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Most patients hospitalized with community-acquired pneumonia received longer duration antibiotic therapy than needed, increasing the risk of post-discharge adverse events, a large study found.
James Lopez Bernal, Peter Hobbelen and Gayatri Amirthalingam
Strategies to control varicella vary across Europe. Evidence from established programmes has prompted the United Kingdom to re-evaluate the need for universal vaccination. The burden of complicated varicella is a key parameter in the cost-effectiveness analysis.
Our objective was to estimate the burden of complicated varicella in England.
This electronic health record surveillance study used data from all NHS hospitals in England to identify varicella admissions between 2004 and 2017. The incidence of pre-defined complications of varicella was estimated using ICD-10 codes. Inpatient costs were calculated based on the payment rules for providers of NHS services.
There were 61,024 admissions with varicella between 2004 and 2017 and 38.1% had a recognised varicella complication. Incidence of hospitalisation increased by 25% and the proportion with complicated varicella by 24% from 2004/05 to 2016/17. The most common complications were bacterial skin infections (11.25%), pneumonia (4.82%), febrile convulsions (3.39%) and encephalitis (2.44%). Complication rates were higher in older age groups and the type of complications more severe. Length of stay for complicated varicella was 3.1 times longer than for uncomplicated varicella and inpatient costs were 72% greater.
Complicated varicella has a substantial health and economic burden. These data together with data on impact on quality of life are important in informing the cost-effectiveness analysis of universal varicella vaccination.
Zerbaxa (ceftolozane and tazobactam) for hospital- and ventilator-associated bacterial pneumonia was initially approved for complicated intra-abdominal and urinary tract infections.
Kati Räisänen, Irma Koivula, Heikki Ilmavirta, Santeri Puranen, Teemu Kallonen, Outi Lyytikäinen and Jari Jalava
In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.
The EMA committee recommends that bacterial lysate only be used for the prevention of recurrent respiratory infections, with the exception of pneumonia.
The new semisynthetic pleuromutilin antibiotic will be available for oral and IV administration with a short 5- to 7-day course of therapy for community-acquired bacterial pneumonia (CABP).
Annemarie Fritsch, Brunhilde Schweiger and Barbara Biere
Recent data on influenza C virus indicate a possible higher clinical impact in specified patient populations than previously thought.
We aimed to investigate influenza C virus circulation in Germany.
A total of 1,588 samples from 0 to 4 year-old children presenting as outpatients with influenza-like illness (ILI) or acute respiratory infection were analysed retrospectively. The samples represented a subset of all samples from the German national surveillance system for influenza in this age group in 2012–14. The presence of influenza C virus was investigated by real-time PCR. For positive samples, information on symptoms as well as other respiratory virus co-infections was considered. Retrieved influenza C viral sequences were phylogenetically characterised.
Influenza C viral RNA was detected in 20 (1.3% of) samples, including 16 during the 2012/13 season. The majority (18/20) of influenza C-positive patients had ILI according to the European Union definition, one patient had pneumonia. Viruses belonged to the C/Sao Paulo and C/Kanagawa lineages. Most (11/20) samples were co-infected with other respiratory viruses.
Our data are the first on influenza C virus circulation in Germany and notably from a European national surveillance system. The low detection frequency and the identified virus variants confirm earlier observations outside a surveillance system. More virus detections during the 2012/13 season indicate a variable circulation intensity in the different years studied. Influenza C virus can be considered for ILI patients. Future studies addressing its clinical impact, especially in patients with severe disease are needed.
On December 31, 2018, Public Health --- Seattle & King County (PHSKC) was notified by the Antibiotic Resistance Laboratory Network regarding a carbapenem-resistant Klebsiella pneumoniae (CR-Kp) isolate cultured from the urinary tract in a man aged 65 years.
In 2018, CDC was notified about students hospitalized for pneumonia of unknown etiology after returning from Mexico.
During July and August 2019, five patients were identified at two hospitals in North Carolina with acute lung injury potentially associated with e-cigarette use.
Bovine Pleuropneumonia -- NamibiaInformation received on [and dated] 26 Jun 2019 from Dr. Adrianatus Florentius Maseke, Chief Veterinary Officer, Veterinary Services, Ministry of Agriculture, Water and Forestry, Windhoek, NamibiaSummaryReport type: Immediate notificationDate of start of the event: 20 May 2019Date of confirmation of the event: 27 May 2019Report date: 26 Jun 2019Date submitted to OIE: 26 Jun 2019Reason for notification: Recurrence of a listed diseaseDate of previous occurrence: 12 Feb
Foot and Mouth, Lumpy Skin Disease, Peste des petits ruminants, Sheep/Goat Pox, Newcastle Disease, Pneumonia -- KenyaKenyan animal medicine manufacturer Kenya Veterinary Vaccines Production Institute (KEVEVAPI) is under siege after being accused of manufacturing contaminated drugs.An African Union report QCR 849, authored by the Union's Pan African Vaccine Centre [see comment - Mod.AS], details the level of contamination of many of the products released by KEVEVAPI over the time period assessed by the report.The matter has incensed some practitioners, who want to call for an audit of the practices at
Equine Herpes Virus -- United StatesHerpesvirus is highly contagious among horses and can cause a variety of ailments in equids, including rhinopneumonitis (a respiratory disease usually found in young horses), abortion in broodmares, and equine herpes myeloencephalopathy (EHM, the neurologic form).In many horses, the first or only sign of EHV-1 infection is fever, which can go undetected. In addition to fever, other common signs of EHV-1 infection in young horses include cough, decreased appetite, depression, and a nasal
Equine Herpes Virus -- United StatesHerpesvirus is highly contagious among horses and can cause a variety of ailments in equids, including rhinopneumonitis (a respiratory disease usually found in young horses), abortion in broodmares, and EHM.In many horses, the 1st or only sign of EHV-1 infection is fever, which can go undetected. In addition to fever, other common signs of EHV-1 infection in young horses include cough, decreased appetite, depression, and a nasal discharge. Pregnant mares typically show no signs of
Equine Herpes Virus -- NorwayInformation received on [and dated] 08 Mar /2019 from Dre Kristina Landsverk, Chief Veterinary Officer, Norwegian Food Safety Authority, Norwegian Food Safety Authority, Brumunddal, NorwaySummaryReport type: immediate notificationDate of start of the event: 25 Feb 2019Date of confirmation of the event: 27 Feb 2019Report date: 8 Mar 2019Date submitted to OIE: 8 Mar 2019Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 2006Manifestation of
Other Animal Disease -- United KingdomThere has been an outbreak of equine viral arteritis (EVA), a serious viral disease in horses, in Dorset.The UK's Chief Veterinary Officer confirmed today (5 Apr 2019) that 2 cases of EVA in non-thoroughbred stallions have been discovered on a premises in the county.Although deaths from EVA are very rare in healthy adults, pregnant mares that become infected may abort, and very young foals may die from a form of pneumonia as a result of it.Humans can spread the disease
Plague -- ChinaTwo people in China have been diagnosed with plague, the latest cases of a disease more commonly associated with historical catastrophe.Plague is caused by the bacterium _Yersinia pestis_ and can arise in 3 forms -- a lung infection, known as pneumonic plague; a blood infection, known as septicemic plague; and a form that affects the lymph nodes, called bubonic plague. This infection was behind several pandemics including the Black Death of the late middle ages, which is estimated to have
Equine Herpes Virus -- Germany
Equine Herpes Virus -- Sweden
Diarrhea -- BangladeshMolecular characterization and analysis of _Mycoplasma pneumoniae_ among patients of all ages with community-acquired pneumonia during an epidemic in China.Jiuxin Qu, Shuyan Chen, Fang Bao, Li Gu, Bin Cao.Int J Infect Dis. 2019; 83(June): 26-31.Exploring bacterial resistance in Northern Oman, a foundation for implementing evidence-based antimicrobial stewardship program.Diaa Al Rahmany, Adel Albeloushi, Iman Alreesi, Ahmed Alzaabi, Mohammed Alreesi, Laura Pontiggia, et al.Int J
Other Human Disease -- Worldwide/UnknownRisk modelling the mortality impact of antimicrobial resistance in secondary pneumococcal pneumonia infections during the 2009 influenza pandemicCarrie E. Barnes, C. Raina MacIntyreInternational Journal of Infectious Diseases, Volume 85, August 2019, pp. 1-6Prevalence and 30-day all-cause mortality of carbapenem-and colistin-resistant bacteraemia caused by _Acinetobacter baumannii_, _Pseudomonas aeruginosa_, and _Klebsiella pneumoniae_: Description of a decade-long trendA.
Klebsiella pneumoniae, Hospital-Related Infection -- Worldwide/Unknown1. David S, Reuter S, Harris SR, et al. Epidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is driven by nosocomial spread. Nat Microbiol. Published: 29 Jul 2019; Abstract-----------"Public health interventions to control the current epidemic of carbapenem-resistant _Klebsiella pneumoniae_ rely on a comprehensive understanding of its emergence and spread over a wide range of geographical scales. We analysed the genome sequences and epidemiological data of [more than] 1700
Legionnaires' -- CanadaCristin Muecke, the deputy chief medical officer of health, is urging anyone who develops pneumonia-like or respiratory symptoms to promptly seek medical care.There is an outbreak of Legionnaires' disease in the greater Moncton area, with 7 confirmed cases of the severe pneumonia in the past month, New Brunswick's deputy chief medical officer of health announced on Thursday [1 Aug 2019].Public Health is working with "multiple partners" to investigate the source of the _Legionella_
Legionnaires' -- United StatesOfficials from the California Department of Rehabilitation and Corrections are investigating the presence of deadly Legionnaires' disease bacteria at a Central Valley prison. Last month [March 2019], one inmate at the California Health Care Facility in Stockton (CHCF) died of the disease -- considered a severe form of pneumonia -- and a 2nd inmate tested positive for the bacteria but is now in stable condition.Corrections officials had thought the bacteria were isolated to one housing unit
Legionnaires' -- United StatesOfficials said 5 guests who stayed at a prominent downtown Atlanta hotel have become sick with legionnaires' disease, prompting an investigation of the hotel on [Mon 15 Jul 2019]. "Based on epidemiological evidence we have an outbreak among people who stayed at the [Sheraton Atlanta] during the same time period," said Nancy Nydam, director of communications at Georgia Department of Public Health, on [Tue 16 Jul 2019].Legionnaires' is a serious form of pneumonia that is non-contagious.
Legionnaires' -- United StatesThe state Department of Public Health [DPH] has opened an investigation into a Rocky Hill nursing home after 2 residents were diagnosed with legionnaires' disease and one of them died. DPH officials said they are coordinating a review with management at the facility, Apple Rehab. The department was notified on 17 Jul  that a resident at the nursing home had contracted the disease.Legionnaires' is a type of pneumonia caused by ingesting [inhaling aerosols or aspirating, not ingesting
Undiagnosed -- MalaysiaOur nation is now concerned over the deaths of 14 Orang Asli from the Bateq community in Kuala Koh, Kelantan. The real cause for the string of deaths must be quickly ascertained to prevent more from becoming victims.Environmental groups are saying that water pollution is the cause. While water pollution is a very important factor, the effect should be gastroenteritis rather than pneumonia. Apparently, tuberculosis and leptospirosis have been ruled out, but has miliary tuberculosis been
Klebsiella pneumoniae -- Papua New GuineaPapua New Guinea health officials have been dispatched to the Eastern Highlands after dozens of people reportedly died in a disease outbreak. The provincial governor, Peter Numu, told local media 35 people at the local hospital died from curable diseases. He said 11 died over the weekend [27-28 Jul 2019], although he didn't specify when the others died.PNG's Health Minister, Elias Kapavore, said health department officials alongside the World Health Organisation will arrive in Goroka town
Respiratory Illness -- United StatesTesting will continue this week to try to learn why 55 residents of the Greenspring assisted-living center in Springfield have become ill, 20 have been hospitalized, and 2 have died in recent weeks. County health officials say the center has been closed to new admissions while efforts to pinpoint the cause of the infections continue."The individuals who died were hospitalized with pneumonia. Both were older adults and had complex medical problems. The Health Department does not know the
Undiagnosed -- United StatesTwo people have died and 18 others have been hospitalized after a "respiratory outbreak" at a Virginia retirement community, according to officials. The Fairfax County Department of Health said that 54 individuals had become ill with "respiratory symptoms, ranging from upper respiratory symptoms (cough) to pneumonia" in the last 11 days at Greenspring Retirement Community in Springfield.In a letter Wednesday [10 Jul 2019] to residents obtained by ABC News affiliate WJLA-TV in Washington,
Vincent Jarlier, Liselotte Diaz Högberg, Ole E Heuer, José Campos, Tim Eckmanns, Christian G Giske, Hajo Grundmann, Alan P Johnson, Gunnar Kahlmeter, Jos Monen, Annalisa Pantosti, Gian Maria Rossolini, Nienke van de Sande-Bruinsma, Alkiviadis Vatopoulos, Dorota Żabicka, Helena Žemličková, Dominique L Monnet, Gunnar Skov Simonsen and EARS-Net participants
Antibiotic resistance, either intrinsic or acquired, is a major obstacle for treating bacterial infections.
Our objective was to compare the country-specific species distribution of the four Gram-negative species Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter species and the proportions of selected acquired resistance traits within these species.
We used data reported for 2016 to the European Antimicrobial Resistance Surveillance Network (EARS-Net) by 30 countries in the European Union and European Economic Area.
The country-specific species distribution varied considerably. While E. coli accounted for 31.9% to 81.0% (median: 69.0%) of all reported isolates, the two most common intrinsically resistant species P. aeruginosa and Acinetobacter spp. combined (PSEACI) accounted for 5.5% to 39.2% of isolates (median: 10.1%). Similarly, large national differences were noted for the percentages of acquired non-susceptibility to third-generation cephalosporins, carbapenems and fluoroquinolones. There was a strong positive rank correlation between the country-specific percentages of PSEACI and the percentages of non-susceptibility to the above antibiotics in all four species (rho > 0.75 for 10 of the 11 pairs of variables tested).
Countries with the highest proportion of P. aeruginosa and Acinetobacter spp. were also those where the rates of acquired non-susceptibility in all four studied species were highest. The differences are probably related to national differences in antibiotic consumption and infection prevention and control routines.
What antibiotic would you prescribe when de-escalating therapy for community-acquired pneumonia?
Influenza activity in the United States remained elevated through February 2, 2019, and is expected to continue for several more weeks. Compared with recent influenza seasons, as of February 2, 2019, severity this season has been low, with a lower percentage of outpatient visits for influenza-like illness, lower rates of hospitalization, and fewer deaths attributed to pneumonia and influenza.
The diagnostic and treatment complexities of community-acquired pneumonia are far from straightforward.
Retningslinjer til sundhedsprofessionelle vedr. håndtering af infektion med zikavirus (2019)
Antiviral behandling af hiv smittede personer (2019)
Lumbalpunktur af patienter i blodfortyndende behandling (2019)
Lack of weight gain during the first two months of treatment and HIV independently predict unsuccessful treatment outcomes in tuberculosis
14.11.2019The Journal of Infectious Diseases Advance Access
Diverse HIV-1 Drug Resistance Profiles at Screening for ACTG A5288: A Study of People Experiencing Virologic Failure on Second-line ART in Resource Limited Settings
14.11.2019Clinical Infectious Diseases Advance Access
Tuberculosis outbreaks among students in mainland China: a systematic review and meta-analysis
14.11.2019Latest Results for BMC Infectious Diseases
Correction to: Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI)
14.11.2019Latest Results for Malaria Journal
Analysis on external competency assessment for malaria microscopists in China
14.11.2019Latest Results for Malaria Journal
Hvad mener Professor Troels Lillebæk om artiklen"The global prevalence of latent tuberculosis: a systematic review and meta-analysis."?
Hvad mener Professor Lars Østergaard om artiklen"Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial."?
Hvad tænker Professor Thomas Benfield om"Oral versus Intravenous Antibiotics for Bone and Joint Infection."?
Hvorfor anbefaler Professor Niels Obel artiklen"Early, Goal-Directed Therapy for Septic Shock - A Patient-Level Meta-Analysis."?
Hvorfor anbefaler Professor Thomas Benfield artiklen"Duration of Antibiotic Treatment in Community-Acquired Pneumonia: A Multicenter Randomized Clinical Trial."?
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