Nyt fra tidsskrifterne
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#99305
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#99306
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#99248
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#99249
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#99250
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#98963
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#98766
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#97822
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#90604
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#90571
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#88346
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#81392
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#60445
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=cvid&setpoint=60025#60025
Søgeord (cvid) valgt.
14 emner vises.
Clinical Infectious Diseases, 10.02.2024
Tilføjet 10.02.2024
Abstract Background Since publication of Duke criteria for infective endocarditis (IE) diagnosis, several modifications have been proposed. We aimed to evaluate the diagnostic performance of the Duke-ISCVID 2023 criteria compared to prior versions from 2000 (Duke-Li 2000) and 2015 (Duke-ESC 2015).Methods This study was conducted at two University Hospitals between 2014-2022 among patients with suspected IE. A case was classified as IE (final IE diagnosis) by the Endocarditis Team. Sensitivity for each version of the Duke criteria was calculated among patients with confirmed IE based on pathological, surgical and microbiological data. Specificity for each version of the Duke criteria was calculated among patients with suspected IE for whom IE diagnosis was ruled out.Results In total 2132 episodes with suspected IE were included; of which 1101 (52%) had final IE diagnosis. Definite IE by pathologic criteria was found in 285 (13%), 285 (13%), and 345 (16%) patients using the Duke-Li 2000, Duke-ESC 2015 or the Duke-ISCVID 2023 criteria, respectively. IE was excluded by histopathology in 25 (1%) patients. The Duke-ISCVID 2023 clinical criteria showed a higher sensitivity (84%) compared to previous versions (70%). However, specificity of the new clinical criteria was lower (60%) compared to previous versions (74%).Conclusions The Duke-ISCVID 2023 criteria led to an increase in sensitivity compared to previous versions. Further studies are needed to evaluate items that could increase sensitivity by reducing the number of IE patients misclassified as possible, but without having detrimental effect on specificity of Duke criteria.
Læs mere Tjek på PubMedClinical Infectious Diseases, 10.02.2024
Tilføjet 10.02.2024
Abstract Background Revised diagnostic criteria for infective endocarditis (IE), the 2023 Duke-ISCVID criteria, were recently presented and need validation. Here, we compare the 2000 modified Duke criteria for IE with Duke-ISCVID among patients with bacteremia and relate the diagnostic classification to IE-treatment.Methods We reanalyzed patient cohorts with Stapylococcus aureus, Staphylococcus lugdunensis, non-beta-hemolytic streptococci, Streptococcus-like bacteria, Streptococcus dysgalactiae, Enterococcus faecalis and HACEK bacteremia. Episodes were classified as definite, possible or rejected IE with the modified Duke and Duke-ISCVID criteria. Reclassification included the microbiology criteria, PET-CT and cardiac implanted elect-ronical devices. To calculate sensitivity, patients treated as IE were considered as having IE.Results In 4050 episodes of bacteremia, the modified Duke criteria criteria assigned 307episodes (7.6%) as definite IE, 1190 episodes (29%) as possible IE and 2553 episodes (63%) as rejected IE. Using the Duke-ISCVID criteria, 13 episodes (0.3%) were reclassified from possible to definite IE and 475 episodes (12%) were reclassified from rejected to possible IE. With the modified Duke criteria, 79 episodes that were treated as IE were classified as possible IE and eleven of these episodes were reclassified to definite IE with Duke-ISCVID. Applying the decision to treat for IE as reference standard, the sensitivity of the Duke-ISCVID criteria was 80%. None of the 475 episodes reclassified to possible IE were treated as IE.Conclusions The Duke-ISCVID criteria reclassified a small proportion of episodes to definite IE at the expense of more episodes of possible IE. Future criteria should minimize the possible group while keeping or improving sensitivity.
Læs mere Tjek på PubMedClinical Infectious Diseases, 9.02.2024
Tilføjet 9.02.2024
Abstract Background The 2023 Duke-ISCVID Criteria for infective endocarditis (IE) were proposed as an updated diagnostic classification of IE. Using an open prospective multicenter cohort of patients treated for IE, we compared the performance of these new criteria to that of the 2000 Modified Duke and 2015 ESC criteria.Methods Cases of patients treated for IE between January 2017 and October 2022 were adjudicated as certain IE or not. Each case was also categorized as either definite or possible/rejected within each classification. Sensitivity, specificity, and accuracy were estimated, with 95% confidence intervals.Results Of the 1194 patients analyzed (mean age 66.1 years, 71.2% men), 414 (34.7%) had a prosthetic valve and 284 (23.8%) had a cardiac implanted electronic device (CIED); 946 (79.2%) were adjudicated as certain IE; 978 (81.9%), 997 (83.5%), and 1057 (88.5%) were classified as definite IE in the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID criteria, respectively. The sensitivity of each set of criteria was 93.2% [91.6-94.8], 95.0% [93.7-96.4], and 97.6% [96.6-98.6], respectively (p
Læs mere Tjek på PubMedClinical Infectious Diseases, 9.02.2024
Tilføjet 9.02.2024
Abstract Background The 2023 Duke-ISCVID classification is a new diagnostic tool for infective endocarditis, updating the 2000 modified Duke and the 2015 ESC classifications. In comparison, its’ sensitivity is higher, however its’ specificity remains to be evaluated and compared to that of the two other classifications in endocarditis suspected patients.Methods We retrospectively collected the characteristics of patients hospitalized in Bichat University’s Hospital, Paris, in 2021, who had been evaluated for clinical suspicion of endocarditis, have had at least a transthoracic echocardiography, two pairs of blood cultures, 3-month follow-up and in whom endocarditis diagnosis was finally rejected. All patients were classified by 2000 modified Duke, 2015 ESC and 2023 Duke-ISCVID, as though the endocarditis diagnosis had not been rejected.Results In total, 130 patients’ charts were analyzed. Mean age was 62 years, 84 (64.6%) were male, 39 (30.0%) had prosthetic cardiac valve or valve repair, 21 (16.2%) cardiac implanted electronic device, and 30 (23.1%) other cardiac conditions. Overall, 5, 2 and 5 patients were falsely classified as definite endocarditis with the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID classifications, respectively. The corresponding specificities were 96.2% (95% CI [90.8%; 98.6%]), 98.5% (95% CI [93.9%; 99.7%]), and 96.2% (95% CI [90.8%; 98.6%]). The rates of possible endocarditis were of 38%, 35%, and 35% in the 3 classifications, respectively.Conclusion The 2023 Duke-ISCVID classification is highly specific for ruling out the diagnosis of definite infective endocarditis in patients who had been evaluated for IE.
Læs mere Tjek på PubMedClinical Infectious Diseases, 9.02.2024
Tilføjet 9.02.2024
Abstract Introduction The 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) Criteria for IE were introduced to improve classification of infective endocarditis (IE) for research and clinical purposes. External validation studies are required.Methods We studied consecutive patients with suspected IE referred to the IE Team of Amsterdam University Medical Center (October 2016-March 2021). An international expert panel independently reviewed case summaries, and assigned a final diagnosis of “IE” or “Not IE” , which served as the reference standard, to which the “Definite” Duke-ISCVID classifications were compared. We also evaluated accuracy when excluding cardiac surgery and pathology data (“Clinical Criteria”). Lastly, we compared the 2023 Duke-ISCVID to the 2000 Modified Duke Criteria and the 2015 and 2023 European Society of Cardiology (ESC) Criteria.Results 595 consecutive patients with suspected IE were included: 399 (67%) were adjudicated as IE; 111 (19%) had prosthetic valve IE and 48 (8%) had cardiac implantable electronic device IE. The 2023 Duke-ISCVID Criteria were more sensitive than either the Modified Duke or 2015 ESC Criteria (84.2% vs 74.9% and 80% respectively, p < 0.001) without significant loss of specificity. The 2023 Duke-ISCVID Criteria were similarly sensitive but more specific than the 2023 ESC Criteria (94% vs 82%, p
Læs mere Tjek på PubMedClinical & Experimental Immunology, 3.02.2024
Tilføjet 3.02.2024
Summary Selective IgA deficiency (sIgAD) and Common Variable Immunodeficiency (CVID) and Transient Hypogammaglobulinemia of Infancy (THI) are the most frequent forms of primary antibody deficiencies. Difficulties in initial diagnosis, especially in the early childhood, the familiar occurrence of these diseases, as well as the possibility of progression to each other suggest common cellular and molecular patomechanism and a similar genetic background. In this review, we discuss both similarities and differences of these three humoral immunodeficiencies, focusing on current and novel therapeutic approaches. We summarize immunoglobulin substitution, antibiotic prophylaxis, treatment of autoimmune diseases and other common complications, i.e. cytopenias, gastrointestinal complications, and granulomatous disease. We discuss novel therapeutic approaches such as allogenic stem cell transplantation and therapies targeting specific proteins, dependant on the patient’s genetic defect. The diversity of possible therapeutics models result from a great heterogeneity of the disease variants, implying the need of personalized medicine approach as a future of primary humoral immunodeficiencies treatment.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
Clinical Infectious Diseases, 3.01.2024
Tilføjet 3.01.2024
Abstract Background The Duke criteria for infective endocarditis (IE) diagnosis underwent revisions in 2023 by the European Society of Cardiology (ESC) and the International Society for Cardiovascular Infectious Diseases (ISCVID). This study aims to assess the diagnostic accuracy of these criteria, focusing on patients with Staphylococcus aureus bacteremia (SAB).Methods This Swiss multicenter study conducted between 2014 and 2023 pooled data from three cohorts. It evaluated the performance of each iteration of the Duke criteria by assessing the degree of concordance between definite S. aureus IE (SAIE) and the diagnoses made by the Endocarditis Team (2018-23) or IE expert clinicians (2014-17).Results Among 1344 SAB episodes analyzed, 486 (36%) were identified as cases of SAIE. The 2023 Duke-ISCVID and 2023 Duke-ESC criteria demonstrated improved sensitivity for SAIE diagnosis (81% and 82%, respectively) compared to the 2015 Duke-ESC criteria (75%). However, the new criteria exhibited reduced specificity for SAIE (96% for both) compared to the 2015 criteria (99%). Spondylodiscitis was more prevalent among patients with SAIE compared to those with SAB alone (10% versus 7%, P 0.026). However, when patients meeting the minor 2015 Duke-ESC vascular criterion were excluded, the incidence of spondylodiscitis was similar between SAIE and SAB patients (6% versus 5%, P 0.461).Conclusions The 2023 Duke-ISCVID and 2023 Duke-ESC clinical criteria, show improved sensitivity for SAIE diagnosis compared to 2015 Duke-ESC criteria. However, this increase in sensitivity comes at the expense of reduced specificity. Future research should aim at evaluating the impact of each component introduced within these criteria.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.06.2023
Tilføjet 30.06.2023
Clinical Infectious Diseases, 29.06.2023
Tilføjet 29.06.2023
Clinical Infectious Diseases, 5.05.2023
Tilføjet 5.05.2023
AbstractThe microbiology, epidemiology, diagnostics, and treatment of infective endocarditis (IE) have changed significantly since the Duke Criteria were published in 1994 and modified in 2000. The International Society for Cardiovascular Infectious Diseases (ISCVID) convened a multidisciplinary Working Group to update the diagnostic criteria for IE. The resulting 2023 Duke-ISCVID IE Criteria propose significant changes, including new microbiology diagnostics (enzyme immunoassay for Bartonella species, PCR, amplicon/metagenomic sequencing, in situ hybridization), imaging ([18F]FDG PET/CT, Cardiac Computed Tomography), and inclusion of intraoperative inspection as a new Major Clinical Criterion. The list of “typical” microorganisms causing IE was expanded and includes pathogens to be considered as typical only in the presence of intracardiac prostheses. The requirements for timing and separate venipunctures for blood cultures were removed. Last, additional predisposing conditions (transcatheter valve implants, endovascular cardiac implantable electronic devices, prior IE) were clarified. These diagnostic criteria should be updated periodically by making the ISCVID-Duke Criteria available online as a “Living Document”.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 27.12.2022
Tilføjet 27.12.2022
AbstractCommon variable immunodeficiency (CVID) is a “late-onset” primary immunodeficiency characterized by variable manifestations and genetic heterogeneity. A monogenic cause of CVID has been reported in 10% of patients. In this study, we identified two novel pathogenic variants implicated in monogenic CVID by whole exome sequencing (WES) analysis: a heterozygous nuclear factor κB subunit 1 (NFKB1) p.G686fs mutation and a homozygous inducible T-cell co-stimulator (ICOS) p.L96Sfs mutation. The predicted crystal models indicated premature truncation of the two mutated proteins. Both variants were demonstrated as loss-of-function mutations and were associated with overlapped manifestations of respiratory fungal infection and splenomegaly. We further performed a detailed assessment of immunologic phenotypes and impaired lymphocyte functions in patients. Moreover, we discovered an association between monoclonal T-large granular lymphocyte proliferation and ICOS-deficient CVID for the first time. These observations lead to a new perspective on the underlying genetic heterogeneity of CVID.
Læs mere Tjek på PubMedGodsell, Jack; Chan, Samantha; Slade, Charlotte; Bryant, Vanessa; Douglass, Jo Anne; Sasadeusz, Joe; Yong, Michelle K.
Current Opinion in Infectious Diseases, 1.12.2021
Tilføjet 22.11.2021
Purpose of review
Cytomegalovirus (CMV) infection and disease are well described in the setting of secondary immunodeficiency. Less is known about CMV in the context of primary immunodeficiencies (PIDs), where inborn errors in one or more arms of the immune system result in variable degrees of CMV susceptibility.
Recent findings
PID presents unique challenges in the diagnosis and management of CMV disease. The clinical presentation of CMV in PID is often severe, accelerated by underlying immune dysregulation and iatrogenic immunosuppression. Here we describe the clinical significance of CMV infection in PID, the key components of immune defence against CMV and how these are affected in specific PIDs. CMV disease is under-recognized as a complication of common variable immunodeficiency (CVID). High rates of CMV end-organ disease, mortality, development of CMV resistance and prolonged antiviral use have been observed in individuals with CVID.
Summary
We recommend that clinicians tailor their approach to the individual based on their underlying immune deficit and maintain a high index of suspicion and low threshold for treatment. More research is required to improve stratification of CMV risk in PID, develop new diagnostic tools and manage end-organ disease in this cohort.
Læs mere Tjek på PubMedMarta Dafne Cabañero-Navalon, Victor Garcia-Bustos, Paula Ruiz-Rodriguez, Iñaki Comas, Mireia Coscollá, Llúcia Martinez-Priego, José Todolí, Pedro Moral Moral
Clinical Microbiology and Infection, 10.11.2021
Tilføjet 10.11.2021
A 22-year-old man with common variable immunodeficiency (CVID) complicated with granulomatous–lymphocytic interstitial lung disease (GLILD) previously treated with azathioprine and a 4-weekly course of rituximab 3 years before who was receiving subcutaneous (SC) immunoglobulin replacement therapy (IRT) was diagnosed of COVID-19 by SARS-CoV-2 reverse-transcriptase-polymerase-chain-reaction (RT-PCR) of a nasopharyngeal swab specimen after a 4-day history of fever. He quarantined at home but was later admitted to the hospital with COVID-19 bilateral pneumonia and hypoxemia on day 20.
Læs mere Tjek på PubMed