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47 ud af 47 tidsskrifter valgt, søgeord (urin) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
1305 emner vises.
Gebreyohannes, E. A., Wolde, H. F., Akalu, T. Y., Clements, A. C. A., Alene, K. A.
BMJ Open, 7.03.2024
Tilføjet 7.03.2024
ObjectivesThis systematic review aimed to summarise existing literature on the impacts of armed conflicts on tuberculosis burden and treatment outcomes. DesignA systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sourcesPubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, ScienceDirect, Embase and medRxiv. Data extraction and synthesisThree reviewers independently screened, selected eligible studies and extracted data. A narrative review was undertaken to summarise the findings qualitatively. ResultsEleven studies were included in this review, reporting on tuberculosis incidence rates, prevalence and treatment outcomes, including mortality. Overall, the impact of armed conflicts on case notifications was variable. Six studies reported overall increases in tuberculosis case notifications following the onset of conflicts, while three studies reported overall decreases in tuberculosis case notifications. Factors, including limited access to healthcare services, challenges in surveillance and laboratory confirmation, the destruction of health systems and incapacitating the healthcare workforce, contributed to a decrease in the number of notified cases. The higher tuberculosis notification in some of the studies could be attributed to the disruption of tuberculosis prevention and control programmes as well as increased socioeconomic deprivation, including malnutrition, mass migration, poor living conditions and overcrowding that are worsened during conflicts. Armed conflicts without effective interventions were associated with worse tuberculosis treatment outcomes, including lower proportions of people with treatment success and higher proportions of people with loss to follow-up, mortality and treatment failure. However, implementing various interventions in conflict settings (such as establishing a National Tuberculosis Control Programme) led to higher tuberculosis notification rates and treatment success. ConclusionThe impact of armed conflicts on tuberculosis notification is complex and is influenced by multiple factors. The findings of this review underscore the importance of concerted efforts to control tuberculosis in conflict settings using available resources.
Læs mere Tjek på PubMedDadabhai, Sufia; Chou, Victoria B.; Pinilla, Mauricio; Chinula, Lameck; Owor, Maxensia; Violari, Avy; Moodley, Dhayendre; Stranix-Chibanda, Lynda; Matubu, Taguma Allen; Chareka, Gift Tafadzwa; Theron, Gerhard; Kinikar, Aarti Avinash; Mubiana-Mbewe, Mwangelwa; Fairlie, Lee; Bobat, Raziya; Mmbaga, Blandina Theophil; Flynn, Patricia M.; Taha, Taha E.; McCarthy, Katie S.; Browning, Renee; Mofenson, Lynne M.; Brummel, Sean S.; Fowler, Mary Glenn; for the IMPAACT PROMISE 1077BF/FF team.
AIDS, 7.03.2024
Tilføjet 7.03.2024
Background: IMPAACT 1077BF/FF compared the safety/efficacy of two HIV antiretroviral therapy (ART) regimens to zidovudine (ZDV) alone during pregnancy for HIV prevention. PROMISE found an increased risk of preterm delivery (
Læs mere Tjek på PubMedInfection, 7.03.2024
Tilføjet 7.03.2024
Abstract Background Listeria monocytogenes is a bacterial pathogen known for causing listeriosis, a foodborne illness with a wide spectrum of clinical presentations ranging from mild gastroenteritis to severe invasive disease, particularly affecting immunocompromised individuals, pregnant women, newborns, and the elderly. Successful treatment of patients with recurring listeria episodes due to colonised foreign material is often challenging, typically requiring a combination of antimicrobial treatment and surgical removal. Case presentation Here, we present a particularly complex case of chronic invasive listeriosis with a total of six relapses. After extensive investigations, the patient\'s ICD device was identified as the focus of infection. Conclusion The confirmation of relapses through cgMLST analysis highlights the persistence of Listeria monocytogenes and the potential for recurrence even after apparent resolution of symptoms in patients with foreign material. It emphasises the necessity for a comprehensive assessment to identify and mitigate the risk of relapses, thereby ensuring optimal management and outcomes.
Læs mere Tjek på PubMedInfection, 7.03.2024
Tilføjet 7.03.2024
Abstract Purpose To explore occupational and non-occupational risk and protective factors for the coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs). Methods Serum specimens and questionnaire data were obtained between October 7 and December 16, 2021 from COVID-19-vaccinated HCWs at a quaternary care hospital in Munich, Germany, and were analyzed in the RisCoin Study. Results Of 3,696 participants evaluated, 6.6% have had COVID-19 at least once. Multivariate logistic regression analysis identified working in patient care occupations (7.3% had COVID-19, 95% CI 6.4–8.3, Pr = 0.0002), especially as nurses, to be a potential occupation-related COVID-19 risk factor. Non-occupational factors significantly associated with high rates of the disease were contacts to COVID-19 cases in the community (12.8% had COVID-19, 95% CI 10.3–15.8, Pr
Læs mere Tjek på PubMedInfection, 7.03.2024
Tilføjet 7.03.2024
Abstract Background The incidence of metastatic complications in Gram-negative bloodstream infection (GN-BSI) remains undefined. This retrospective cohort study examines the incidence and predictors of complications within 90 days of GN-BSI. Methods Patients with GN-BSIs hospitalized at two Prisma Health-Midlands hospitals in Columbia, South Carolina, USA from 1 January 2012 through 30 June 2015 were included. Complications of GN-BSI included endocarditis, septic arthritis, osteomyelitis, spinal infections, deep-seated abscesses, and recurrent GN-BSI. Kaplan–Meier analysis and multivariate Cox proportional hazards regression were used to examine incidence and risk factors of complications, respectively. Results Among 752 patients with GN-BSI, median age was 66 years and 380 (50.5%) were women. The urinary tract was the most common source of GN-BSI (378; 50.3%) and Escherichia coli was the most common bacteria (375; 49.9%). Overall, 13.9% of patients developed complications within 90 days of GN-BSI. The median time to identification of these complications was 5.2 days from initial GN-BSI. Independent risk factors for complications were presence of indwelling prosthetic material (hazards ratio [HR] 1.73, 95% confidence intervals [CI] 1.08–2.78), injection drug use (HR 6.84, 95% CI 1.63–28.74), non-urinary source (HR 1.98, 95% CI 1.18–3.23), BSI due to S. marcescens, P. mirabilis or P. aeruginosa (HR 1.78, 95% CI 1.05–3.03), early clinical failure criteria (HR 1.19 per point, 95% CI 1.03–1.36), and persistent GN-BSI (HR 2.97, 95% CI 1.26–6.99). Conclusions Complications of GN-BSI are relatively common and may be predicted based on initial clinical response to antimicrobial therapy, follow-up blood culture results, and other host and microbiological factors.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.03.2024
Tilføjet 7.03.2024
Abstract Background Invasive meningococcal disease (IMD), including sepsis and meningitis, can develop when Neisseria meningitidis bacteria breach the barrier and gain access to the circulation. While IMD is a rare outcome of bacterial exposure, colonization of the oropharynx is present in approximately 10% of the human population. This asymptomatic carriage can be long or short term, and it is unknown which determining factors regulate bacterial colonization. Despite descriptions of many bacterial virulence factors and recent advances in detailed genetic identification and characterization of bacteria, the factors mediating invasion and disease vs. asymptomatic carriage following bacterial colonization remain unknown. The pharyngeal epithelia play a role in the innate immune defense against pathogens, and the aim of this study was to investigate the proinflammatory response of pharyngeal epithelial cells following meningococcal exposure to describe the potential inflammatory mediation performed during the initial host‒pathogen interaction. Clinically relevant isolates of serogroups B, C, W and Y, derived from patients with meningococcal disease as well as asymptomatic carriers, were included in the study. Results The most potent cellular response with proinflammatory secretion of TNF, IL-6, CXCL8, CCL2, IL-1β and IL-18 was found in response to invasive serogroup B isolates. This potent response pattern was also mirrored by increased bacterial adhesion to cells as well as induced cell death. It was, however, only with serogroup B isolates where the most potent cellular response was toward the IMD isolates. In contrast, the most potent cellular response using serogroup Y isolates was directed toward the carriage isolates rather than the IMD isolates. In addition, by comparing isolates from outbreaks in Sweden (epidemiologically linked and highly genetically similar), we found the most potent proinflammatory response in cells exposed to carriage isolates rather than the IMD isolates. Conclusion Although certain expected correlations between host‒pathogen interactions and cellular proinflammatory responses were found using IMD serogroup B isolates, our data indicate that carriage isolates invoke stronger proinflammatory activation of the epithelial lining than IMD isolates.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.03.2024
Tilføjet 7.03.2024
Abstract Background Coronavirus disease 2019 (COVID-19) has become a global health issue with various effects on the physical and mental state of the societies. The aim of this study was to identify the demographic characteristics and mental health condition of Tehran Municipality employees during the COVID-19 pandemic. Methods This cross-sectional study was performed on Tehran Municipality employees in 2020–2021. Participants were selected using stratified random sampling and were divided into COVID-19 and uninfected groups. Demographic characteristics, COVID-19 risk behaviors, General Health Questionnaire-28 (GHQ-28), and Well- Being Social Inventory were filled for all participants. Results A total of 510 participants (363 uninfected participants and 147 participants with COVID-19) were evaluated. The prevalence of female gender was significantly higher in COVID-19 group compared to uninfected group (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.03.2024
Tilføjet 7.03.2024
Background Nontuberculous mycobacteria (NTM) are environmental bacteria which may cause chronic lung disease. The prevalence of NTM pulmonary infection and disease has been increasing in the United States and globally. The predominant clinically relevant species of NTM in the United States are Mycobacterium avium complex (MAC) species and Mycobacterium abscessus. With the development of rapid species identification methods for NTM (e.g. PCR probes), more testing for NTM is being conducted through commercial labs, such as Laboratory Corporation of America (Labcorp), which provides deidentified real-time testing data to the Centers for Disease Control (CDC) pursuant to a data sharing agreement. Because NTM lung infections are not reportable in most states, other data sources are key to understanding NTM testing patterns, positivity rates, and species distributions to track infection trends and identify clinical care needs. Methods We obtained national Labcorp data for the period January 2019 through mid-April 2022. We subset the data to only respiratory samples sent for Acid Fast Bacilli (AFB) cultures. NTM positive results were defined as those which identified an NTM species and are not Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium gordonae. Results Overall, 112,528 respiratory samples were sent for AFB testing during the study period; 26.3% were from the Southeast U.S., identified as HSS Region IV in the Labcorp dataset, and 23.0% were from the Pacific and South Pacific region (Region IX). The culture positive prevalence ranged from 20.2% in the Southeast to 9.2% in the East North Central region (Region V). In the Southeast US, M. abscessus prevalence was 4.0%. For MAC, the highest prevalence was observed in the Mountain region (Region VII) (13.5%) and the lowest proportion was in the East South Central region (7.3%, Region III). Among positive tests, the proportion which was MAC varied from 61.8% to 88.9% and was highest in the Northeast U.S. The proportion of positive samples which were M. abscessus ranged from 3.8% to 19.7% and was highest in the Southeast. Conclusions The Southeastern region of the U.S. has the highest rate of culture positivity in Labcorp tests for total NTM and, of all positive tests, the highest proportion of M. abscessus. These estimates may underrepresent the true number of M. abscessus infections because M. absesscus-specific probes are not commercially available and not all NTM testing in the United States is done by Labcorp. Analysis of real-time testing data from commercial laboratories may provide insights into risk factors for NTM culture positivity in ‘hotspot’ areas.
Læs mere Tjek på PubMedXin Hu, Bo Zhu, Bokai Zhang, Lidan Zeng
PLoS One Infectious Diseases, 7.03.2024
Tilføjet 7.03.2024
by Xin Hu, Bo Zhu, Bokai Zhang, Lidan Zeng The linkages between the US and China, the world’s two major agricultural powers, have brought great uncertainty to the global food markets. Inspired by these, this paper examines the extreme risk spillovers between US and Chinese agricultural futures markets during significant crises. We use a copula-conditional value at risk (CoVaR) model with Markov-switching regimes to capture the tail dependence in their pair markets. The study covers the period from January 2006 to December 2022 and identifies two distinct dependence regimes (stable and crisis periods). Moreover, we find significant and asymmetric upside/downside extreme risk spillovers between the US and Chinese markets, which are highly volatile in crises. Additionally, the impact of international capital flows (the financial channel) on risk spillovers is particularly pronounced during the global financial crisis. During the period of the COVID-19 pandemic and the Russia-Ukraine 2022 war, the impact of supply chain disruptions (the non-financial channel) is highlighted. Our findings provide a theoretical reference for monitoring the co-movements in agricultural futures markets and practical insights for managing investment portfolios and enhancing food market stability during crises.
Læs mere Tjek på PubMedKetan Patel, Daniel J. Smith, Christopher C. Huntley, Sunita D. Channa, Anita Pye, Andrew P. Dickens, Nicola Gale, Alice M. Turner
PLoS One Infectious Diseases, 7.03.2024
Tilføjet 7.03.2024
by Ketan Patel, Daniel J. Smith, Christopher C. Huntley, Sunita D. Channa, Anita Pye, Andrew P. Dickens, Nicola Gale, Alice M. Turner Background Within primary care there exists a cohort of patients misdiagnosed with Chronic Obstructive Pulmonary Disease (COPD). Misdiagnosis can have a detrimental impact on healthcare finances and patient health and so understanding the factors leading to misdiagnosis is crucial in order to reduce misdiagnosis in the future. The objective of this study is to understand and explore the perceived causes of COPD misdiagnosis in primary care. Methods A sequential mixed methods study, quantifying prevalence and features of patients misdiagnosed with COPD in primary care followed by a qualitative analysis to explore perceived causes of misdiagnosis. Quantitative data was collected for 206 patients identified as misdiagnosed with COPD within the INTEGR COPD study (NCT03482700). Qualitative data collected from 21 healthcare professionals involved in providing COPD care and 8 misdiagnosed patients who were recruited using a maximum variation purposive sampling. Results Misinterpretation of spirometry results was the prevailing factor leading to patients initially being misdiagnosed with COPD, affecting 59% of misdiagnosed patients in this cohort. Of the 99 patients who were investigated for their underlying diagnosis; 41% had normal spirometry and 40% had asthma. Further investigation through qualitative methodology uncovered reluctance to challenge historical misdiagnoses and challenges in differential diagnosis as the underlying explanations for COPD misdiagnosis in this cohort. Conclusions Patients historically diagnosed with COPD without spirometric evidence are at risk of remaining labelled and treated for COPD despite non-obstructive respiratory physiology, leading to a persistent cohort of patients misdiagnosed with COPD in primary care. The lack of spirometry services during and after the COVID19 pandemic in primary care risks adding to the cohort of misdiagnosed patients. Support from respiratory specialists can potentially help to reduce the prevalence of COPD misdiagnosis in primary care. Trial registration NCT03482700.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
Abstract Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections is challenging with current serology assays and is further complicated by the marked decrease in routine viral testing practices as viral transmission increased during Omicron. Here, we provide proof-of-principle that high-avidity anti-nucleocapsid (N) antibodies detects reinfections after a single infection with higher specificity (85%; 95% confidence interval [95% CI], 80%–90%) compared to anti-N antibody levels (72%; 95% CI, 66%–79%) in a vaccinated cohort. This method could be used to retroactively investigate the epidemiology and incremental long-term health consequences of SARS-CoV-2 reinfections.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 6.03.2024
Tilføjet 6.03.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 3 Pages: 576-587
Læs mere Tjek på PubMedClinical Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
Abstract The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician and the microbiologists who provide enormous value to the health care team. This document, developed by experts in both adult and pediatric laboratory and clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. Sections are divided into anatomic systems, including Bloodstream Infections and Infections of the Cardiovascular System, Central Nervous System Infections, Ocular Infections, Soft Tissue Infections of the Head and Neck, Upper Respiratory Infections, Lower Respiratory Tract infections, Infections of the Gastrointestinal Tract, Intraabdominal Infections, Bone and Joint Infections, Urinary Tract Infections, Genital Infections, and Skin and Soft Tissue Infections; or into etiologic agent groups, including arboviral Infections, Viral Syndromes, and Blood and Tissue Parasite Infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also addressed. There is redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a reference to guide physicians in choosing tests that will aid them to diagnose infectious diseases in their patients.
Læs mere Tjek på PubMedDantong Li, Shang Ma, Binfei Dang, Huifeng Shi, Yuan Wei, Xiaoli Wang
International Journal of Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
Since the first case was reported in the United States in 1981, the prevalence of AIDS has been a significant public health concern, especially in low- and middle-income countries (LMICs). Statistics provided by the World Health Organization (WHO) showed that in 2021, among the 36.7 million surviving adult infections, the number of infected women was 19.7 million (more than 50%)[1]. Furthermore, the risk of Mother-to-Child Transmission of HIV during pregnancy or delivery was estimated to be between 15% and 30% if antiretroviral treatment (ART) is not administered[2].
Læs mere Tjek på PubMedGhannam, A. B., Ibrahim, H. A., Hammoud, B., Hamam, R.
BMJ Open, 6.03.2024
Tilføjet 6.03.2024
ObjectivesThe objective of the study is to investigate the effects of the COVID-19 pandemic, the economic crisis and the Beirut explosion on the training and work of ophthalmology residents and faculty in Lebanon. DesignThis is an observational cohort survey-based research conducted between January and December 2022. SettingThe study targeted all ophthalmology residents and core faculty in Lebanon. ParticipantsA total of 52 participants, including 27 residents and 25 core faculty members, completed the survey. Primary outcome measurePrimary outcomes comprised the subjectively reported effect of the three major external stressors on the training and well-being of ophthalmology trainees and educators in Lebanon. ResultsThe study found that the majority of ophthalmology residents and core faculty members were significantly affected by the COVID-19 pandemic, Beirut explosion and the economic crisis in Lebanon. Significant percentage reported financial burden, decrease in outpatient and surgical load and educational activities. Furthermore, most participants reported higher levels of stress, anxiety and depression during the time of crises. ConclusionsThis study emphasises the need to support healthcare professionals during times of crisis, as they are on the frontlines and can experience high levels of stress, anxiety and depression. By providing support and resources to healthcare professionals, they can better cope with the challenges they face and continue to provide essential care to their patients.
Læs mere Tjek på PubMedSamtlebe, P., Niemann, J., Markert, J., Knöchelmann, A., Bernard, M.
BMJ Open, 6.03.2024
Tilføjet 6.03.2024
IntroductionThe COVID-19 pandemic has shown the importance of resilient, modern, and well-equipped public health administrations from national to communal levels. In Germany, the surveillance, contact tracing, and local adaptions went through local health offices, revealing both their important role and also their lack of equipment and general preparation for health crises. Research on the mode of operation of the public health service (PHS), especially in a time of crisis, is rare. The present study aims to qualitatively and quantitatively assess problem areas, conflict potentials, and challenges that have become apparent for the PHS of Saxony-Anhalt during the pandemic. It focuses on the individual insight of employees of the PHS of Saxony-Anhalt and its 14 health offices to derive concrete needs and fields of action for increasing pandemic preparedness. Furthermore, the prospective personnel and resource-based requirements as well as the necessary structural and organisational changes of the public health departments are to be considered. Methods and analysisThe study will follow a sequential mixed-methods approach. Introductory expert interviews (n=12) with leading staff of Saxony-Anhalt’s PHS will be conducted, followed by focus group interviews (n=4) with personnel from all departments involved in the pandemic response. Thereafter, a quantitative survey will be carried out to validate and complement the results of the qualitative phase. Ethics and disseminationEthical approval was obtained by the Martin-Luther-Universität Halle-Wittenberg ethics commission (Ref number 2023-102). The authors will submit the results of the study to relevant peer-reviewed journals and give national and international oral presentations to researchers, members of the PHS, and policymakers.
Læs mere Tjek på PubMedTurnbull, S. L., Dack, C., Lei, J., Aksu, I., Grant, S., Lasseter, G., Silarova, B., Ainsworth, B.
BMJ Open, 6.03.2024
Tilføjet 6.03.2024
ObjectivesTo explore how healthcare practitioners (HCPs) made decisions about the implementation of digital health technologies (DHTs) in their clinical practice before and during the COVID-19 pandemic. DesignA multimethods study, comprising semistructured interviews conducted prior to the COVID-19 pandemic, supplemented with an online survey that was conducted during the pandemic with a different sample, to ensure the qualitative findings remained relevant within the rapidly changing healthcare context. Participants were recruited through HCP networks, snowballing and social media. Data were analysed thematically. SettingPhone interviews and online survey. ParticipantsHCPs represented a range of professions from primary and secondary care across England, with varied socioeconomic deprivation. Results24 HCPs were interviewed, and 16 HCPs responded to the survey. In the interviews, HCPs described three levels where decisions were made, which determined who would have access to what DHTs: health organisation, HCP and patient levels. These decisions resulted in the unequal implementation of DHTs across health services, created barriers for HCPs using DHTs in their practice and influenced HCPs’ decisions on which patients to supply DHTs with. In the survey, HCPs described being provided support to overcome some of the barriers at the organisation and HCP level during the pandemic. However, they cited similar concerns to pre-pandemic about barriers patients faced using DHTs (eg, digital literacy). In the absence of centralised guidance on how to manage these barriers, health services made their own decisions about how to adapt their services for those who struggled with DHTs. ConclusionsDecision-making at the health organisation, HCP and patient levels influences inequalities in access to DHTs for HCPs and patients. The mobilisation of centralised information and resources during the pandemic can be viewed as good practice for reducing barriers to use of DHTs for HCPs. However, attention must also be paid to reducing barriers to accessing DHTs for patients.
Læs mere Tjek på PubMedZhao, Q., Dong, L., Wang, L., Zhao, H., Zhu, X., Zhang, Z., Liu, J.
BMJ Open, 6.03.2024
Tilføjet 6.03.2024
ObjectiveMedication non-adherence to immunosuppressants threatens allograft survival and function maintenance among solid organ transplant (SOT) recipients. This study aimed to investigate the prevalence of immunosuppressant medication non-adherence and associated factors during the COVID-19 reopening period among Chinese SOT recipients. DesignCross-sectional study. SettingSouth-central China. PopulationAdult patients who received SOT with functioning graft. MethodsSociodemographic questionnaire and scales to measure physical activity, depression and medication non-adherence were used to collect data. Logistic regression analysis was conducted to identify factors associated with medication non-adherence. Mediation and moderated mediation analyses were performed to examine the potential mechanisms influencing medication behaviour during the pandemic reopening period using SPSS PROCESS macro 4.3 software. ResultsA total of 1121 participants were recruited and the prevalence of medication non-adherence was 36.3% in this study. Recipients who were men, had a higher monthly income, lived alone, had received transplantation for a minimum of 3 years, had received COVID-19 vaccination and experienced depressive symptoms exhibited an increased risk of non-adherence. Contrarily, those who engaged in high-intensity physical activity exhibited a decreased risk. Physical activity was negatively associated with medication non-adherence (r=–0.124, p
Læs mere Tjek på PubMedZoe Raglow, Diya Surie, James D Chappell, Yuwei Zhu, Emily T Martin, Jennie H Kwon, Anne E Frosch, Amira Mohamed, Julie Gilbert, Emily E Bendall, Auden Bahr, Natasha Halasa, H Keipp Talbot, Carlos G Grijalva, Adrienne Baughman, Kelsey N Womack, Cassandra Johnson, Sydney A Swan, Emilia Koumans, Meredith L McMorrow, Jennifer L Harcourt, Lydia J Atherton, Ashley Burroughs, Natalie J Thornburg, Wesley H Self, Adam S Lauring, Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Lancet Microbe, 6.03.2024
Tilføjet 6.03.2024
In this cohort, prolonged replication-competent omicron SARS-CoV-2 infections were uncommon. Within-host evolutionary rates were similar across patients, but individuals with infections lasting longer than 56 days accumulated spike mutations, which were distinct from those seen globally. Populations at high risk should be targeted for repeated testing and treatment and monitored for the emergence of antiviral resistance.
Læs mere Tjek på PubMedSimon Feys, Sam Vanmassenhove, Sirima Kraisin, Karen Yu, Cato Jacobs, Bram Boeckx, Seppe Cambier, Cristina Cunha, Yves Debaveye, Samuel M Gonçalves, Greet Hermans, Stephanie Humblet-Baron, Sander Jansen, Katrien Lagrou, Philippe Meersseman, Johan Neyts, Marijke Peetermans, Joana Rocha-Pereira, Rogier Schepers, Valérie Spalart, Marick R Starick, Karin Thevissen, Thomas Van Brussel, Tina Van Buyten, Pierre Van Mol, Christophe Vandenbriele, Lore Vanderbeke, Els Wauters, Alexander Wilmer, Johan Van Weyenbergh, Frank L Van De Veerdonk, Agostinho Carvalho, Paul Proost, Kimberly Martinod, Diether Lambrechts, Joost Wauters
Lancet Microbe, 6.03.2024
Tilføjet 6.03.2024
Qualitative and quantitative disturbances in monocyte, macrophage, B-cell, and T-cell populations could predispose patients with severe COVID-19 to develop CAPA. Hybrid neutrophils form a specialised response to CAPA, and an adequate neutrophil response to CAPA is a major determinant for survival in these patients. Therefore, measuring bronchoalveolar lavage NETs could have diagnostic and prognostic value in patients with CAPA. Clinicians should be wary of aspergillosis when using immunomodulatory therapy that might inhibit NETosis to treat patients with severe COVID-19.
Læs mere Tjek på PubMedTshepiso Mbangiwa, Aude Sturny-Leclère, Kwana Lechiile, Cheusisime Kajanga, Timothée Boyer-Chammard, Jennifer C Hoving, Tshepo Leeme, Melanie Moyo, Nabila Youssouf, David S Lawrence, Henry Mwandumba, Mosepele Mosepele, Thomas S Harrison, Joseph N Jarvis, Olivier Lortholary, Alexandre Alanio, AMBITION Study Group
Lancet Microbe, 6.03.2024
Tilføjet 6.03.2024
QSP1 and 28S rRNA assays are useful in identifying Cryptococcus species. qPCR results correlate well with baseline quantitative cryptococcal culture and show a similar decline in fungal load during induction therapy. These assays could be a faster alternative to quantitative cryptococcal culture to determine fungal load clearance. The clinical implications of the possible detection of viable but non-culturable cells in CSF during induction therapy remain unclear.
Læs mere Tjek på PubMedManu P Bilsen, Simon P Conroy, Caroline Schneeberger, Tamara N Platteel, Cees van Nieuwkoop, Lona Mody, Jeffrey M Caterino, Suzanne E Geerlings, Bela Köves, Florian Wagenlehner, Marleen Kunneman, Leo G Visser, Merel M C Lambregts, UTI Reference Standard Consensus Group
Lancet Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
The absence of a consensus-based reference standard for urinary tract infection (UTI) research adversely affects the internal and external validity of diagnostic and therapeutic studies. This omission hinders the accumulation of evidence for a disease that imposes a substantial burden on patients and society, particularly in an era of increasing antimicrobial resistance. We did a three-round Delphi study involving an international, multidisciplinary panel of UTI experts (n=46) and achieved a high degree of consensus (94%) on the final reference standard.
Læs mere Tjek på PubMedApirak Bumyut, Sasithorn Thanapop, Ni Made Utami Dwipayanti
PLoS One Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
by Apirak Bumyut, Sasithorn Thanapop, Ni Made Utami Dwipayanti Community-based tourism (CBT) in Thailand faces challenges in adapting to COVID-19 prevention measures. The purpose of the study was to evaluate levels of knowledge, practice, and compliance regarding safety and health measures of the entrepreneur in managing CBT under the Safety and Health Administration (SHA) standard in the new normal situation. A descriptive cross-sectional study was conducted on twenty-one entrepreneurs from three CBTs in three districts in Nakhon Si Thammarat, in the months of February—May 2021. Levels of knowledge and practice were evaluated by questionnaires and compliance level was evaluated by SHA standard checklist. The level of knowledge and practice were categorized sufficient and insufficient, while compliance level was categorized as high or low if scores met or exceeded 80%, based on Bloom’s cut-off point. Information on sociodemographic characteristics was also gathered. Fisher’s exact test with a 95% confidence level (α < 0.05) was used for statistical analysis. The findings revealed that 66.7% and 38.1% of the establishments in the study had sufficient knowledge (Mean ± SD: 46.9 ± 7.2, Max: 55.0, Min: 33.0) and sufficient practice (Mean ± SD: 40.4 ± 9.2, Max: 55.0, Min: 29.0), respectively. In addition, the study found that knowledge level was significantly associated with practice level at a p-value of 0.018. However, compliance level was not related to knowledge and practice. In conclusion, the low level of compliance was due to a lack of understanding and motivation to comply with the standard, and the budget of small establishments in CBT for bringing them up to the SHA standard was quite limited. Therefore, the related organizations should use a variety of strategies to encourage entrepreneurs, such as partnership building and resource support.
Læs mere Tjek på PubMedPumin Nutaratat, Tantip Arigul, Nantana Srisuk, Worarat Kruasuwan
PLoS One Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
by Pumin Nutaratat, Tantip Arigul, Nantana Srisuk, Worarat Kruasuwan Environmental variations have been observed to influence bacterial community composition, thereby impacting biological activities in the soil. Together, the information on bacterial functional groups in Phatthalung sago palm-growing soils remains limited. In this work, the core soil bacterial community in the Phatthalung sago palm-growing areas during both the summer and rainy seasons was examined using V3-V4 amplicon sequencing. Our findings demonstrated that the seasons had no significant effects on the alpha diversity, but the beta diversity of the community was influenced by seasonal variations. The bacteria in the phyla Acidobacteriota, Actinobacteriota, Chloroflexi, Methylomirabilota, Planctomycetota, and Proteobacteria were predominantly identified across the soil samples. Among these, 26 genera were classified as a core microbiome, mostly belonging to uncultured bacteria. Gene functions related to photorespiration and methanogenesis were enriched in both seasons. Genes related to aerobic chemoheterotrophy metabolisms and nitrogen fixation were more abundant in the rainy season soils, while, human pathogen pneumonia-related genes were overrepresented in the summer season. The investigation not only provides into the bacterial composition inherent to the sago palm-cultivated soil but also the gene functions during the shift in seasons.
Læs mere Tjek på PubMedMarina Charquero-Ballester, Jessica Gabriele Walter, Astrid Sletten Rybner, Ida Anthonj Nissen, Kenneth Christian Enevoldsen, Anja Bechmann
PLoS One Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
by Marina Charquero-Ballester, Jessica Gabriele Walter, Astrid Sletten Rybner, Ida Anthonj Nissen, Kenneth Christian Enevoldsen, Anja Bechmann During the Covid-19 crisis, citizens turned to Twitter for information seeking, emotional outlet and sense-making of the crisis, creating ad hoc social communities using crisis-specific hashtags. The theory of ambient affiliation posits that the use of hashtags upscales the call to affiliate with the values expressed in the tweet. Given the deep functional tie between values and emotions, hashtag use might further amplify certain emotions. While emotions in crises-hashtagged communities have been previously investigated, the hypothesis of amplification of emotions through hashtag use has not yet been tested. We investigate such effect during the Covid-19 crisis in a scenario of high-trust Nordic societies, focusing on non-hashtagged, crisis hashtagged (e.g., ‘#Covid-19’) and threat hashtagged (e.g., ‘#misinformation’) tweets. To do so we apply XLM-RoBERTa to estimate Anger, Fear, Sadness, Disgust, Joy and Optimism. Our results revealed that crisis-hashtagged (#Covid-19) tweets expressed more negative emotions (Anger, Fear, Disgust and Sadness) and less positive emotions (Optimism and Joy) than non-hashtagged Covid-19 tweets for all countries except Finland. Threat tweets (#misinformation) expressed even more negative emotions (Anger, Fear, Disgust) and less positive emotions (Optimism and Joy) than #Covid-19 tweets, with a particularly large effect for Anger. Our findings provide useful context for previous research on collective emotions during crises, as most Twitter content is not hashtagged, and given the faster spread of emotionally charged content, further support the special focus on specific ad hoc communities for crisis and threat management and monitoring.
Læs mere Tjek på PubMedMay Oo Lwin, Anita Sheldenkar, Pei Ling Tng
PLoS One Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
by May Oo Lwin, Anita Sheldenkar, Pei Ling Tng The prevalence of health myths is increasing with the rise of Internet use. Left unaddressed, online falsehoods can lead to harmful behaviours. In times of crisis, such as the recent COVID-19 pandemic, the circulation of many myths is exacerbated, often to varying degrees among different cultures. Singapore is a multicultural hub in Asia with Western and Asian influences. Although several studies have examined health myths from a Western or Eastern perspective, little research has investigated online health falsehoods in a population that is culturally exposed to both. Furthermore, most studies examined myths cross-sectionally instead of capturing trends in myth prevalence over time, particularly during crisis situations. Given these literature gaps, we investigated popular myths surrounding the recent COVID-19 pandemic within the multicultural setting of Singapore, by examining its general population. We further examined changes in myth beliefs over the two-year period during the pandemic, and population demographic differences in myth beliefs. Using randomised sampling, two online surveys of nationally representative samples of adults (aged 21–70 years) residing in Singapore were conducted, the first between October 2020 and February 2021 (N = 949), and the second between March and April 2022 (N = 1084). Results showed that 12.7% to 57.5% of the population were unable to identify various myths, such as COVID-19 was manmade, and that three of these myths persisted significantly over time (increases ranging from 3.9% to 9.8%). However, belief in myths varied across population demographics, with ethnic minorities (Indians and Malays), females, young adults and those with lower education levels being more susceptible to myths than their counterparts (p < 0.05). Our findings suggest that current debunking efforts are insufficient to effectively counter misinformation beliefs during health crises. Instead, a post-COVID-19 landscape will require targeted approaches aimed at vulnerable population sub-groups, that also focus on the erroneous beliefs with long staying power.
Læs mere Tjek på PubMedMalaria Journal, 6.03.2024
Tilføjet 6.03.2024
Abstract Background There are several indications that pesticides used in agriculture contribute to the emergence and spread of resistance of mosquitoes to vector control insecticides. However, the impact of such an indirect selection pressure has rarely been quantified and the molecular mechanisms involved are still poorly characterized. In this context, experimental selection with different agrochemical mixtures was conducted in Anopheles gambiae. The multi-generational impact of agrochemicals on insecticide resistance was evaluated by phenotypic and molecular approaches. Methods Mosquito larvae were selected for 30 generations with three different agrochemical mixtures containing (i) insecticides, (ii) non-insecticides compounds, and (iii) both insecticide and non-insecticide compounds. Every five generations, the resistance of adults to deltamethrin and bendiocarb was monitored using bioassays. The frequencies of the kdr (L995F) and ace1 (G119S) target-site mutations were monitored every 10 generations. RNAseq was performed on all lines at generation 30 in order to identify gene transcription level variations and polymorphisms associated with each selection regime. Results Larval selection with agrochemical mixtures did not affect bendiocarb resistance and did not select for ace1 mutation. Contrastingly, an increased deltamethrin resistance was observed in the three selected lines. Such increased resistance was not majorly associated with the presence of kdr L995F mutation in selected lines. RNA-seq identified 63 candidate resistance genes over-transcribed in at least one selected line. These include genes coding for detoxification enzymes or cuticular proteins previously associated with insecticide resistance, and other genes potentially associated with chemical stress response. Combining an allele frequency filtering with a Bayesian FST-based genome scan allowed to identify genes under selection across multiple genomic loci, supporting a multigenic adaptive response to agrochemical mixtures. Conclusion This study supports the role of agrochemical contaminants as a significant larval selection pressure favouring insecticide resistance in malaria vectors. Such selection pressures likely impact kdr mutations and detoxification enzymes, but also more generalist mechanisms such as cuticle resistance, which could potentially lead to cross-tolerance to unrelated insecticide compounds. Such indirect effect of global landscape pollution on mosquito resistance to public health insecticides deserves further attention since it can affect the nature and dynamics of resistance alleles circulating in malaria vectors and impact the efficacy of control vector strategies.
Læs mere Tjek på PubMedNa Wu, Zhiwei Chen, Guanhua Zha, Zhiling Deng, Wenhan Huang, Dachuan Cai, Mingli Peng, Peng Hu, Lin Tang, Hong Ren
Journal of Medical Virology, 5.03.2024
Tilføjet 5.03.2024
Infectious Disease Modelling, 5.03.2024
Tilføjet 5.03.2024
Publication date: Available online 4 March 2024 Source: Infectious Disease Modelling Author(s): Joshua Ladau, Eoin L. Brodie, Nicola Falco, Ishan Bansal, Elijah B. Hoffman, Marcin P. Joachimiak, Ana M. Mora, Angelica M. Walker, Haruko M. Wainwright, Yulun Wu, Mirko Pavicic, Daniel Jacobson, Matthias Hess, James B. Brown, Katrina Abuabara
Læs mere Tjek på PubMedJournal of Infectious Diseases, 5.03.2024
Tilføjet 5.03.2024
Abstract Background The RTS, S/AS01E malaria vaccine (RTS, S) is recommended for children in moderate-to-high Plasmodium falciparum malaria transmission areas. This phase 2b trial (NCT03276962) evaluates RTS, S fractional- and full-dose regimens in Ghana and Kenya.Methods 1500 children aged 5-17 months were randomised (1:1:1:1:1) to receive RTS, S or rabies control vaccine. RTS, S groups received two full RTS, S doses at month (M)0/M1 followed by either full (groups R012-20, R012-14-26) or fractional (1/5) doses (groups Fx012-14-26, Fx017-20-32).Results At M32 post-first dose, vaccine efficacy (VE) against clinical malaria (all episodes) ranged from 38% (R012-20; 95%CI: 24-49) to 53% (R012-14-26; 95%CI: 42-62). Vaccine impact estimates (cumulative number of malaria cases averted/1000 children vaccinated) were 1344 (R012-20), 2450 (R012-14-26), 2273 (Fx012-14-26), 2112 (Fx017-20-32). To account for differences in vaccine volume (fractional- versus full-dose), in a post-hoc analysis, we also estimated cases averted/1000 RTS, S full-dose equivalents: 336 (R012-20), 490 (R012-14-26), 874 (Fx012-14-26), 880 (Fx017-20-32).Conclusions VE against clinical malaria was similar in all RTS, S groups. Vaccine impact accounting for full-dose equivalence suggests that using fractional-dose regimens could be a viable dose-sparing strategy. If borne out through trial end (M50), these observations underscore the means to reduce cost per regimen with a goal of maximising impact and optimising supply.
Læs mere Tjek på PubMedMelaku, T., Mekonnen, Z., Terefe Tucho, G., Mecha, M., Ardal, C., Jahre, M.
BMJ Open, 5.03.2024
Tilføjet 5.03.2024
ObjectivesLockdowns and border closures impacted medicine availability during the COVID-19 pandemic. This study aimed to assess the availability of essential, generic medicines for chronic diseases at public pharmaceutical supply agencies in Ethiopia. DesignComparative cross-sectional study. SettingThe availability of essential, generic medicines for chronic diseases was assessed at two public pharmaceutical supply agency hubs. ParticipantsThe current study included public supply agency hub managers, warehouse managers and forecasting officers at the study setting. OutcomesThe assessment encompassed the availability of chronic medicines on the day of data collection, as well as records spanning 8 months before the outbreak and 1 year during the pandemic. A total of 22 medicines were selected based on their inclusion in the national essential drug list for public health facilities, including 17 medicines for cardiovascular disease and 5 for diabetes mellitus. ResultsThe results of the study indicate that the mean availability of the selected basket medicines was 43.3% (95% CI: 37.1 to 49.5) during COVID-19, which was significantly lower than the availability of 67.4% (95% CI: 62.2 to 72.6) before the outbreak (p
Læs mere Tjek på PubMedLauriane Sollelis, Virginia M. Howick, Matthias Marti
Trends in Parasitology, 5.03.2024
Tilføjet 5.03.2024
Malaria parasites have coevolved with humans over thousands of years, mirroring their migration out of Africa. They persist to this day, despite continuous elimination efforts worldwide. These parasites can adapt to changing environments during infection of human and mosquito, and when expanding the geographical range by switching vector species. Recent studies in the human malaria parasite, Plasmodium falciparum, identified determinants governing the plasticity of sexual conversion rates, sex ratio, and vector competence. Here we summarize the latest literature revealing environmental, epigenetic, and genetic determinants of malaria transmission.
Læs mere Tjek på PubMedInfection, 5.03.2024
Tilføjet 5.03.2024
Abstract Purpose To explore occupational and non-occupational risk and protective factors for the coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs). Methods Serum specimens and questionnaire data were obtained between October 7 and December 16, 2021 from COVID-19-vaccinated HCWs at a quaternary care hospital in Munich, Germany, and were analyzed in the RisCoin Study. Results Of 3,696 participants evaluated, 6.6% have had COVID-19 at least once. Multivariate logistic regression analysis identified working in patient care occupations (7.3% had COVID-19, 95% CI 6.4–8.3, Pr = 0.0002), especially as nurses, to be a potential occupation-related COVID-19 risk factor. Non-occupational factors significantly associated with high rates of the disease were contacts to COVID-19 cases in the community (12.8% had COVID-19, 95% CI 10.3–15.8, Pr
Læs mere Tjek på PubMedInfection, 5.03.2024
Tilføjet 5.03.2024
Abstract Background The incidence of metastatic complications in Gram-negative bloodstream infection (GN-BSI) remains undefined. This retrospective cohort study examines the incidence and predictors of complications within 90 days of GN-BSI. Methods Patients with GN-BSIs hospitalized at two Prisma Health-Midlands hospitals in Columbia, South Carolina, USA from 1 January 2012 through 30 June 2015 were included. Complications of GN-BSI included endocarditis, septic arthritis, osteomyelitis, spinal infections, deep-seated abscesses, and recurrent GN-BSI. Kaplan–Meier analysis and multivariate Cox proportional hazards regression were used to examine incidence and risk factors of complications, respectively. Results Among 752 patients with GN-BSI, median age was 66 years and 380 (50.5%) were women. The urinary tract was the most common source of GN-BSI (378; 50.3%) and Escherichia coli was the most common bacteria (375; 49.9%). Overall, 13.9% of patients developed complications within 90 days of GN-BSI. The median time to identification of these complications was 5.2 days from initial GN-BSI. Independent risk factors for complications were presence of indwelling prosthetic material (hazards ratio [HR] 1.73, 95% confidence intervals [CI] 1.08–2.78), injection drug use (HR 6.84, 95% CI 1.63–28.74), non-urinary source (HR 1.98, 95% CI 1.18–3.23), BSI due to S. marcescens, P. mirabilis or P. aeruginosa (HR 1.78, 95% CI 1.05–3.03), early clinical failure criteria (HR 1.19 per point, 95% CI 1.03–1.36), and persistent GN-BSI (HR 2.97, 95% CI 1.26–6.99). Conclusions Complications of GN-BSI are relatively common and may be predicted based on initial clinical response to antimicrobial therapy, follow-up blood culture results, and other host and microbiological factors.
Læs mere Tjek på PubMedInfection, 5.03.2024
Tilføjet 5.03.2024
Abstract Purpose The massive increase of infections with Group A Streptococcus (GAS) in 2022–2023 coincided in Switzerland with a change of the recommendations for the management of GAS pharyngitis. Therefore, the objective of the present study was to investigate whether the clinical manifestations and management before hospitalization for GAS infection differed in 2022–2023 compared with 2013–2022. Methods Retrospective study of GAS infections requiring hospitalization in patients below 16 years. Preadmission illness (modified McIsaac score), oral antibiotic use, and outcome in 2022–2023 were compared with 2013–2022. Time series were compared with surveillance data for respiratory viruses. Results In 2022–2023, the median modified McIsaac score was lower (2 [IQR 2–3] vs. 3 [IQR 2–4], p =
Læs mere Tjek på PubMedInfection, 5.03.2024
Tilføjet 5.03.2024
Abstract Purpose Outpatient parenteral antimicrobial therapy (OPAT) is a standard for antimicrobial therapy internationally. With this prospective cohort study, we aimed to assess the impact of an OPAT service as part of antimicrobial stewardship (AMS) and evaluate the safety and efficiency of the program while illuminating the financial benefit for the hospital. Methods Socio-demographic data, treatment regimen and outcomes were prospectively recorded for all patients assigned to the program of the OPAT unit of the University Hospital of Zurich between November 2018 and September 2022. Results In total, we recorded 303 OPAT assignments of which 260 resulted in effective OPAT episodes. The 260 OPAT episodes were further optimized toward the choice of antimicrobial agent (n = 18) and length of therapy (n = 6). Moreover, OPAT resulted in alteration of patient assessment and care led by AMS strategies in 247 of 260 episodes (95%). While the bed days saved per year increased consistently with time, a total of 3934 in-hospital treatment days were saved amounting to a cost saving of 9,835,000 CHF over 47 months. Adverse events were recorded in 46 cases whilst only two of these have been the reason for readmission during OPAT treatment. Clinical cure was noted in 77% (199/260) and was negatively associated with Charlson Comorbidity Index (CCI; OR per 1 unit higher 0.85 (95% CI 0.78–0.93)). Conclusion This study demonstrates the impact of an OPAT service in the framework of AMS as well as its benefits for the hospital whilst preserving safety and efficacy for the patient’s parenteral antimicrobial treatment.
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.03.2024
Tilføjet 5.03.2024
Abstract Malaria infection is a multifactorial disease partly modulated by host immuno-genetic factors. Recent evidence has demonstrated the importance of Interleukin-17 family proinflammatory cytokines and their genetic variants in host immunity. However, limited knowledge exists about their role in parasitic infections such as malaria. We aimed to investigate IL-17A serum levels in patients with severe and uncomplicated malaria and gene polymorphism’s influence on the IL-17A serum levels. In this research, 125 severe (SM) and uncomplicated (UM) malaria patients and 48 free malaria controls were enrolled. IL-17A serum levels were measured with ELISA. PCR and DNA sequencing were used to assess host genetic polymorphisms in IL-17A. We performed a multivariate regression to estimate the impact of human IL-17A variants on IL-17A serum levels and malaria outcomes. Elevated serum IL-17A levels accompanied by increased parasitemia were found in SM patients compared to UM and controls (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.03.2024
Tilføjet 5.03.2024
Abstract Background The performance of the sepsis-induced coagulopathy (SIC) and sequential organ failure assessment (SOFA) scores in predicting the prognoses of patients with sepsis has been validated. This study aimed to investigate the time course of SIC and SOFA scores and their association with outcomes in patients with sepsis. Methods This prospective study enrolled 209 patients with sepsis admitted to the emergency department. The SIC and SOFA scores of the patients were assessed on days 1, 2, and 4. Patients were categorized into survivor or non-survivor groups based on their 28-day survival. We conducted a generalized estimating equation analysis to evaluate the time course of SIC and SOFA scores and the corresponding differences between the two groups. The predictive value of SIC and SOFA scores at different time points for sepsis prognosis was evaluated. Results In the non-survivor group, SIC and SOFA scores gradually increased during the first 4 days (P < 0.05). In the survivor group, the SIC and SOFA scores on day 2 were significantly higher than those on day 1 (P < 0.05); however, they decreased on day 4, dropping below the levels observed on day 1 (P < 0.05). The non-survivors showed higher SIC scores on days 2 (P < 0.05) and 4 (P < 0.001) than the survivors, whereas no significant differences were found between the two groups on day 1 (P > 0.05). The performance of SIC scores on day 4 for predicting mortality was more accurate than that on day 2, with areas under the curve of 0.749 (95% confidence interval [CI]: 0.674–0.823), and 0.601 (95% CI: 0.524–0.679), respectively. The SIC scores demonstrated comparable predictive accuracy for 28-day mortality to the SOFA scores on days 2 and 4. Cox proportional hazards models indicated that SIC on day 4 (hazard ratio [HR] = 3.736; 95% CI: 2.025–6.891) was an independent risk factor for 28-day mortality. Conclusions The time course of SIC and SOFA scores differed between surviving and non-surviving patients with sepsis, and persistent high SIC and SOFA scores can predict 28-day mortality.
Læs mere Tjek på PubMedElena Cama, Loren Brener, Timothy Broady, Robyn Horwitz, Defeng Jin, Hoang Minh Khoi Vu, K. O. E. Wu, Carla Treloar
PLoS One Infectious Diseases, 4.03.2024
Tilføjet 4.03.2024
by Elena Cama, Loren Brener, Timothy Broady, Robyn Horwitz, Defeng Jin, Hoang Minh Khoi Vu, K. O. E. Wu, Carla Treloar Research has shown that there are significant gaps in hepatitis B knowledge among migrant communities who are at risk of hepatitis B, such as Chinese and Vietnamese communities. Many students studying within Australia come from countries with high prevalence of hepatitis B. However, there is very little research examining hepatitis B knowledge, screening, or vaccination among university students in Australia or worldwide. The aim of this paper was to measure both levels of and demographic differences in hepatitis B screening and knowledge among Chinese and Vietnamese students in Australia. Online surveys were completed by 112 Chinese- and 95 Vietnamese-identifying students in Australia, measuring knowledge of hepatitis B, engagement in screening and vaccination, and demographic characteristics. Results show that although engagement in screening and vaccination for hepatitis B was high, there were significant gaps in knowledge around transmission of hepatitis B. There were also some key demographic differences in screening and knowledge. For instance, those born in Australia were more likely to have been screened compared to those born Mainland China, Hong Kong, or Vietnam. Chinese students born in Australia had lower levels of knowledge compared to those born in Mainland China or Hong Kong. Among both samples, knowing someone living with hepatitis B was associated with higher levels of knowledge. Findings underscore the need for education-based interventions to address the significant gaps that exist in knowledge around hepatitis B, with a specific need for culturally appropriate resources in a range of languages to cater to the diverse communities who may be at risk of hepatitis B.
Læs mere Tjek på PubMedGetaneh Alemu, Arancha Amor, Endalkachew Nibret, Abaineh Munshea, Melaku Anegagrie
PLoS One Infectious Diseases, 4.03.2024
Tilføjet 4.03.2024
by Getaneh Alemu, Arancha Amor, Endalkachew Nibret, Abaineh Munshea, Melaku Anegagrie Background Schistosoma mansoni and S. haematobium infections have been public health problems in Ethiopia, S. mansoni being more prevalent. To reduce the burden of schistosomiasis, a national school-based prazequantel (PZQ) mass drug administration (MDA) program has been implemented since November 2015. Nevertheless, S. mansoni infection is still a major public health problem throughout the country. Reduced efficacy of PZQ is reported by a few studies in Ethiopia, but adequate data in different geographical settings is lacking. Hence, this study aimed to assess the efficacy and safety of PZQ for the treatment of S. mansoni infection across different transmission settings in Amhara Regional State, northwest Ethiopia. Methods A school-based single-arm prospective cohort study was conducted from February to June, 2023 among 130 S. mansoni-infected school-aged children (SAC). Forty-two, 37, and 51 S. mansoni-infected SAC were recruited from purposely selected schools located in low, moderate, and high transmission districts, respectively. School-aged children who were tested positive both by Kato Katz (KK) using stool samples and by the point of care circulating cathodic antigen (POC-CCA) test using urine samples at baseline were treated with a standard dose of PZQ and followed for 21 days for the occurrence of adverse events. After three weeks post-treatment, stool and urine samples were re-tested using KK and POC-CCA. Then the cure rate (CR), egg reduction rate (ERR), and treatment-associated adverse events were determined. The data were analyzed using SPSS version 21. Results Out of the total 130 study participants, 110 completed the follow-up. The CR and ERR of PZQ treatment were 88.2% (95%CI: 82.7–93.6) and 93.5% (95%CI: 85.4–98.5), respectively, by KK. The CR of PZQ based on the POC-CCA test was 70.9% (95%CI: 62.7–79.1) and 75.5% (95%CI: 67.3–83.6) depending on whether the interpretation of ‘trace’ results was made as positive or negative, respectively. After treatment on the 21st day, 78 and 83 participants tested negative both by KK and POC-CCA, with respective interpretations of ‘trace’ POC-CCA test results as positive or negative. The CR in low, moderate and high transmission settings was 91.7%, 91.2% and 82.5%, respectively (p = 0.377) when evaluated by KK. The CR among SAC with a light infection at baseline (95.7%) by KK was higher than that of moderate (81.5%) and heavy (64.3%) infections (χ2 = 12.53, p = 0.002). Twenty-six (23.6%) participants manifested at least one adverse event. Eleven (10.0%), eight (7.3%), six (5.5%), and three (2.7%) participants complained about abdominal pain, nausea, headache, and anorexia, respectively. All adverse events were mild, needing no intervention. Occurrence of adverse events was slightly higher in high endemic areas (32.5%) than moderate (23.5%) and low endemic areas (p = 0.279). Conclusions A single dose of 40 mg/kg PZQ was efficacious and safe for the treatment of S. mansoni infection when it was evaluated by the KK test, but a lower efficacy was recorded when it was evaluated by the POC-CCA test. However, the POC-CCA test’s specificity, clearance time of CCA from urine after treatment, and interpretation of weakly reactive (trace) test results need further research.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.03.2024
Tilføjet 4.03.2024
Abstract Patients with B-cell lymphomas have altered cellular components of vaccine responses due to malignancy and therapy, and the optimal timing of vaccination relative to therapy remains unknown. SARS-CoV-2 vaccines created an opportunity for new insights in vaccine timing because patients were challenged with a novel antigen across multiple phases of treatment. We studied serologic mRNA vaccine response in retrospective and prospective cohorts with lymphoma and CLL, paired with clinical and research immune parameters. Reduced serologic response was observed more frequently during active therapies, but non-response was also common within observation and post-treatment groups. Total IgA and IgM correlated with successful vaccine response. In individuals treated with CART-19, non-response was associated with reduced B and T follicular helper cells. Predictors of vaccine response varied by disease and therapeutic group, and therefore further studies of immune health during and after cancer therapies are needed to allow individualized vaccine timing.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.03.2024
Tilføjet 4.03.2024
Abstract Background Critical illness induces immune disorders associated with an increased risk of hospital-acquired pneumonia (HAP) and acute respiratory distress syndrome (ARDS). Torque Teno Virus (TTV), from the Anelloviridae family, are proposed as a biomarker to measure the level of immunosuppression. Our objective was to describe the kinetics of TTV DNA loads and their association with critical-illness related complications.Methods We performed a longitudinal study in 115 brain-injured patients from a prospective cohort, collected endotracheal and blood samples at three time points (T1, T2, T3) during the two weeks post-admission in intensive care unit, and measured viral DNA loads using the TTV R-gene® kit (Biomerieux) and a pan-Anelloviridae in house qRT-PCR.Results TTV DNA was detected in the blood of 69, 71, and 64% of brain-injured patients at T1, T2 and T3 respectively. Time-associated variations of TTV and Anellovirus (AV) DNA loads were observed. Using a linear mixed-effects model, we found that HAP and ARDS were associated with lower blood AV DNA loads.Conclusion Our results show that HAP or ARDS in critically ill patients are associated to changes in AV DNA loads, and should be evaluated further as a biomarker of immune disorders leading to these complications.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.03.2024
Tilføjet 4.03.2024
Abstract Background Polyomavirus nephropathy (PyVN) leads to kidney transplant dysfunction and loss. Since a definitive diagnosis requires an invasive kidney biopsy, a timely diagnosis is often hampered. In this clinical dilemma the PyV-haufen-test, centering around the detection of three-dimensional PyV aggregates in the urine, might provide crucial diagnostic information.Methods A multistep experimental design. Hypothesis: PyV-haufen form within the kidneys under high concentrations of uromodulin, a kidney specific protein; PyV-haufen are kidney-specific-disease-markers.Results Investigative step A showed colocalization of uromodulin with aggregated PyV (i) in ten kidneys with PyVN by immunohistochemistry, (ii) in urine samples containing PyV-haufen by electron microscopy/immunogold labeling (n = 3), and (iii) in urine samples containing PyV-haufen by immunoprecipitation assays (n = 4). Investigative step B: In in-vitro experiments only high uromodulin concentrations of ≥ 1.25 mg/mL aggregated PyV, as is expected to occur within injured nephrons. In contrast, in voided urine samples (n = 59) uromodulin concentrations were below aggregation concentrations (1.2 -19.6 µg/mL). Investigative step C: 0/11 (0%) uromodulin KO-/- mice with histologic signs of PyVN showed urinary PyV-haufen shedding compared to 10/14 (71%) WT+/+ mice.Conclusion PyV-haufen form within kidneys under high uromodulin concentrations. Thus, PyV-haufen detected in the urine are specific biomarkers for intra-renal disease, i.e. definitive PyVN.
Læs mere Tjek på PubMedCED Rees, BMC Swift, P Haldar
International Journal of Infectious Diseases, 4.03.2024
Tilføjet 4.03.2024
Tuberculosis (TB), an aerosol transmitted infection caused by Mycobacterium tuberculosis (Mtb), remains the commonest cause of death globally, from an infectious bacterial disease. Nine years on from the launch of the WHO\'s END-TB strategy, disease incidence rates are stubbornly unchanged [1]. While this represents, in part, a reversal of improving trends caused by the COVID-19 pandemic, it also reflects the fragility and inadequacy of healthcare systems to sustain TB control [2]. Although multifactorial, a key reason for this is the ineffectiveness of existing clinical tools to meet the two key objectives of the END-TB strategy – (i) early diagnosis and treatment of TB disease (to limit onward transmission); and (ii) disease prevention through screening for asymptomatic TB infection (TBI).
Læs mere Tjek på PubMedClinical & Experimental Immunology, 2.03.2024
Tilføjet 2.03.2024
Abstract Sepsis is characterised by a dysfunctional host response to infection culminating in life-threatening organ failure that requires complex patient management and rapid intervention. Timely diagnosis of the underlying cause of sepsis is crucial, and identifying those at risk of complications and death is imperative for triaging treatment and resource allocation. Here, we explored the potential of explainable machine learning models to predict mortality and causative pathogen in sepsis patients. By using a modelling pipeline employing multiple feature selection algorithms, we demonstrate the feasibility to identify integrative patterns from clinical parameters, plasma biomarkers and extensive phenotyping of blood immune cells. Whilst no single variable had sufficient predictive power, models that combined five and more features showed a macro area under the curve (AUC) of 0.85 to predict 90 day mortality after sepsis diagnosis, and a macro AUC of 0.86 to discriminate between Gram-positive and Gram-negative bacterial infections. Parameters associated with the cellular immune response contributed the most to models predictive of 90 day mortality, most notably, the proportion of T cells among PBMCs, together with expression of CXCR3 by CD4+ T cells and CD25 by mucosal-associated invariant T (MAIT) cells. Frequencies of Vδ2+ γδ T cells had the most profound impact on the prediction of Gram-negative infections, alongside other T cell-related variables and total neutrophil count. Overall, our findings highlight the added value of measuring the proportion and activation patterns of conventional and unconventional T cells in the blood of sepsis patients in combination with other immunological, biochemical and clinical parameters.
Læs mere Tjek på PubMedInfection, 2.03.2024
Tilføjet 2.03.2024
Abstract Purpose The massive increase of infections with Group A Streptococcus (GAS) in 2022–2023 coincided in Switzerland with a change of the recommendations for the management of GAS pharyngitis. Therefore, the objective of the present study was to investigate whether the clinical manifestations and management before hospitalization for GAS infection differed in 2022–2023 compared with 2013–2022. Methods Retrospective study of GAS infections requiring hospitalization in patients below 16 years. Preadmission illness (modified McIsaac score), oral antibiotic use, and outcome in 2022–2023 were compared with 2013–2022. Time series were compared with surveillance data for respiratory viruses. Results In 2022–2023, the median modified McIsaac score was lower (2 [IQR 2–3] vs. 3 [IQR 2–4], p =
Læs mere Tjek på PubMedLim, L.-l., Williams, K., Francis, J. J., Wroth, M., Breen, J.
BMJ Open, 2.03.2024
Tilføjet 2.03.2024
ObjectiveThe ‘To Dip or Not to Dip’ (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were to use a qualitative approach to (1) evaluate potential influences on the delivery of the TDONTD intervention in Australian residential aged care homes (RACHs) by identifying perceived barriers and enablers to delivery and acceptance; and (2) propose intervention strategies to address barriers and enhance enablers. DesignA qualitative before–after process evaluation of a multisite implementation study using interviews with nurse and pharmacist implementers. SettingThis study was conducted in 12 Australian RACHs. ParticipantsParticipants included 17 on-site nurse champions and 4 pharmacists (existing contracted providers). InterventionResources from England’s TDONTD intervention were adapted for an Australian context. Key resources delivered were case-based education, staff training video, clinical pathway and an audit tool. ResultsKey barriers to TDONTD were beliefs about nursing capabilities in diagnosing infection, beliefs about consequences (fear of missing infection) and social influences (pressure from family, doctors and hospitals). Key enablers were perceived increased nurse and carer knowledge (around UTI and asymptomatic bacteriuria), resources from a credible source, empowerment of nurse champions to apply knowledge and skills in delivering operational change initiatives, pharmacist-delivered education and organisational policy or process change. Of TDONTD’s key components, the clinical pathway substituted dipstick testing in diagnosing UTI, delivery of case-based education was enhanced by their attendance and support of the intervention and the antibiotic audit tool generated feedback that champions shared with staff. ConclusionsOur study confirms the core components of TDONTD and strategies to enhance delivery and overcome barriers. To further reduce barriers to TDONTD, broader advocacy work is required to raise awareness of dipstick testing as a low-value test in older persons and by linking it to healthcare professionals and consumer education.
Læs mere Tjek på PubMedSergio P. Alpuche-Lazcano, Robert J. Scarborough and Anne Gatignol
Retrovirology, 2.03.2024
Tilføjet 2.03.2024
Human immunodeficiency virus (HIV) and human T cell leukemia virus (HTLV) have replicative and latent stages of infection. The status of the viruses is dependent on the cells that harbour them and on different...
Læs mere Tjek på PubMedShivakoti, Rupak; Giganti, Mark J; Lederman, Michael M; Ketchum, Rachel; Brummel, Sean; Moisi, Daniela; Dadabhai, Sufia; Moodley, Dhayendre; Violari, Avy; Chinula, Lameck; Owor, Maxensia; Gupta, Amita; Currier, Judith S.; Taha, Taha E; Fowler, Mary Glenn; for the PROMISE study team
AIDS, 2.03.2024
Tilføjet 2.03.2024
Objective : HIV treatment regimen during pregnancy was associated with preterm delivery (PTD) in the PROMISE 1077 BF trial. Systemic inflammation among pregnant women with HIV could help explain differences in PTD by treatment regimen. We assessed associations between inflammation, treatment regimen, and PTD. Design/Methods : A nested 1:1 case-control study (N = 362) was conducted within a multi-country randomized trial comparing three HIV regimens in pregnant women: zidovudine alone, or combination antiretroviral therapy (ART) with lopinavir/ritonavir and either zidovudine or tenofovir. Cases were women with PTD (
Læs mere Tjek på PubMedBughrara, Nibras F.; Neilson, Maegan R.; Jones, Stephanie; Workman, Lorna; Chopra, Amit; Pustavoitau, Aliaksei
Critical Care Explorations, 2.03.2024
Tilføjet 2.03.2024
OBJECTIVES: We assessed the efficacy of 1-day training in echocardiography assessment using subxiphoid-only (EASy) followed by supervised image interpretation and decision-making during patient rounds as a novel approach to scaling up the use of point-of-care ultrasound (POCUS) in critically ill patients. DESIGN: Retrospective analysis of medical records and EASy examination images. SETTING: Tertiary care academic hospital. PATIENTS: A total of 14 adults (> 18 yr old) with COVID-19-associated respiratory failure under the care of Albany Medical Center’s surge response team from April 6–17, 2020 who received at least one EASy examination. INTERVENTIONS: Residents (previously novice sonographers) were trained in EASy examination using 1 day of didactic and hands-on training, followed by independent image acquisition and supervised image interpretation, identification of hemodynamic patterns, and clinical decision-making facilitated by an echocardiography-certified physician during daily rounds. MEASUREMENTS AND MAIN RESULTS: We recorded the quality of resident-obtained EASy images, scanning time, and frequency with which the supervising physician had to repeat the examination or obtain additional images. A total of 63 EASy examinations were performed; average scanning time was 4.3 minutes. Resident-obtained images were sufficient for clinical decision-making on 55 occasions (87%), in the remaining 8 (13%) the supervising physician obtained further images. CONCLUSIONS: EASy examination is an efficient, valuable tool under conditions of scarce resources. The educational model of 1-day training followed by supervised image interpretation and decision-making allows rapid expansion of the pool of sonographers and implementation of bedside echocardiography into routine ICU patient management.
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