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Zuo, L., Li, X., Wang, L., Yuan, H., Liao, Z., Zhou, S., Wu, J., Guan, X., Liu, Y.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
ObjectivesThis study aims to investigate the diagnostic value of heparin-binding protein (HBP) in sepsis and develop a sepsis diagnostic model incorporating HBP with key biomarkers and disease-related scores for rapid, and accurate diagnosis of sepsis in the intensive care unit (ICU). DesignClinical retrospective cross-sectional study. SettingA comprehensive teaching tertiary hospital in China. ParticipantsAdult patients (aged ≥18 years) who underwent HBP testing or whose blood samples were collected when admitted to the ICU. Main outcome measuresHBP, C reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), interleukin-6 (IL-6), lactate (LAC), Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) score were recorded. ResultsBetween March 2019 and December 2021, 326 patients were enrolled in this study. The patients were categorised into a non-infection group (control group), infection group, sepsis group and septic shock group based on the final diagnosis. The HBP levels in the sepsis group and septic shock group were 45.7 and 69.0 ng/mL, respectively, which were significantly higher than those in the control group (18.0 ng/mL) and infection group (24.0 ng/mL) (p
Læs mere Tjek på PubMedChen, W.-y., Guo, Z.-b., Kong, T.-y., Chen, W.-x., Chen, X.-h., Yang, Q., Wen, Y.-c., Wen, Q.-r., Zhou, F., Xiong, X.-m., Wen, D.-l., Zhang, Z.-h.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
IntroductionSevere septic cardiomyopathy (SCM) is one of the main causes of refractory septic shock (RSS), with a high mortality. The application of venoarterial extracorporeal membrane oxygenation (ECMO) to support the impaired cardiac function in patients with septic shock remains controversial. Moreover, no prospective studies have been taken to address whether venoarterial ECMO treatment could improve the outcome of patients with sepsis-induced cardiogenic shock. The objective of this study is to assess whether venoarterial ECMO treatment can improve the 30-day survival rate of patients with sepsis-induced refractory cardiogenic shock. Methods and analysisExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated is a prospective, multicentre, non-randomised, cohort study on the application of ECMO in SCM. At least 64 patients with SCM and RSS will be enrolled in an estimated ratio of 1:1.5. Participants taking venoarterial ECMO during the period of study are referred to as cohort 1, and patients receiving only conventional therapy without ECMO belong to cohort 2. The primary outcome is survival in a 30-day follow-up period. Other end points include survival to intensive care unit (ICU) discharge, hospital survival, 6-month survival, quality of life for long-term survival (EQ-5D score), successful rate of ECMO weaning, long-term survivors’ cardiac function, the number of days alive without continuous renal replacement therapy, mechanical ventilation and vasopressor, ICU and hospital length of stay, the rate of complications potentially related to ECMO treatment. Ethics and disseminationThe trial has been approved by the Clinical Research and Application Institutional Review Board of the Second Affiliated Hospital of Guangzhou Medical University (2020-hs-51). Participants will be screened and enrolled from ICU patients with septic shock by clinicians, with no public advertisement for recruitment. Results will be disseminated in research journals and through conference presentations. Trial registration number NCT05184296.
Læs mere Tjek på PubMedKawakatsu, Y., Mosser, J. F., Adolph, C., Baffoe, P., Cheshi, F., Aiga, H., Watkins, D. A., Sherr, K. H.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
BackgroundNational-level coverage estimates of maternal and child health (MCH) services mask district-level and community-level geographical inequities. The purpose of this study is to estimate grid-level coverage of essential MCH services in Nigeria using machine learning techniques. MethodsEssential MCH services in this study included antenatal care, facility-based delivery, childhood vaccinations and treatments of childhood illnesses. We estimated generalised additive models (GAMs) and gradient boosting regressions (GB) for each essential MCH service using data from five national representative cross-sectional surveys in Nigeria from 2003 to 2018 and geospatial socioeconomic, environmental and physical characteristics. Using the best-performed model for each service, we map predicted coverage at 1 km2 and 5 km2 spatial resolutions in urban and rural areas, respectively. ResultsGAMs consistently outperformed GB models across a range of essential MCH services, demonstrating low systematic prediction errors. High-resolution maps revealed stark geographic disparities in MCH service coverage, especially between rural and urban areas and among different states and service types. Temporal trends indicated an overall increase in MCH service coverage from 2003 to 2018, although with variations by service type and location. Priority areas with lower coverage of both maternal and vaccination services were identified, mostly located in the northern parts of Nigeria. ConclusionHigh-resolution spatial estimates can guide geographic prioritisation and help develop better strategies for implementation plans, allowing limited resources to be targeted to areas with lower coverage of essential MCH services.
Læs mere Tjek på PubMedShanaube, K., Ndubani, R., Kelly, H., Webb, E., Mayaud, P., Lamberti, O., Fitzpatrick, J., Kasese, N., Sturt, A., Van Lieshout, L., Van Dam, G., Corstjens, P. L. A. M., Kosloff, B., Bond, V., Hayes, R., Terris-Prestholt, F., Webster, B., Vwalika, B., Hansingo, I., Ayles, H., Bustinduy, A. L.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
IntroductionMultiplathogen home-based self-sampling offers an opportunity to increase access to screening and treatment in endemic settings with high coinfection prevalence of sexually transmitted (HIV, Trichomonas vaginalis (Tv), human papillomavirus (HPV)) and non-sexually transmitted pathogens (Schistosoma haematobium (Sh)). Chronic coinfections may lead to disability (female genital schistosomiasis) and death (cervical cancer). The Zipime-Weka-Schista (Do self-testing sister!) study aims to evaluate the validity, acceptability, uptake, impact and cost-effectiveness of multipathogen self-sampling for genital infections among women in Zambia. Methods and analysisThis is a longitudinal cohort study aiming to enrol 2500 non-pregnant, sexually active and non-menstruating women aged 15–50 years from two districts in Zambia with 2-year follow-up. During home visits, community health workers offer HIV and Tv self-testing and cervicovaginal self-swabs for (1) HPV by GeneXpert and, (2) Sh DNA detection by conventional (PCR)and isothermal (recombinase polymerase assay) molecular methods. Schistosoma ova and circulating anodic antigen are detected in urine. At a clinic follow-up, midwives perform the same procedures and obtain hand-held colposcopic images. High-risk HPV positive women are referred for a two-quadrant cervical biopsy according to age and HIV status. A cost-effectiveness analysis is conducted in parallel. Ethics and disseminationThe University of Zambia Biomedical Research Ethics Committee (UNZABREC) (reference: 1858-2021), the London School of Hygiene and Tropical Medicine (reference: 25258), Ministry of Health and local superintendents approved the study in September 2021.Written informed consent was obtained from all participants prior to enrolment. Identifiable data collected are stored securely and their confidentiality is protected in accordance with the Data Protection Act 1998.
Læs mere Tjek på PubMedLiu, C.-W., Jeyakumar, N., McArthur, E., Sontrop, J. M., Myran, D. T., Schwartz, K. L., Sood, M. M., Tanuseputro, P., Garg, A. X.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
ObjectivesTo determine COVID-19 vaccine uptake among physicians in Ontario, Canada from 14 December 2020 to 13 February 2022. DesignPopulation-based retrospective cohort study. SettingAll registered physicians in Ontario, Canada using data from linked provincial administrative healthcare databases. Participants41 267 physicians (including postgraduate trainees) who were Ontario residents and registered with the College of Physicians and Surgeons of Ontario were included. Physicians who were out of province, had not accessed Ontario Health Insurance Plan-insured services for their own care for ≥5 years and those with missing identifiers were excluded. Primary and secondary outcome measuresPrimary outcomes were the proportions of physicians who were recorded to have received at least one, at least two and three doses of a Health Canada-approved COVID-19 vaccine by study end date. Secondary outcomes were how uptake varied by physician characteristics (including age, sex, specialty and residential location) and time elapsed between doses. ResultsOf 41 267 physicians, (56% male, mean age 47 years), 39 359 (95.4%) received at least one dose, 39 148 (94.9%) received at least two doses and 35 834 (86.8%) received three doses of a COVID-19 vaccine. Of those who received three doses, the proportions were 90.4% among those aged ≥60 years and 81.2–89.5% among other age groups; 88.7% among family physicians and 89% among specialists. 1908 physicians (4.6%) had no record of vaccination, and this included 3.4% of family physicians and 4.1% of specialists; however, 28% of this group had missing specialty information. ConclusionsIn Ontario, within 14 months of COVID-19 vaccine availability, 86.8% of physicians had three doses of a COVID-19 vaccine, compared with 45.6% of the general population. Findings may signify physicians’ confidence in the safety and effectiveness of COVID-19 vaccines.
Læs mere Tjek på PubMedLuo, S., Bao, F., Wu, H., Ma, W., Zhu, L., Huang, X., Yang, R., Peng, L., Gao, L., Wu, X., Zhong, L., Dong, Y., Li, B., Ma, W., Liu, A.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
Introduction Ixodes ticks are pivotal in transmitting diseases like Lyme disease and human granulocytic anaplasmosis, caused by Borrelia burgdorferi and Anaplasma phagocytophilum, respectively. These pathogens not only affect humans through single or multiple tick bites but also pose risks to animal hosts, leading to potential coinfections. Despite regional studies indicating significant prevalence, their global coinfection data remain sparse. This study aims to bridge this gap through a systematic review and meta-analysis of B. burgdorferi and A. phagocytophilum coinfections in Ixodes ticks worldwide. Addressing data limitations and study variability, it seeks to provide a nuanced understanding of coinfection patterns, their epidemiological implications and inform targeted prevention strategies. Methods and analysisFollowing Preferred Reporting Items for Systematic Review and Meta-analysis Protocols 2015 guidelines and PROSPERO registration, this study will undertake a thorough database search without constraints on language or publication date, using standardised screening and data extraction protocols. The quality and bias of studies will be evaluated using Joanna Briggs Institute tools. In the statistical analysis phase, conducted in R, we will initially determine the use of fixed or random-effects models based on the assessment of data heterogeneity. This choice will guide the framework for subsequent analyses. Within the selected model’s framework, we will perform subgroup analyses and meta-regression to investigate the effects of various factors, ensuring that each step is tailored to the initial model selection to maintain analytical consistency. Ethics and disseminationAs this study does not involve clinical research or data collection from subjects, ethical approval is not required. We will uphold ethical standards in synthesising and reporting data. Study outcomes will be published in peer-reviewed journals, communicating findings to the scientific community and contributing to the understanding of Ixodes tickborne diseases. PROSPERO registration numberCRD42023449735.
Læs mere Tjek på PubMedShi, Y., Gao, H., Yan, Y., Li, X., Ping, W., Yang, H., Du, Y.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
ObjectiveTo examine the associations between career choice motivation and professionalism among medical students based on gender in the context of COVID-19. DesignCross-sectional study. SettingThe study was conducted at a medical school in China. MethodsA total of 1421 second-year to fourth-year medical students participated in the survey using cluster sampling. They were asked to complete questionnaires on demographic information, career choice motivation and professionalism. Linear regression models were used to analyse the relationship between career choice motivations and professionalism based on gender differences. ResultsFemale medical students outperformed males in professionalism (p
Læs mere Tjek på PubMedMehboodi, F., Zamanzadeh, V., Rahmani, A., Dianat, I., Shabanloie, R.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
ObjectiveThis study explored the consequences of COVID-19 on the occupational safety and health of nurses. DesignQualitative conventional content analysis. Participants14 nurses selected by purposeful sampling method. SettingFive educational and non-educational hospitals in the Northwest of Iran. Data collection and analysisSemistructured interviews were used for data collection and analysed using conventional content analysis. ResultsTwo main categories have emerged from the data: reduced quality of professional life and post-traumatic growth. Reduced quality of professional life, which has two subcategories including job dissatisfaction and burnout, has a negative nature, and has had many negative effects on the physical, mental and well-being of nursing personnel during the coronavirus era. On the other hand, post-traumatic growth, with two subcategories that include promoting safe behaviour and gaining a positive self-concept, has a positive nature. ConclusionsMaintaining the occupational health and safety of nurses plays an important role in providing quality services to patients. Therefore, it is necessary for managers and policymakers to use the experiences related to the COVID-19 crisis, to prevent negative factors and strengthen positive factors, to maintain the safety and occupational health of nurses, and increase the quality of care.
Læs mere Tjek på PubMedSkjevling, L., Goll, R., Hanssen, H. M., Johnsen, P. H.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
IntroductionThe observed alteration of the intestinal microbiota in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the effect of transferring a healthy gut flora from a faecal donor using a faecal microbiota transplantation (FMT) will be explored in this trial. Methods and analysisThis is a protocol for a randomised, double-blind, placebo-controlled, parallel-group, single-centre trial, with 12 months follow-up. 80 participants will be included and randomised (1:1:2) to either donor FMT (from two different donors) or placebo (autologous FMT). Participants will be included by the International Clinical Criteria for ME/CFS. The clinical measures of ME/CFS and disease activity include Modified DePaul Questionnaire, Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), 36-Item Short Form Health Survey (SF-36), ROMA IV criteria, Food Frequency Questionnaire, Repeatable Battery for the Assessment of Neuropsychological Status, heart rate variability testing and reports on the use of antibiotics and food supplements, as well as biobanking of blood, urine and faeces. The primary endpoint is proportion with treatment success in FSS score in donor versus autologous FMT group 3 months after treatment. Treatment success is defined as an FSS improvement of more than 1.2 points from baseline at 3 months after treatment. Adverse events will be registered throughout the study. Ethics and disseminationThe Regional Committee for Medical Research Ethics Northern Norway has approved the study. The study has commenced in May 2019. Findings will be disseminated in international peer-reviewed journal(s), submitted to relevant conferences, and trial participants will be informed via phone calls. Trial registration number NCT03691987.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
Abstract We conducted a systematic review to explore the relationship between perceived risk for HIV acquisition and sexual HIV exposure among sexual and gender minorities. We included 39 studies divided into (i) correlations or associations, (ii) models using sexual HIV exposure as the outcome, and (iii) models using perceived risk for HIV acquisition as the outcome. The sample size range was from 55 to 16,667 participants, primarily cisgender men who have sex with men (73.3%) and White (51.3%). Sexual HIV exposure and perceived risk for HIV acquisition assessments and recall time frames across studies differed markedly. Most of studies (84.6%) found significant correlations, comparisons, or associations between different levels of perceived risk for HIV acquisition and high sexual HIV exposure. In addition, 51.3% of studies reported other variables associated with high sexual HIV exposure (i.e., misuse of substances or alcohol) or with high perceived risk for HIV acquisition (i.e., younger age). In conclusion, the association between perceived risk for HIV acquisition and sexual HIV exposure has shown to be consistent. However, the assessment for perceived risk for HIV acquisition should include more components of perception (i.e., an affective component), or for sexual HIV exposure should consider the different estimated sexual per-acts probability of acquiring HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
Abstract We conducted a systematic review to explore the relationship between perceived risk for HIV acquisition and sexual HIV exposure among sexual and gender minorities. We included 39 studies divided into (i) correlations or associations, (ii) models using sexual HIV exposure as the outcome, and (iii) models using perceived risk for HIV acquisition as the outcome. The sample size range was from 55 to 16,667 participants, primarily cisgender men who have sex with men (73.3%) and White (51.3%). Sexual HIV exposure and perceived risk for HIV acquisition assessments and recall time frames across studies differed markedly. Most of studies (84.6%) found significant correlations, comparisons, or associations between different levels of perceived risk for HIV acquisition and high sexual HIV exposure. In addition, 51.3% of studies reported other variables associated with high sexual HIV exposure (i.e., misuse of substances or alcohol) or with high perceived risk for HIV acquisition (i.e., younger age). In conclusion, the association between perceived risk for HIV acquisition and sexual HIV exposure has shown to be consistent. However, the assessment for perceived risk for HIV acquisition should include more components of perception (i.e., an affective component), or for sexual HIV exposure should consider the different estimated sexual per-acts probability of acquiring HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
Abstract Purpose Frailty is a vulnerable state to stressors due to the loss of physiological reserve as a result of multisystem dysfunction. The physiological and laboratory-based frailty index (FI-Lab), depending on laboratory values and vital signs, is a powerful tool to capture frailty status. The aim of this study was to assess the relationship between FI-Lab and in-hospital mortality in patients with septic shock. Methods Baseline data for patients with sepsis in the intensive care unit were retrieved from the Critical Care Medicine Database (MIMIC-IV, v2.2). The primary outcome was mortality during hospitalization. The propensity score matching (PSM) method was used to analyze the basic conditions during hospitalization between groups.The FI-Lab was analysed for its relationship with in-hospital mortality using logistic regression according to continuous and categorical variables, respectively, and described using the restricted cubic spline (RCS). Survival was compared between groups using Kaplan-Meier (KM) curves. Subgroup analyses were used to improve the stability of the results. Results A total of 9219 patients were included. A cohort score of 1803 matched patients was generated after PSM. The analyses showed that non-surviving patients with septic shock in the ICU had a high FI-Lab index (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
Abstract Purpose Frailty is a vulnerable state to stressors due to the loss of physiological reserve as a result of multisystem dysfunction. The physiological and laboratory-based frailty index (FI-Lab), depending on laboratory values and vital signs, is a powerful tool to capture frailty status. The aim of this study was to assess the relationship between FI-Lab and in-hospital mortality in patients with septic shock. Methods Baseline data for patients with sepsis in the intensive care unit were retrieved from the Critical Care Medicine Database (MIMIC-IV, v2.2). The primary outcome was mortality during hospitalization. The propensity score matching (PSM) method was used to analyze the basic conditions during hospitalization between groups.The FI-Lab was analysed for its relationship with in-hospital mortality using logistic regression according to continuous and categorical variables, respectively, and described using the restricted cubic spline (RCS). Survival was compared between groups using Kaplan-Meier (KM) curves. Subgroup analyses were used to improve the stability of the results. Results A total of 9219 patients were included. A cohort score of 1803 matched patients was generated after PSM. The analyses showed that non-surviving patients with septic shock in the ICU had a high FI-Lab index (P
Læs mere Tjek på PubMedOuli XieMark R. DaviesSteven Y. C. Tong1Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia2Monash Infectious Diseases, Monash Health, Melbourne, Australia3Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia4Victorian Infectious Disease Service, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, AustraliaGraeme N. ForrestLaurens Manning
Clinical Microbiology Reviews, 11.06.2024
Tilføjet 11.06.2024
Youjia Zhong, Alicia Y. H. Kang, Carina J. X. Tay, Hui’ En Li, Nurul Elyana, Chee Wah Tan, Wee Chee Yap, Joey M. E. Lim, Nina Le Bert, Kuan Rong Chan, Eugenia Z. Ong, Jenny G. Low, Lynette P. Shek, Elizabeth Huiwen Tham, Eng Eong Ooi
Nature, 11.06.2024
Tilføjet 11.06.2024
Nature, 11.06.2024
Tilføjet 11.06.2024
Xiaoyou Hu Xu Bai Fangling Tian Yifan Xing Yi Shi Yimin Tong Jin Zhong a CAS Key Laboratory of Molecular Virology and Immunology, Shanghai Institute of Immunity and Infection, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Shanghai, People’s Republic of Chinab University of Chinese Academy of Sciences, Beijing, People’s Republic of Chinac Institute of Microbiology, Chinese Academy of Sciences, Beijing, People’s Republic of Chinad School of Life Science and Technology, ShanghaiTech University, Shanghai, People's Republic of China
Emerg Microbes Infect, 11.06.2024
Tilføjet 11.06.2024
Ah-Ra Lee Sang-Hyun Kim Su-Yeon Hong Sang-Ho Lee Jae Sang Oh Kyung Yong Lee Seong-Jun Kim Tomohiro Ishikawa Sang-Mu Shim Hee Il Lee Sang-Uk Seo a Department of Biomedicine & Health Sciences, Graduate School, The Catholic University of Korea, Seoul, Republic of Koreab Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Koreac Department of Neurosurgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Koread Division of Cancer Biology, Research Institute, National Cancer Center, Goyang, Republic of Koreae Center for Infectious Disease Vaccine and Diagnosis Innovation (CEVI), Korea Research Institute of Chemical Technology, Daejeon, Republic of Koreaf Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi, Japang Division of Acute Virus Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Koreah Division of Vectors and Parasitic Diseases, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
Emerg Microbes Infect, 11.06.2024
Tilføjet 11.06.2024
Cintia Fabbri Marta Giovanetti Victoria Luppo Vagner Fonseca Jorge Garcia Cintia Barulli Mariel Feroci Sofia Perrone Doraldina Casoni Sergio Giamperetti Maria Cristina Alvarez Lopez Maria Delia Foussal Mauricio Figueredo Karina Salvatierra Sergio Lejona Natalia Ruiz Diaz Gonzalo Castro Gabriela Bravo Noelia Jackel Carina Sen Tomás Poklepovich Caride Leticia Franco Carlos Giovachini Jairo Mendez Rico Luiz Carlos Junior Alcantara Maria Alejandra Morales a Instituto Nacional de Enfermedaes Virales Humanas “Dr. Maiztegui”, ANLIS, Pergamino, Argentinab Department of Sciences and Technologies for Sustainable Development and One Health, Universita Campus Bio-Medico di Roma, Rome, Italyc Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazild Climate Amplified Diseases and Epidemics (CLIMADE), Minas Gerais, Brazile Departamento de Ciências Exatas e da Terra, Universidade do Estado da Bahia, Salvador, Brazilf Hospital de Infecciosas Francisco Javier Muñiz, CABA, Buenos Aires, Argentinag Hospital General de Niños R. Gutiérrez, CABA, Buenos Aires, Argentinah Hospital Julio C. Perrando, Chaco, Argentinai Hospital de Alta Complejidad “Pte. Juan Domingo Perón”, Formosa, Argentinaj Laboratorio de Alta Complejidad de Posadas, Misiones, Argentinak CEMAR – Secretaria de Salud – Municipalidad de Rosario, Santa Fe, Argentinal Laboratorio Central de Redes y Programas de Corrientes, Corrientes, Argentinam Laboratorio Central de la Provincia de Cordoba, Córdoba, Argentinan Hospital Señor del Milagro, Salta, Argentinao Unidad Operativa, Centro Nacional de Genómica y Bioinformática, ANLISp Infectious Hazards Management, Health Emergencies Department (PHE), Pan American Health Organi-zation/World Health Organization (PAHO/WHO), Washington, DC, USAq Direccion de Epidemiologia, Minsiterio de Salud de la Nacion, Buenos Aires, Argentina
Emerg Microbes Infect, 11.06.2024
Tilføjet 11.06.2024
Scott M. Reid Alexander M. P. Byrne Fabian Z. X. Lean Craig S. Ross Andrei Pascu Richard Hepple Maria Dominguez Susanne Frost Vivien J. Coward Alejandro Núñez Joe James Levon Stephan James N. Aegerter Ian H. Brown Ashley C. Banyard a Virology Department, Animal and Plant Health Agency (APHA) Weybridge, Addlestone, UKb Pathology and Animal Sciences Department, APHA Weybridge, Addlestone, UKc APHA England Field Delivery, APHA Stafford, Stafford, UKd APHA Bridgwater, Bridgwater, UKe APHA England Field Delivery, Stroud, UKf APHA Bakewell, Bakewell, UKg WOAH/FAO International Reference Laboratory for Avian Influenza, APHA Weybridge, Addlestone, UKh Veterinary Exotic Notifiable Disease Unit (VENDU), London, UKi APHA Sand Hutton, National Wildlife Management Centre, York, UK
Emerg Microbes Infect, 11.06.2024
Tilføjet 11.06.2024
Zhi Zhang Lina Li Hongsheng Wang Xin Ran Yuan Chen Xinyao Liu Yuping Ran a Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, People’s Republic of Chinab Department of Dermatovenereology, Henan Provincial People’s Hospital (People’s Hospital of Zhengzhou University), Zhengzhou, People’s Republic of Chinac Laboratory of Mycobacteria, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People’s Republic of China
Emerg Microbes Infect, 11.06.2024
Tilføjet 11.06.2024
Wolde Facha, Takele Tadesse, Eskinder Wolka, Ayalew Astatkie
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Wolde Facha, Takele Tadesse, Eskinder Wolka, Ayalew Astatkie Background High viral load during pregnancy and breastfeeding period is the risk factor for vertical transmission of human immunodeficiency virus (HIV). Currently, Dolutegravir (DTG)-based regimens are recommended to attain adequate viral load suppression (VLS) among women. However, its effect on VLS has not been investigated among women in PMTCT care in Ethiopia. Objective This study aimed to investigate the rate of viral load non-suppression among women exposed to DTG-based versus Efavirenz (EFV)-based regimens in Ethiopia. Methods An uncontrolled before-and-after study design was conducted among 924 women (462 on EFV-based and 462 on DTG-based regimens) enrolled in PMTCT care from September 2015 to February 2023. The outcome variable was the viral load (VL) non-suppression among women on PMTCT care. A modified Poisson regression model was employed, and the proportion was computed to compare the rate of VL non-suppression in both groups. The risk ratio (RR) with a 95% confidence interval (CI) was calculated to assess viral load non-suppression among women on DTG-based and EFV-based regimens by adjusting for other variables. Results The overall rate of non-suppressed VL was 16.2% (95% CI: 14.0–18.8%). Mothers on DTG-based regimens had approximately a 30% (adjusted risk ratio (aRR): 0.70; 95% CI: 0.52–0.94) lesser risk of developing non-suppressed VL than women on EFV-based regimens. Besides, older women were 1.38 times (aRR: 1.38; 95% CI: 1.04–1.83); mothers who did not disclose their HIV status to their partners were 2.54 times (aRR: 2.54; 95% CI: 1.91–3.38); and mothers who had poor or fair adherence to antiretroviral (ARV) drugs were 2.11 times (aRR: 2.11; 95% CI: 1.45–3.07) at higher risk of non-suppressed VL. Conclusion Women on DTG-based regimens had a significantly suppressed VL compared to those on EFV-based regimens. Thus, administering DTG-based first-line ART regimens should be strengthened to achieve global and national targets on VLS.
Læs mere Tjek på PubMedMmatlou Ouma Moloisi, Stanley Chibuzor Onwubu
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Mmatlou Ouma Moloisi, Stanley Chibuzor Onwubu Background The proper management of isolation waste is of utmost importance in healthcare facilities to prevent the spread of infections and protect both healthcare workers and the general public. This study investigated waste handlers’ knowledge of the management of isolation waste at Dr. George Mukhari Academic Hospital in Gauteng, South Africa. Methods A survey was conducted to assess waste handlers’ understanding of waste types, colour codes, safety precautions, and awareness of internal policies related to isolation waste management. Results The study found that the majority of waste handlers demonstrated a good understanding of waste types generated in the isolation unit, including sharps waste, human tissue waste, infectious waste, and general waste. They also correctly identified examples of sharp waste, such as injections, blades, glass slides, and needles. Additionally, most respondents were aware of the colour code used for representing infectious waste as \'yellow\' and \'red.\' The study revealed a statistically significant association between waste handlers’ age and their knowledge of isolation waste, suggesting that age may influence their understanding of waste management practices. Furthermore, experience was found to be significantly associated with waste handlers’ knowledge of the health-hazardous nature of isolation waste. While the majority of waste handlers recognized the importance of wearing protective clothing and correctly marking isolation waste, some respondents were not aware of the internal policy for waste handling such as guidelines and protocols specific to the segregation, packaging, labeling, and disposal of waste generated within the isolation units. Conclusion and contribution These findings highlight the importance of continuous training, targeted education, and policy dissemination to ensure effective waste management and adherence to safety protocols among waste handlers.
Læs mere Tjek på PubMedJohn Gameli Deku, Enoch Aninagyei, Israel Bedzina, Gameli Nudo, Emmanuel Ativi, Prosper Mensah, Solomon Wireko, Aaron Osei-Tutu, Emmanuel Duker, Innocent Afeke
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by John Gameli Deku, Enoch Aninagyei, Israel Bedzina, Gameli Nudo, Emmanuel Ativi, Prosper Mensah, Solomon Wireko, Aaron Osei-Tutu, Emmanuel Duker, Innocent Afeke Background Tuberculosis remains a major public health threat worldwide, causing significant morbidity and mortality, particularly in low- and middle-income countries. In recent years, efforts to combat tuberculosis have focused on strengthening healthcare systems and increasing access to diagnostics and treatment services. There is scarcity of data on the prevalence of Mycobacterium tuberculosis and rifampicin-resistant tuberculosis in the Volta region of Ghana. Therefore, the aim of this study was to determine the trends of Mycobacterium tuberculosis and rifampicin resistance in a major teaching hospital in Ghana spanning a six-year period. Methodology A retrospective cross-sectional hospital study was conducted at Ho Teaching Hospital, Ho, Ghana. Study data included archived results on tuberculosis testing using GeneXpert from 2016–2021. Archived data on tuberculosis testing were collected and entered using Microsoft Excel 2019. IBM SPSS (v26) was used for a statistical analysis of the prevalence of tuberculosis. P-value
Læs mere Tjek på PubMedAlfred Kipyegon Keter, Fiona Vanobberghen, Lutgarde Lynen, Alastair Van Heerden, Jana Fehr, Stephen Olivier, Emily B. Wong, Tracy R. Glass, Klaus Reither, Els Goetghebeur, Bart K. M. Jacobs
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Alfred Kipyegon Keter, Fiona Vanobberghen, Lutgarde Lynen, Alastair Van Heerden, Jana Fehr, Stephen Olivier, Emily B. Wong, Tracy R. Glass, Klaus Reither, Els Goetghebeur, Bart K. M. Jacobs Background Estimation of prevalence and diagnostic test accuracy in tuberculosis (TB) prevalence surveys suffer from reference standard and verification biases. The former is attributed to the imperfect reference test used to bacteriologically confirm TB disease. The latter occurs when only the participants screening positive for any TB-compatible symptom or chest X-ray abnormality are selected for bacteriological testing (verification). Bayesian latent class analysis (LCA) alleviates the reference standard bias but suffers verification bias in TB prevalence surveys. This work aims to identify best-practice approaches to simultaneously alleviate the reference standard and verification biases in the estimates of pulmonary TB prevalence and diagnostic test performance in TB prevalence surveys. Methods We performed a secondary analysis of 9869 participants aged ≥15 years from a community-based multimorbidity screening study in a rural district of KwaZulu-Natal, South Africa (Vukuzazi study). Participants were eligible for bacteriological testing using Xpert Ultra and culture if they reported any cardinal TB symptom or had an abnormal chest X-ray finding. We conducted Bayesian LCA in five ways to handle the unverified individuals: (i) complete-case analysis, (ii) analysis assuming the unverified individuals would be negative if bacteriologically tested, (iii) analysis of multiply-imputed datasets with imputation of the missing bacteriological test results for the unverified individuals using multivariate imputation via chained equations (MICE), and simultaneous imputation of the missing bacteriological test results in the analysis model assuming the missing bacteriological test results were (iv) missing at random (MAR), and (v) missing not at random (MNAR). We compared the results of (i)-(iii) to the analysis based on a composite reference standard (CRS) of Xpert Ultra and culture. Through simulation with an overall true prevalence of 2.0%, we evaluated the ability of the models to alleviate both biases simultaneously. Results Based on simulation, Bayesian LCA with simultaneous imputation of the missing bacteriological test results under the assumption that the missing data are MAR and MNAR alleviate the reference standard and verification biases. CRS-based analysis and Bayesian LCA assuming the unverified are negative for TB alleviate the biases only when the true overall prevalence is
Læs mere Tjek på PubMedZobaida Ahmed, Yuanyuan Gu, Kompal Sinha, Mutsa Mutowo, Natalie Gauld, Bonny Parkinson
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Zobaida Ahmed, Yuanyuan Gu, Kompal Sinha, Mutsa Mutowo, Natalie Gauld, Bonny Parkinson Introduction The prevention of unintended pregnancy is a public health issue affecting women worldwide. In Australia, women are required to get a prescription to obtain the oral contraceptive pill (OCP), which may limit access and be a barrier to its initiation and continuing use. Changing the availability of the OCP from prescription-only to over-the-counter (OTC) is one solution, however, to ensure success policymakers need to understand women’s preferences. Telehealth services also might serve as an alternative to obtain prescriptions and increase accessibility to OCPs. This study aims to explore the preferences for OTC OCPs among Australian women, and whether the expansion of telehealth impacted women’s preferences. Methods A mixed methods approach was used to explore women’s preferences regarding access to the OCP. Focus group discussions (FGDs) were conducted to organically identify the preferences followed by an empirical ranking exercise. Three FGDs in two phases were conducted, pre and post-expansion of telehealth in Australia due to the COVID-19 pandemic. Convenience sampling was employed. The technique of constant comparison was used for thematic analysis where transcripts were analysed iteratively, and codes were allowed to emerge during the process to give the best chance for the attributes to develop from the data. Results Thematic analysis revealed that women perceived OTC availability of OCPs as a mechanism to increase the accessibility of contraception by reducing cost, travel time, waiting time, and increasing opening hours. They also believed that it would increase adherence to OCPs. However, some potential safety concerns and logistical issues were raised, including pharmacist training, access to patient’s medical history, the ability to discuss other health issues or undertake opportunistic health screening, adherence to checklists, and privacy in the pharmacy environment. Following the expansion of telehealth, accessibility issues such as opening hours, travel time, and location of the facility were considered less important. Conclusions The participants expressed their support for reclassifying OCPs to OTC, particularly for repeat prescriptions, as it would save valuable resources and time. However, some safety and logistical issues were raised. Women indicated they would balance these concerns with the benefits when deciding to use OTC OCPs. This could be explored using a discrete choice experiment. The expansion of telehealth was perceived to reduce barriers to accessing OCPs. The findings are likely to be informative for policymakers deciding whether to reclassify OCPs to OTC, and the concerns of women that need addressing to ensure the success of any policy change.
Læs mere Tjek på PubMedLuis Martinez-Villegas, Paula Lado, Hans Klompen, Selena Wang, Caleb Cummings, Risa Pesapane, Sarah M. Short
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Luis Martinez-Villegas, Paula Lado, Hans Klompen, Selena Wang, Caleb Cummings, Risa Pesapane, Sarah M. Short Amblyomma americanum, a known vector of multiple tick-borne pathogens, has expanded its geographic distribution across the United States in the past decades. Tick microbiomes may play a role shaping their host’s life history and vectorial capacity. Bacterial communities associated with A. americanum may reflect, or enable, geographic expansion and studying the microbiota will improve understanding of tick-borne disease ecology. We examined the microbiota structure of 189 adult ticks collected in four regions encompassing their historical and current geographic distribution. Both geographic region of origin and sex were significant predictors of alpha diversity. As in other tick models, within-sample diversity was low and uneven given the presence of dominant endosymbionts. Beta diversity analyses revealed that bacterial profiles of ticks of both sexes collected in the West were significantly different from those of the Historic range. Biomarkers were identified for all regions except the historical range. In addition, Bray-Curtis dissimilarities overall increased with distance between sites. Relative quantification of ecological processes showed that, for females and males, respectively, drift and dispersal limitation were the primary drivers of community assembly. Collectively, our findings highlight how microbiota structural variance discriminates the western-expanded populations of A. americanum ticks from the Historical range. Spatial autocorrelation, and particularly the detection of non-selective ecological processes, are indicative of geographic isolation. We also found that prevalence of Ehrlichia chaffeensis, E. ewingii, and Anaplasma phagocytophilum ranged from 3.40–5.11% and did not significantly differ by region. Rickettsia rickettsii was absent from our samples. Our conclusions demonstrate the value of synergistic analysis of biogeographic and microbial ecology data in investigating range expansion in A. americanum and potentially other tick vectors as well.
Læs mere Tjek på PubMedSowptika Pal, Ramani Yuvaraj, Hari Krishnan, Balasubramanian Venkatraman, Jayanthi Abraham, Anilkumar Gopinathan
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Sowptika Pal, Ramani Yuvaraj, Hari Krishnan, Balasubramanian Venkatraman, Jayanthi Abraham, Anilkumar Gopinathan This paper reports the results of gamma irradiation experiments and whole genome sequencing (WGS) performed on vegetative cells of two radiation resistant bacterial strains, Metabacillus halosaccharovorans (VITHBRA001) and Bacillus paralicheniformis (VITHBRA024) (D10 values 2.32 kGy and 1.42 kGy, respectively), inhabiting the top-ranking high background radiation area (HBRA) of Chavara-Neendakara placer deposit (Kerala, India). The present investigation has been carried out in the context that information on strategies of bacteria having mid-range resistance for gamma radiation is inadequate. WGS, annotation, COG and KEGG analyses and manual curation of genes helped us address the possible pathways involved in the major domains of radiation resistance, involving recombination repair, base excision repair, nucleotide excision repair and mismatch repair, and the antioxidant genes, which the candidate could activate to survive under ionizing radiation. Additionally, with the help of these data, we could compare the candidate strains with that of the extremely radiation resistant model bacterium Deinococccus radiodurans, so as to find the commonalities existing in their strategies of resistance on the one hand, and also the rationale behind the difference in D10, on the other. Genomic analysis of VITHBRA001 and VITHBRA024 has further helped us ascertain the difference in capability of radiation resistance between the two strains. Significantly, the genes such as uvsE (NER), frnE (protein protection), ppk1 and ppx (non-enzymatic metabolite production) and those for carotenoid biosynthesis, are endogenous to VITHBRA001, but absent in VITHBRA024, which could explain the former’s better radiation resistance. Further, this is the first-time study performed on any bacterial population inhabiting an HBRA. This study also brings forward the two species whose radiation resistance has not been reported thus far, and add to the knowledge on radiation resistant capabilities of the phylum Firmicutes which are abundantly observed in extreme environment.
Læs mere Tjek på PubMedRachelle Ashcroft, Catherine Donnelly, Peter Sheffield, Simon Lam, Connor Kemp, Keith Adamson, Judith Belle Brown
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Rachelle Ashcroft, Catherine Donnelly, Peter Sheffield, Simon Lam, Connor Kemp, Keith Adamson, Judith Belle Brown Background Primary health care (PHC) teams contributed to all phases of the COVID-19 vaccination distribution. However, there has been criticism for not fully utilizing the expertise and infrastructure of PHC teams for vaccination distribution. Our study sought to understand the role PHC teams had in the distribution of the COVID-19 vaccine in Ontario, Canada. The key objective informing this study was to explore the experiences and perspectives of interprofessional PHC teams in the distribution of COVID-19 vaccination across Ontario. Methods A qualitative approach was used for this study, which involved 39 participants from the six health regions of the province. Eight focus groups were conducted with a range of interprofessional healthcare providers, administrators, and staff working in PHC teams across Ontario. The sample reflected a diverse range of clinical, administrative, and leadership roles in PHC. Focus groups were audio-recorded and transcribed, while transcriptions were then analyzed using thematic analysis. Results We identified the following four themes in the data: i) PHC teams know their patients; ii) mobilizing team capacity for vaccination, iii) intersectoral collaborations, and iv) operational challenges. Conclusions PHC teams were an instrumental component in supporting COVID-19 vaccinations in Ontario. The involvement of PHC in future vaccination efforts is key but requires additional resourcing and inclusion of PHC in decision-making. This will ensure provider well-being and maintain collaborations established during COVID-19 vaccination.
Læs mere Tjek på PubMedMiranda A. Lewis, Ketki Patil, Khalil Ettayebi, Mary K. Estes, Robert L. Atmar, Sasirekha Ramani
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Miranda A. Lewis, Ketki Patil, Khalil Ettayebi, Mary K. Estes, Robert L. Atmar, Sasirekha Ramani In vitro models, such as primary cells and continuous cell lines routinely used for evaluating drug candidates, have limitations in their translational relevance to human diseases. Organotypic cultures are increasingly being used to assess therapeutics for various cancers and infectious diseases. Monitoring drug cytotoxicity in cell cultures is crucial in drug development, and several commercially available kits for cytotoxicity assessment offer distinct advantages and limitations. Given the complexity of organoid cultures, including donor-driven variability, we investigated drug-treated, tissue stem cell-derived human intestinal organoid responses with commonly used cell cytotoxicity assay kits. Using seven different compounds, we compared the cytotoxicity assay performance of two different leaky membrane-based and two metabolism-based assays. Significant variability was seen in reported viability outcomes across assays and organoid lines. High baseline activity of lactate dehydrogenase (LDH) in four human intestinal organoid lines required modification of the standard LDH assay protocol. Additionally, the LDH assay reported unique resilience to damage in a genetically-modified line contrasting results compared to other assays. This study highlights factors that can impact the measurement of cell cytotoxicity in intestinal organoid models, which are emerging as valuable new tools for research and pre-clinical drug testing and suggest the need for using multiple assay types to ensure reliable cytotoxicity assessment.
Læs mere Tjek på PubMedRyosuke Nakai, Hiroyuki Kusada, Fumihiro Sassa, Ayaka Makino, Susumu Morigasaki, Hisayoshi Hayashi, Naoki Takaya, Hideyuki Tamaki
PLoS One Infectious Diseases, 11.06.2024
Tilføjet 11.06.2024
by Ryosuke Nakai, Hiroyuki Kusada, Fumihiro Sassa, Ayaka Makino, Susumu Morigasaki, Hisayoshi Hayashi, Naoki Takaya, Hideyuki Tamaki Our previous studies indicate the abundant and diverse presence of yet-to-be-cultured microorganisms in the micropore-filtered fractions of various environmental samples. Here, we isolated a novel bacterium (designated as strain TMPK1T) from a 0.45-μm-filtered soil suspension by using a gel-filled microwell array device comprising 900 microwells and characterized its phylogenetic and physiological features. This strain showed low 16S rRNA gene sequence identities (
Læs mere Tjek på PubMedMalaria Journal, 10.06.2024
Tilføjet 10.06.2024
Abstract Background Results of spatial and temporal comparison of malaria hotspots and coldspots could improve the health measures of malaria control and eradication strategies. The study aimed to reveal the spatially and temporally independent correlations between the potentially most effective background variables and the number of autochthonous malaria cases. Methods Relationships between malaria cases and background variables were studied in 2 km × 2 km sized quadrates (10 Central European and 10 African). In addition to the current habitat structure of the African sites, annual precipitation, and annual mean temperature, data of the above parameters detected in the nineteenth and twentieth centuries and currently in the Central European sites were included in the analyses (n = 40). Mann–Whitney tests, Principal Component Analysis, and Generalized Linear Models were used for the examinations. Results In addition to the apparent significant positive correlation of malaria cases with annual rainfall and mean temperature, several correlations were found for habitat parameters. The cover of marshlands in the 19th-century habitat structure of Central European quadrates was considerably the same as in the recent African ones. The extent of rural residential areas was significantly smaller in the 19th-century habitat structure of Central European quadrats than in present-day African ones. According to the revealed correlations, the surface cover of rural residential areas is the main driver of the number of autochthonous malaria cases that we can directly impact. Conclusions The study confirmed with historical comparison that not only the annual rainfall and mean temperature, the cover of marshlands and other habitats with breeding sites, but also the elements of the rural human environment play a significant role in the high number of autochthonous malaria cases, probably through the concentration and enhancing sites for vector mosquitoes. The latter confirms that a rapid urbanization process could reduce malaria cases in the most infected areas of Africa. Until the latter happens, extensive biological control of Anopheles larvae and chemical control (both outdoor and indoor) of their imagoes, further mosquito nets, repellents, and carbon dioxide traps will need to be applied more widely in the most heavily infested areas.
Læs mere Tjek på PubMedMalaria Journal, 10.06.2024
Tilføjet 10.06.2024
Abstract Background Plasmodium vivax malaria is a leading cause of morbidity in Ethiopia. The first-line treatment for P. vivax is chloroquine (CQ) and primaquine (PQ), but there have been local reports of CQ resistance. A clinical study was conducted to determine the efficacy of CQ for the treatment of P. vivax malaria in southern Ethiopia. Methods In 2021, patients with P. vivax mono-infection and uncomplicated malaria were enrolled and treated with 25 mg/kg CQ for 3 consecutive days. Patients were followed for 28 days according to WHO guidelines. The data were analysed using per-protocol (PP) and Kaplan‒Meier (K‒M) analyses to estimate the risk of recurrent P. vivax parasitaemia on day 28. Results A total of 88 patients were enrolled, 78 (88.6%) of whom completed the 28 days of follow-up. Overall, 76 (97.4%) patients had adequate clinical and parasitological responses, and two patients had late parasitological failures. The initial therapeutic response was rapid, with 100% clearance of asexual parasitaemia within 48 h. Conclusion Despite previous reports of declining chloroquine efficacy against P. vivax, CQ retains high therapeutic efficacy in southern Ethiopia, supporting the current national treatment guidelines. Ongoing clinical monitoring of CQ efficacy supported by advanced molecular methods is warranted to inform national surveillance and ensure optimal treatment guidelines.
Læs mere Tjek på PubMedMalaria Journal, 10.06.2024
Tilføjet 10.06.2024
Abstract Background The World Health Organization novel malaria vaccine for at-risk children has the potential to greatly reduce the current malaria burden in sub-Saharan Africa. However, most studies have reported contradictory findings regarding community willingness for the vaccine, which could easily undermine the expected benefits of the vaccine. This study aims to ascertain the current state of community readiness and acceptance for the implementation of a novel malaria vaccine (RTS,S/ASO1) among at-risk children in sub-Saharan Africa, based on available evidence. Methods This study will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol (PRISMA-P) guidelines. Relevant studies will be comprehensively searched from PubMed, ScienceDirect, Web of Science, Google Scholar, and African journals online, in accordance with the Cochrane search guidelines. Two independent reviewers will screen titles, abstracts and full texts of eligible studies based on some specified eligibility criteria. When it is feasible to conduct a meta-analysis, a random effects model will be employed to estimate the common effect due to anticipated high heterogeneity of the data. The effect measure for readiness or acceptance will be reported as a pooled proportion with corresponding 95% confidence interval. Additionally, odds ratios with 95% confidence interval will be estimated to assess factors associated with readiness. These will be presented on a forest plot. Dissemination plans The findings of the study will be peer-reviewed and published in a scientific journal. Conference presentations will also be made to the different stakeholders in the malaria vaccination campaigns. Systematic review registration The protocol has been registered with PROSPERO Registration Number: CRD42023480528.
Læs mere Tjek på PubMedInfection, 10.06.2024
Tilføjet 10.06.2024
Abstract Purpose Ureaplasma urealyticum is a rare pathogen associated with septic arthritis that predominantly affects patients with hypogammaglobulinemia. Bacterial identification of fastidious organisms is challenging because they are undetectable by routine culture testing. To the best of our knowledge, this is the first report of septic arthritis induced by U. urealyticum infection in Japan. Case description We describe the case of a 23-year-old Japanese female with secondary hypogammaglobulinemia (serum immunoglobulin level
Læs mere Tjek på PubMedInfection, 10.06.2024
Tilføjet 10.06.2024
Abstract Background The landscape of Pseudomonas infective endocarditis (IE) is evolving with the widespread use of cardiac implantable devices and hospital-acquired infections. This systematic review aimed to evaluate the emerging risk factors and outcomes in Pseudomonas IE. Methods A literature search was performed in major electronic databases (PubMed, Scopus, and Google Scholar) with appropriate keywords and combinations till November 2023. We recorded data for risk factors, diagnostic and treatment modalities. This study is registered with PROSPERO, CRD42023442807. Results A total of 218 cases (131 articles) were included. Intravenous drug use (IDUs) and prosthetic valve endocarditis (PVE) were major risk factors for IE (37.6% and 22%). However, the prosthetic valve was the predominant risk factor in the last two decades (23.5%). Paravalvular complications (paravalvular leak, abscess, or pseudoaneurysm) were described in 40 cases (18%), and the vast majority belonged to the aortic valve (70%). The mean time from symptom onset to presentation was 14 days. The incidence of difficult-to-treat resistant (DTR) pseudomonas was 7.4%. Valve replacement was performed in 57.3% of cases. Combination antibiotics were used in most cases (77%), with the aminoglycosides-based combination being the most frequently used (66%). The overall mortality rate was 26.1%. The recurrence rate was 11.2%. Almost half of these patients were IDUs (47%), and most had aortic valve endocarditis (76%). Conclusions This review highlights the changing epidemiology of Pseudomonas endocarditis with the emergence of prosthetic valve infections. Acute presentation and associated high mortality are characteristic of Pseudomonas IE and require aggressive diagnostic and therapeutic approach.
Læs mere Tjek på PubMedInfection, 10.06.2024
Tilføjet 10.06.2024
Abstract Purpose Most data regarding infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) comes from TAVI registries, rather than IE dedicated cohorts. The objective of our study was to compare the clinical and microbiological profile, imaging features and outcomes of patients with IE after SAVR with a biological prosthetic valve (IE-SAVR) and IE after TAVI (IE-TAVI) from 6 centres with an Endocarditis Team (ET) and broad experience in IE. Methods Retrospective analysis of prospectively collected data. From the time of first TAVI implantation in each centre to March 2021, all consecutive patients admitted for IE-SAVR or IE-TAVI were prospectively enrolled. Follow-up was monitored during admission and at 12 months after discharge. Results 169 patients with IE-SAVR and 41 with IE-TAVI were analysed. Early episodes were more frequent among IE-TAVI. Clinical course during hospitalization was similar in both groups, except for a higher incidence of atrioventricular block in IE-SAVR. The most frequently causative microorganisms were S. epidermidis, Enterococcus spp. and S. aureus in both groups. Periannular complications were more frequent in IE-SAVR. Cardiac surgery was performed in 53.6% of IE-SAVR and 7.3% of IE-TAVI (p=0.001), despite up to 54.8% of IE-TAVI patients had an indication. No differences were observed about death during hospitalization (32.7% vs 35.0%), and at 1-year follow-up (41.8% vs 37.5%), regardless of whether the patient underwent surgery or not. Conclusion Patients with IE-TAVI had a higher incidence of early prosthetic valve IE. Compared to IE-SAVR, IE-TAVI patients underwent cardiac surgery much less frequently, despite having surgical indications. However, in-hospital and 1-year mortality rate was similar between both groups.
Læs mere Tjek på PubMedInfection, 10.06.2024
Tilføjet 10.06.2024
Abstract Purpose The worldwide emergence and clonal spread of carbapenem-resistant Acinetobacter baumannii (CRAB) is of great concern. In the present study, we determined the mechanisms of antimicrobial resistance, virulence gene repertoire and genomic relatedness of CRAB isolates circulating in Serbian hospitals. Methods CRAB isolates were analyzed using whole-genome sequencing (WGS) for the presence of antimicrobial resistance-encoding genes, virulence factors-encoding genes, mobile genetic elements and genomic relatedness. Antimicrobial susceptibility testing was done by disk diffusion and broth microdilution methods. Results Eleven isolates exhibited an MDR resistance phenotype, while four of them were XDR. MIC90 for meropenem and imipenem were > 64 µg/mL and 32 µg/mL, respectively. While all CRABs harbored blaOXA−66 variant of blaOXA−51 gene, those assigned to STPas2, STPas636 and STPas492 had blaADC−73,blaADC−74 and blaADC−30 variants, respectively. The following acquired carbapenemases-encoding genes were found: blaOXA−72 (n = 12), blaOXA−23 (n = 3), and blaNDM−1(n = 5), and were mapped to defined mobile genetic elements. MLST analysis assigned the analyzed CRAB isolates to three Pasteur sequence types (STs): STPas2, STPas492, and STPas636. The Majority of strains belonged to International Clone II (ICII) and carried tested virulence-related genes liable for adherence, biofilm formation, iron uptake, heme biosynthesis, zinc utilization, serum resistance, stress adaptation, intracellular survival and toxin activity. Conclusion WGS elucidated the resistance and virulence profiles of CRABs isolated from clinical samples in Serbian hospitals and genomic relatedness of CRAB isolates from Serbia and globally distributed CRABs.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
About 42% of patients with infections caused by pathogens that were resistant to all first-line antibiotics received only older antibiotics rather than newer ones more recently approved by the US Food and Drug Administration, a new study found. The results were based on data from 619 US hospitals and more than 2600 infections caused by drug-resistant gram-negative pathogens.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
Nigeria will be the first country in the world to vaccinate residents aged 1 through 29 years with Men5CV, a novel 1-dose vaccine that protects people from 5 major strains of the meningococcus bacteria (Neisseria meningitidis), the World Health Organization (WHO) announced. The news comes amid a 50% surge in meningitis cases in Africa last year, as well as an uptick in the disease worldwide, including in the US.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
Previous studies have suggested that many people who use proton pump inhibitors (PPIs) might not have a clinical indication for doing so, which is concerning because PPIs have been associated with chronic kidney disease and infection in some observational studies. Now, recent results published in The BMJ show that an intervention targeting overprescribing of PPIs might lead to quick, lasting reductions in their use.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
This Medical News article discusses the current H5N1 avian influenza outbreak in US dairy cattle and its implications for occupational and public health.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
A 3-year-old had spontaneous gingival hemorrhage and bilateral limb weakness with inability to bear weight. He had no preceding oral trauma or recent infection, took no regular medications, and had no recent use of aspirin or nonsteroidal anti-inflammatory drugs; his diet was limited to primarily chicken nuggets and milk. What is the diagnosis and what would you do next?
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
In Reply We appreciate letters about our Review on thyroid cancer. In response to the comments by Drs Beheshtirouy and Shayanfar, the causal association between GLP-1 RA use and thyroid cancer is complex and requires careful consideration of factors that directly or indirectly influence carcinogenesis pathways such as the direct biological effects of the drug, host susceptibility factors (eg, obesity or proinflammatory states), biases embedded in clinical trials, and length of follow-up. To date, evidence investigating causality of this association is inconclusive, so it is premature and inappropriate to include GLP-1 RA use as a risk factor for thyroid cancer. Increased expression of the GLP-1 receptor has been found in medullary thyroid cancer and in nonmedullary thyroid cancer human cell lines, but GLP-1 RAs did not significantly affect proliferation of these cell lines, signaling pathways, mitochondrial respiration, or glycolysis, suggesting that there is limited carcinogenic evidence of GLP-1 RA in human tissues, particularly in nonmedullary thyroid cancer. In a systematic review and meta-analysis of 64 randomized trials, there were only 26 reporting cases of thyroid cancer associated with use of GLP-1 RAs. Although there was an increased relative risk for thyroid cancer on the fixed-effect meta-analysis (odds ratio, 1.52 [95% CI, 1.01-2.29]), statistical significance was lost in the random-effect analysis (odds ratio, 1.41 [95% CI, 0.91-2.17]), and in the leave-one-out sensitivity analysis of 5 studies. In that systematic review, an analysis that focused on the specific diagnoses of papillary thyroid cancer and medullary thyroid cancer also did not reach statistical significance.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.06.2024
Tilføjet 10.06.2024
This Viewpoint discusses recommendations from the US Centers for Disease Control and Prevention for newly licensed immunizations for respiratory syncytial virus in infants, children with high-risk conditions, and older adults.
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