 9.07.2022
Tilføjet 11.07.2022
AbstractDNA double-strand breaks require repair or risk corrupting the language of life. To ensure genome integrity and viability, multiple DNA double-strand break repair pathways function in eukaryotes. Two such repair pathways, canonical non-homologous end joining and homologous recombination, have been extensively studied, while other pathways such as microhomology-mediated end joint and single-strand annealing, once thought to serve as back-ups, now appear to play a fundamental role in DNA repair. Here, we review the molecular details and hierarchy of these four DNA repair pathways, and where possible, a comparison for what is known between animal and fungal models. We address the factors contributing to break repair pathway choice, and aim to explore our understanding and knowledge gaps regarding mechanisms and regulation in filamentous pathogens. We additionally discuss how DNA double-strand break repair pathways influence genome engineering results, including unexpected mutation outcomes. Finally, we review the concept of biased genome evolution in filamentous pathogens, and provide a model, termed Biased Variation, that links DNA double-strand break repair pathways with properties of genome evolution. Despite our extensive knowledge for this universal process, there remain many unanswered questions, for which the answers may improve genome engineering and our understanding of genome evolution.
Læs mere Tjek på PubMedFEMS Microbiology Reviews, 5.07.2022
Tilføjet 11.07.2022
AbstractTermites are a prototypical example of the ‘extended phenotype’ given their ability to shape their environments by constructing complex nesting structures and cultivating fungus gardens. Such engineered structures provide termites with stable, protected habitats and nutritious food sources, respectively. Recent studies have suggested that these termite-engineered structures harbour Actinobacteria-dominated microbial communities. In this review, we describe the composition, activities, and consequences of microbial communities associated with termite mounds, other nests, and fungus gardens. Culture-dependent and culture-independent studies indicate that these structures each harbour specialised microbial communities distinct from those in termite guts and surrounding soils. Termites select microbial communities in these structures through various means: opportunistic recruitment from surrounding soils; controlling physicochemical properties of nesting structures; excreting hydrogen, methane and other gases as bacterial energy sources; and pre-treating lignocellulose to facilitate fungal cultivation in gardens. These engineered communities potentially benefit termites by producing antimicrobial compounds, facilitating lignocellulose digestion, and enhancing energetic efficiency of the termite ‘metaorganism’. Moreover, mound-associated communities have been shown to be globally significant in controlling emissions of methane and enhancing agricultural fertility. Altogether, these considerations suggest that the microbiomes selected by some animals extend much beyond their bodies, providing a new dimension to the ‘extended phenotype’.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.07.2022
Tilføjet 11.07.2022
AbstractBackgroundFrozen foods have rarely been linked to Listeria monocytogenes illness. We describe an outbreak investigation prompted both by hospital clustering of illnesses and product testing.MethodsWe identified outbreak-associated listeriosis cases using whole-genome sequencing (WGS), product testing results, and epidemiologic linkage to cases in the same Kansas hospital. We reviewed hospital medical and dietary records, product invoices, and molecular subtyping results. Federal and state officials tested product and environmental samples for L. monocytogenes.ResultsKansas officials were investigating five cases of listeriosis at a single hospital when, simultaneously, unrelated sampling for a study in South Carolina identified L. monocytogenes in Company A ice cream products made in Texas. Isolates from four patients and Company A products were closely related by WGS, and the four patients with known exposures had consumed milkshakes made with Company A ice cream while hospitalized. Further testing identified L. monocytogenes in ice cream produced in a second Company A production facility in Oklahoma; these isolates were closely related by WGS to those from five patients in three other states. These ten illnesses, involving three deaths, occurred from 2010 through 2015. Company A ultimately recalled all products.ConclusionIn this U.S. outbreak of listeriosis linked to a widely distributed brand of ice cream, WGS and product sampling helped link cases spanning five years to two production facilities, indicating longstanding contamination. Comprehensive sanitation controls and environmental and product testing for L. monocytogenes, with regulatory oversight, should be implemented for ice cream production.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.07.2022
Tilføjet 11.07.2022
Clinical Infectious Diseases, 7.07.2022
Tilføjet 11.07.2022
AbstractBackgroundDiarrhea is the second leading cause of death in children under five years of age globally. The burden of diarrheal mortality is concentrated in low-resource settings. Little is known about the risk factors for childhood death from diarrheal disease in low and middle-income countries.MethodsData from the WHO-coordinated Global Rotavirus and Pediatric Diarrhea Surveillance Networks, which are composed of active, sentinel, hospital-based surveillance sites, were analyzed to assess mortality in children less than five years of age who were hospitalized with diarrhea between 2008-2018. Case fatality risks were calculated, and multivariable logistic regression was performed to identify risk factors for mortality.ResultsThis analysis is comprised of 234,781 cases, including 1,219 deaths, across 57 countries. The overall case fatality risk was found to be 0.5%. Risk factors for death in the multivariable analysis included younger age (for <6 months compared with older ages, OR = 3.54; 95% CI = 2.81-4.50), female sex (OR = 1.18; 95% CI= 1.06-1.81), presenting with persistent diarrhea (OR = 1.91; 95% CI= 1.01-3.25), no vomiting (OR = 1.13, 95% CI= 0.98-1.30), severe dehydration (OR = 3.79; 95% CI = 3.01-4.83), and being negative for rotavirus on an ELISA test (OR = 2.29; 95% CI= 1.92-2.74). Cases from the African Region had the highest odds of death compared with other WHO Regions (OR = 130.62 comparing the African Region to the European region; 95% CI= 55.72-422.73), while cases from the European region had the lowest odds of death.ConclusionsOur findings support known risk factors for childhood diarrheal mortality and highlight the need for interventions to address dehydration and rotavirus-negative diarrheal infections.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.07.2022
Tilføjet 11.07.2022
AbstractWe used variant typing PCR to describe the evolution of SARS-CoV-2 Omicron sublineages between December 2021 and mid-March 2022. The selective advantage of the BA.2 variant over BA.1 is not due to greater nasopharyngeal viral loads.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.07.2022
Tilføjet 11.07.2022
AbstractBackgroundThe immune response to COVID-19 vaccination is inferior in kidney transplant recipients (KTR), and to a lesser extent in patients on dialysis or with chronic kidney disease (CKD). We assessed the immune response 6 months after mRNA-1273 vaccination in kidney patients and compared this to controls.Methods152 participants with CKD stages G4/5 (eGFR <30 mL/min/1.73m2), 145 participants on dialysis, 267 KTR, and 181 controls were included. SARS-CoV-2 Spike S1-specific IgG antibodies were measured by fluorescent bead-based multiplex-immunoassay, neutralizing antibodies to ancestral, Delta and Omicron (BA.1) variants by plaque reduction, and T-cell responses by IFN-γ release assay.ResultsAt 6 months after vaccination S1-specific antibodies were detected in 100% of controls, 98.7% of CKD G4/5 patients, 95.1% of dialysis patients, and 56.6% of KTR. These figures were comparable to the response rates at 28 days, but antibody levels waned significantly. Neutralization of the ancestral and Delta variant was detected in most participants, whereas neutralization of Omicron was mostly absent. S-specific T-cell responses were detected 6 months in 75.0% of controls, 69.4% of CKD G4/5 patients, 52.6% of dialysis patients, and 12.9% of KTR. T-cell responses at 6 months were significantly lower than responses at 28 days.ConclusionsAlthough seropositivity rates at 6 months were comparable to that at 28 days after vaccination, significantly decreased antibody levels and T-cell responses were observed. The combination of low antibody levels, reduced T-cell responses, and absent neutralization of the newly-emerging variants indicates the need for additional boosts or alternative vaccination strategies in KTR.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.07.2022
Tilføjet 11.07.2022
AbstractBackgroundStudies evaluating stroke following varicella zoster infection are limited, and the utility of zoster vaccination against this phenomenon is unclear.PurposeTo determine the risk of stroke 30 days following zoster infection, and to evaluate the impact of zoster vaccinations on the risk of stroke in VZV-infected patients.MethodsThis retrospective case-control study was conducted from January 2010 to January 2020 utilizing nationwide patient data retrieved from the Veterans Affairs’ Corporate Data Warehouse.ResultsA total of 2,165,505 patients 18 years of age or older who received care at a Veterans Affairs facility were included in the study, of which 71,911 patients had a history of zoster infection. Zoster patients were found to have 1.9 times increased likelihood of developing a stroke within 30 days following infection (OR: 1.93 [95% CI: 1.57–2.4] P < 0.0001). A decreased risk of stroke was seen in patients who received the recombinant zoster vaccine (OR 0.57 [95% CI: 0.46-0.72] p < 0.0001) or the live zoster vaccine (OR 0.77 [95% CI: 0.65-0.91] p = 0.002).ConclusionPatients had a significantly higher risk of stroke within the first month following recent herpes zoster infection. Receipt of at least one zoster vaccination was found to mitigate this increased risk. Vaccination may therefore be viewed as a protective tool against the risk of neurologic post-infection sequelae.
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