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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Cancer is associated with excess morbidity and mortality from coronavirus disease 2019 (COVID-19) following infection by the novel pandemic coronavirus SARS-CoV-2. Vaccinations against SARS-CoV-2 have been rapidly developed and proved highly effective in reducing the incidence of severe COVID-19 in clinical trials of healthy populations. However, patients with cancer were excluded from pivotal clinical trials. Early data suggest that vaccine response is less robust in patients with immunosuppressive conditions or treatments, while toxicity and acceptability of COVID-19 vaccines in the cancer population is unknown. Unanswered questions remain about the impact of various cancer characteristics (such as treatment modality and degree of immunosuppression) on serological response to and safety of COVID-19 vaccinations. Furthermore, as the virus and disease manifestations evolve, ongoing data is required to address the impact of new variants.
Methods
SerOzNET is a prospective observational study of adults and children with cancer undergoing routine SARS-CoV-2 vaccination in Australia. Peripheral blood will be collected and processed at five timepoints (one pre-vaccination and four post-vaccination) for analysis of serologic responses to vaccine and exploration of T-cell immune correlates. Cohorts include: solid organ cancer (SOC) or haematological malignancy (HM) patients currently receiving (1) chemotherapy, (2) immune checkpoint inhibitors (3) hormonal or targeted therapy; (4) patients who completed chemotherapy within 6–12 months of vaccination; (5) HM patients with conditions associated with hypogammaglobulinaemia or immunocompromise; (6) SOC or HM patients with allergy to PEG or polysorbate 80. Data from healthy controls already enrolled on several parallel studies with comparable time points will be used for comparison. For children, patients with current or prior cancer who have not received recent systemic therapy will act as controls. Standardised scales for quality-of-life assessment, patient-reported toxicity and vaccine hesitancy will be obtained.
Discussion
The SerOzNET study was commenced in June 2021 to prospectively study immune correlates of vaccination in specific cancer cohorts. The high proportion of the Australian population naïve to COVID-19 infection and vaccination at study commencement has allowed a unique window of opportunity to study vaccine-related immunity. Quality of life and patient-reported adverse events have not yet been reported in detail post-vaccination for cancer patients.
Trial registration This trial is registered on the Australia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001004853. Submitted for registration 25 June 2021. Registered 30 July 2021 (Retrospectively registered). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382281&isReview=true
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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Improving treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) is a leading priority for global TB control. This retrospective cohort study evaluated the factors associated with treatment success among patients treated for MDR-TB in two provinces in Vietnam.
Methods
Treatment outcomes were evaluated for adult patients treated in Hanoi and Thanh Hoa provinces between 2014 and 2016. The primary outcome was the proportion of patients with treatment success, defined as cure or treatment completion. Logistic regression analysis was used to evaluate the relationship between patient clinical and microbiological characteristics and treatment success.
Results
Treatment outcomes were reported in 612 of 662 patients; of these, 401 (65.5)% were successfully treated. The odds of treatment success were lower for male patients (aOR 0.56, 95% CI 0.34–0.90), for people living with HIV (aOR 0.44, 95% CI 0.20–1.00), and for patients treated for extensive antibiotic resistance (pre-XDR-/XDT-TB) (aOR 0.53, 95% CI 0.29–0.97), compared with others. Patients who achieved culture conversion in the first 4 months of treatment had increased odds (aOR 2.93, 95% CI 1.33–6.45) of treatment success. In addition, loss to follow-up was less common among patients covered by social health insurance compared to those who paid for treatment out-of-pocket (aOR 0.55, 95% CI 0.32–0.95).
Conclusions
Among patients with MDR-TB, males, people living with HIV, and those with more extensive antibiotic resistance at diagnosis are at greatest risk of an unsuccessful treatment outcome. Efforts to optimise the management of co-morbidities (such as HIV), ensure rapid bacteriological conversion, and provide financial support for patients promise to improve treatment outcomes.
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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Empiric antimalarial treatment is a component of protocol-based management of Ebola virus disease (EVD), yet this approach has limited clinical evidence for patient-centered benefits.
Methods
This retrospective cohort study evaluated the association between antimalarial treatment and mortality among patients with confirmed EVD. The data was collected from five International Medical Corps operated Ebola Treatment Units (ETUs) in Sierra Leone and Liberia from 2014 through 2015. The standardized protocol used for patient care included empiric oral treatment with combination artemether and lumefantrine, twice daily for three days; however, only a subset of patients received treatment due to resource variability. The outcome of interest was mortality, comparing patients treated with oral antimalarials within 48-h of admission to those not treated. Analysis was conducted with logistic regression to generate adjusted odds ratios (aORs). Multivariable analyses controlled for ETU country, malaria rapid diagnostic test result, age, EVD cycle threshold value, symptoms of bleeding, diarrhea, dysphagia and dyspnea, and additional standard clinical treatments.
Results
Among the 424 cases analyzed, 376 (88.7%) received early oral antimalarials. Across all cases, mortality occurred in 57.5% (244). In comparing unadjusted mortality prevalence, early antimalarial treated cases yielded 55.1% mortality versus 77.1% mortality for those untreated (p = 0.005). Multivariable analysis demonstrated evidence of reduced aOR for mortality with early oral antimalarial treatment versus non-treatment (aOR = 0.34, 95% Confidence Interval: 0.12, 0.92, p = 0.039).
Conclusion
Early oral antimalarial treatment in an EVD outbreak was associated with reduced mortality. Further study is warranted to investigate this association between early oral antimalarial treatment and mortality in EVD patients.
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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Vancomycin-resistant enterococci (VRE) is the cause of severe patient health and monetary burdens. Antibiotic use is a confounding effect to predict VRE in patients, but the antibiotic use of patients who may have frequented the same ward as the patient in question is often neglected. This study investigates how patient movements between hospital wards and their antibiotic use can explain the colonisation of patients with VRE.
Methods
Intrahospital patient movements, antibiotic use and PCR screening data were used from a hospital in the Netherlands. The PageRank algorithm was used to calculate two daily centrality measures based on the spatiotemporal graph to summarise the flow of patients and antibiotics at the ward level. A decision tree model was used to determine a simple set of rules to estimate the daily probability of patient VRE colonisation for each hospital ward. The model performance was improved using a random forest model and compared using 30% test sample.
Results
Centrality covariates summarising the flow of patients and their antibiotic use between hospital wards can be used to predict the daily colonisation of VRE at the hospital ward level. The decision tree model produced a simple set of rules that can be used to determine the daily probability of patient VRE colonisation for each hospital ward. An acceptable area under the ROC curve (AUC) of 0.755 was achieved using the decision tree model and an excellent AUC of 0.883 by the random forest model on the test set. These results confirms that the random forest model performs better than a single decision tree for all levels of model sensitivity and specificity on data not used to estimate the models.
Conclusion
This study showed how the movements of patients inside hospitals and their use of antibiotics could predict the colonisation of patients with VRE at the ward level. Two daily centrality measures were proposed to summarise the flow of patients and antibiotics at the ward level. An early warning system for VRE can be developed to test and further develop infection prevention plans and outbreak strategies using these results.
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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Ventilator-associated pneumonia (VAP) is a severe infection among patients in the neurosurgery intensive care unit (NICU).
Methods
We retrospectively evaluated risk factors for early-onset ventilator-associated pneumonia (EOVAP) from January 2019 to December 2019 at a NICU. A total of 89 NICU patients who were intubated within 48 h of onset and whose mechanical ventilation time was at least 7 days were enrolled. We evaluated EOVAP that occurred within the first 7 days after the onset of mechanical ventilation. The enrolled patients had no history of chronic lung disease and no clinical manifestations of infection before intubation. Clinical data of patients were recorded, and the incidence of and risk factors for EOVAP were analyzed. Patients were also grouped by age (≥ 65 vs. < 65 years) and whether they had received hypothermia treatment or not.
Results
Among 89 mechanically ventilated patients (49 men and 40 women; the mean age ± SD was 60.1 ± 14.3 years), 40 patients (44.9%) developed EOVAP within 7 days and 14 patients (15.7%) had a multidrug resistant bacterial infection. Binary logistic regression analysis indicated that older age (≥ 65 years) (odds ratio [OR]:3.53, 95% confidence interval [CI]:1.27–9.79, P = 0.015) and therapeutic hypothermia (OR:3.68, CI:1.10–12.31, p = 0.034) were independent predictors of EOVAP. Levels of peripheral blood leukocytes, neutrophils and platelets were lower in the therapeutic hypothermia group than those who did not receive hypothermia treatment.
Conclusions
This study found that older age (≥ 65 years) and therapeutic hypothermia were independently associated with the risk of EOVAP in NICU patients.
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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Guillain–Barre syndrome (GBS) is a rare neurological complication of brucellosis, and neurobrucellosis is the most common, but they have many similarities in clinical manifestations. Many clinicians are accustomed to merely explaining the manifestations of nervous system involvement with neurobrucellosis, but they ignore the possibility of GBS, and this leads to misdiagnosis, untimely treatment, and serious consequences.
Case presentation
A 55-year-old male patient was admitted to The First Affiliated Hospital of Harbin Medical University for intermittent fever, fatigue, and waist pain more than three months. Brucellosis was diagnosed from the blood test. Although anti-brucella treatment was given at the time of diagnosis, the disease continued to progress. At the time of the cerebrospinal fluid systematic physical examination and the neuroelectrophysiological test, acute motor sensory axonal neuropathy was diagnosed. The patient was given immediately administered immunoglobulin therapy. After three months of systemic treatment, the patient's muscle strength of the distal limbs gradually recovered. The numbness of the limbs eased slowly, and urination function and respiratory function returned to normal. He could sit by himself.
Conclusions
The possibility of GBS should be closely monitored for when a brucellosis patient shows typical clinical manifestations of progressive muscle weakness, protein-cell separation of the cerebral spinal fluid, and typical demyelinating sensorimotor polyneuropathy.
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BMC Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
Abstract
Background
Chronic granulomatous disease (CGD) is a rare inherited primary immunodeficiency syndrome, manifested as recurrent infections and inflammatory complications. Although prophylactic treatment with antibiotics and antifungals improved the outcome of CGD patients, infections remain the major cause of mortality.
Case presentation
A boy aged 3 years and 8 months was admitted to hospital complaining of lip swelling with fever for half a month and neck abscess for 11 days. After a thorough examination, severe pneumonia, respiratory failure, oral and maxillofacial space infection, and perianal abscess were confirmed. However, his condition didn’t improve after initial comprehensive therapy. Subsequently, overlapping infections of Nocardia farcinica and Aspergillus fumigatus were identified by metagenomic next-generation sequencing. He was treated with imipenem, linezolid, and voriconazole intravenously, plus taking oral compound sulfamethoxazole. Later, his condition improved. Through whole-exome sequencing, the child was ultimately diagnosed as X-linked chronic granulomatous disease (X-CGD) caused by CYBB gene mutation. Allogeneic hematopoietic stem cell transplantation was the potential sanative approach but there were no available human leukocyte antigen compatible donors for the child. The family requested to transfer to a superior hospital for further treatment. Two months later, we followed up the child’s family. Unfortunately, the child had expired due to severe infection.
Conclusion
To our knowledge, this is the first case of overlapping infection of Nocardia farcinica and Aspergillus fumigatus identified by metagenomic next-generation sequencing in a child with X-CGD from China. For infectious pathogens that are hard to diagnosis by traditional detection methods, metagenomic next-generation sequencing is recommended as an adminicle or indispensable approach for microbial identification. Patients with X-CGD have poor prognosis, early diagnosis and intervention of X-CGD may reduce the mortality.
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Desiree Witte, Amanda Handley, Khuzwayo C Jere, Nada Bogandovic-Sakran, Ashley Mpakiza, Ann Turner, Daniel Pavlic, Karen Boniface, Jonathan Mandolo, Darren Suryawijaya Ong, Rhian Bonnici, Frances Justice, Naor Bar-Zeev, Miren Iturriza-Gomara, Jim Ackland, Celeste M Donato, Daniel Cowley, Graeme Barnes, Nigel A Cunliffe, Julie E Bines
Lancet Infectious Diseases, 21.01.2022
Tilføjet 21.01.2022
RV3-BB was well tolerated and immunogenic when co-administered with Expanded Programme on Immunisation vaccines in a neonatal or infant schedule. A lower titre (mid-titre) vaccine generated similar IgA seroconversion to the high-titre vaccine presenting an opportunity to enhance manufacturing capacity and reduce costs. Neonatal administration of the RV3-BB vaccine has the potential to improve protection against rotavirus disease in children in a high-child mortality country in Africa.
Læs mere Tjek på PubMedJohn N. Aucott, Ting Yang, Isaac Yoon, Debra Powell, Steven A. Geller, Alison W. Rebman
International Journal of Infectious Diseases, 20.01.2022
Tilføjet 21.01.2022
The Lancet
Lancet, 22.01.2022
Tilføjet 21.01.2022
Antimicrobial resistance (AMR) is a major cause of death globally, with a burden likely to be higher than that of HIV or malaria, according to the most comprehensive assessment of bacterial AMR to date published in The Lancet. The data presented in this analysis are striking: in 2019, the deaths of 4·95 million people were associated with drug-resistant bacterial infections. 1·27 million deaths were directly caused by AMR. For the first time, the study provides estimates for 204 countries and territories, as well as data for the regional impacts of AMR.
Læs mere Tjek på PubMedVikram Patel
Lancet, 18.12.2021
Tilføjet 21.01.2022
The COVID-19 pandemic has fuelled a global crisis of unmet needs for mental health care, particularly for mood and anxiety disorders.1 Recently, the question of what should be the initial treatment choice for these disorders was thoroughly addressed by Furukawa and colleagues in a systematic review.2 Their network meta-analysis of 81 randomised controlled trials, comprising 13 722 adult participants with acute depressive episodes, compared psychotherapy, antidepressant medication, their combination, standard or usual care in primary or secondary settings, or a pill placebo on remission and sustained response and showed combined treatment or psychotherapy alone outperformed all comparators, and was equally effective.
Læs mere Tjek på PubMedRichard Horton
Lancet, 22.01.2022
Tilføjet 21.01.2022
When Dr Anthony Fauci challenged Senator Rand Paul last week during US congressional hearings, he exposed how politicians have exploited the COVID-19 pandemic for their own personal advantage. Fauci showed screenshots of Senator Paul's website, which included the message “Fire Dr Fauci”. He pointed out that Paul was inviting people to send donations to firefauci.org. He explained how Paul's exaggerations were creating the conditions for violent attacks on himself and his family. In December, 2021, a man was arrested on his way to Washington, DC, with an AR-15 semiautomatic rifle in his car.
Læs mere Tjek på PubMedMichael Marmot
Lancet, 22.01.2022
Tilføjet 21.01.2022
On March 9, 2020, neoliberalism hit the buffers. Put simply, the idea that small states and unbridled markets delivered the best societies was tested to destruction, dramatically so. As the COVID-19 pandemic surged, the stock market went into free fall. The bond market followed. The world's financial system was on a rollercoaster: US Treasury bonds were “lurching up and down in stomach-churning chasms”, to quote Adam Tooze. While global attention focused on the numbers of COVID-19 cases and deaths and governments in the UK and the USA dithered over their response to this pandemic, the world's bankers and finance ministers were looking at the financial numbers.
Læs mere Tjek på PubMedRichard Lane
Lancet, 22.01.2022
Tilføjet 21.01.2022
During Australia's COVID-19 lockdown in 2021, family doctor Jamal Rifi came up with an unusual plan to encourage the remainder of his urban community of Sydney, NSW, Australia, to come forward for COVID-19 vaccination. “I realised we needed to build on our community advocacy work by using an inflatable vaccination facility that could be transported easily into the heart of urban communities that had become COVID-19 hotspots, such as my own suburb of Belmore in southwest Sydney”, Rifi explains. More recently, he has used the vaccination facility to help kick-start a COVID-19 booster programme, and from Jan 10, 2022, has also used it at a local bowling club to serve as a vaccination facility for children aged 5–11 years.
Læs mere Tjek på PubMedGeoff Watts
Lancet, 22.01.2022
Tilføjet 21.01.2022
Leading US infectious disease pathologist. He was born in Alexandria, Egypt, on Nov 24, 1955 and died after a fall in Atlanta, GA, USA, on Nov 21, 2021 aged 65 years.
Læs mere Tjek på PubMedKirsty Brown, Asma Yahyouche, Shamil Haroon, Jenny Camaradou, Grace Turner
Lancet, 22.01.2022
Tilføjet 21.01.2022
People with COVID-19 often have symptoms in the long term (ie, long COVID), including fatigue, breathlessness, and neurocognitive difficulties.1 The disease mechanisms causing long COVID are unknown, and there are no evidence-based treatment options. Clinical guidelines focus on symptom management, and various treatment options are being evaluated.1 The scarcity of advice has often left people with long COVID feeling isolated and frustrated in their search for therapies.
Læs mere Tjek på PubMedIrtiza Qureshi, Mayuri Gogoi, Amani Al-Oraibi, Fatimah Wobi, Daniel Pan, Christopher A Martin, Jonathan Chaloner, Katherine Woolf, Manish Pareek, Laura B Nellums
Lancet, 22.01.2022
Tilføjet 21.01.2022
It is reassuring to see that ministers in the UK are formally acknowledging how people from minority ethnic (ie, defined here as all ethnicities other than White British) backgrounds have been disproportionately affected by COVID-19. However, crucial gaps exist in the collection, analysis, and translation of data to assess the effects of multiple intersecting factors on individuals and communities. The Science and Technology Committee and Health and Social Care Committee report, Coronavirus: lessons learned to date,1 dedicates thirteen paragraphs to how ethnicity ties into disparities and makes five recommendations for how the government could avoid these inequities in the future.
Læs mere Tjek på PubMedTong B Tang
Lancet, 22.01.2022
Tilføjet 21.01.2022
Richard Horton1 and the Editors2 have repeatedly called for closer collaborations in global health. China has been taking decisive, albeit difficult, measures to prevent and manage outbreaks in diverse settings, from city epicentres to rural clusters. Although these policies might be draconian, they resulted in community solidarity and success; with one prerequisite to both solidarity and success being transparency embraced by both the government and the health profession.
Læs mere Tjek på PubMedChiara Alfieri, Marc Egrot, Alice Desclaux, Kelley Sams, CoMeSCov
Lancet, 22.01.2022
Tilføjet 21.01.2022
The Day of the Dead in Italy this year was not only a time for remembrance but also for demanding justice for lives lost to COVID-19. On Nov 2, 2021, members of the #Sereni (also known as Serene and Always United) Association demonstrated in Rome against institutional omerta (ie, law of silence) and for the restoration of a parliamentary commission to examine the management of the epidemic. This event followed 520 complaints that were filed by the association 4 months earlier against the national government, the Ministry of Health, and Lombardy region administrators.
Læs mere Tjek på PubMedJ Vigneshwaran, M Senthil Kumar, Vijayashree Raghavan, Sivagama Sundari
Lancet, 22.01.2022
Tilføjet 21.01.2022
A 60-year-old man attended our hospital reporting generalised tiredness which had gradually developed over the past 4 weeks.
Læs mere Tjek på PubMedPeter B McIntyre, Rakesh Aggarwal, Ilesh Jani, Jaleela Jawad, Sonali Kochhar, Noni MacDonald, Shabir A Madhi, Ezzeddine Mohsni, Kim Mulholland, Kathleen M Neuzil, Hanna Nohynek, Folake Olayinka, Punnee Pitisuttithum, Andrew J Pollard, Alejandro Cravioto
Lancet, 17.12.2021
Tilføjet 21.01.2022
In September, 2020, the WHO Prioritisation Roadmap for COVID-19 vaccines gave priority to prevention of severe disease and the highest risk groups. In July, 2021, the revised Roadmap noted that despite the progressive emergence of SARS-CoV-2 variants of concern, defined as mutations conferring increased infectivity, virulence, or relative capacity for immunological escape, vaccine effectiveness against severe disease had been retained.1 At the end of 2021, global differences in the inter-related variables of population seropositivity2 and vaccine coverage3 have widened, and omicron has been declared the fifth variant of concern.
Læs mere Tjek på PubMedZürcher K, Riou J, Morrow C, et al.
Journal of Infectious Diseases, 18.01.2022
Tilføjet 20.01.2022
AbstractBackgroundCongregate settings, such as healthcare clinics, may play an essential role in Mycobacterium tuberculosis (Mtb) transmission. Using patient and environmental data, we studied transmission at a primary care clinic in South Africa.MethodsWe collected patient movements, cough frequency, and clinical data, and measured indoor carbon dioxide (CO2) levels, relative humidity, and Mtb genomes in the air. We used negative binomial regression model to investigate associations.ResultsWe analyzed 978 unique patients who contributed 14 795 data points. The median patient age was 33 (interquartile range [IQR], 26–41) years, and 757 (77.4%) were female. Overall, median CO2 levels were 564 (IQR 495–646) parts per million and were highest in the morning. Median number of coughs per day was 466 (IQR, 368–503), and overall median Mtb DNA copies/μL/day was 4.2 (IQR, 1.2–9.5). We found an increased presence of Mtb DNA in the air of 32% (95% credible interval, 7%–63%) per 100 additional young adults (aged 15–29 years) and 1% (0–2%) more Mtb DNA per 10% increase of relative humidity. Estimated cumulative transmission risks for patients attending the clinic monthly for at least 1 hour range between 9% and 29%.ConclusionsWe identified young adults and relative humidity as potentially important factors for transmission risks in healthcare clinics. Our approach should be used to detect transmission and evaluate infection control interventions.
Læs mere Tjek på PubMedSpradling P, Xing J, Zhong Y, et al.
Journal of Infectious Diseases, 17.01.2022
Tilføjet 20.01.2022
AbstractHepatitis B virus (HBV) infection causes hepatocellular carcinoma but its association with other cancers is not well established. We compared age-adjusted incidence of primary cancers among 5,773 HBV-infected persons with US cancer registries during 2006–2018. Compared with the US population, substantially higher incidence among HBV-infected persons was observed for hepatocellular carcinoma (Standardized rate ratio [SRR] 30.79), gastric (SRR 7.95), neuroendocrine (SRR 5.88), cholangiocarcinoma (SRR 4.62), and ovarian (SRR 3.72) cancers, and non-Hodgkin lymphoma (SRR 2.52). Clinicians should be aware of a heightened potential for certain non-hepatic malignancies among hepatitis B patients, as earlier diagnosis favors improved survival.
Læs mere Tjek på PubMedZhang Y, D’Souza G, Fakhry C, et al.
Journal of Infectious Diseases, 17.01.2022
Tilføjet 20.01.2022
AbstractBackgroundWhile cervicovaginal microbiome has been associated with cervical human papillomavirus (HPV) infection, little is known regarding the association of oral microbiome with oral HPV, a cause of oropharyngeal cancer.MethodsA cross-sectional analysis of 495 participants from the Men and Women Offering Understanding of Throat HPV study was conducted. 16S rRNA gene amplicon sequencing was performed on saliva samples. HPV DNA in oral rinse samples was tested. Associations of oral microbiome diversity, taxon abundance and predicted functional pathways with oral HPV were assessed, adjusting for age, race/ethnicity, education, HIV, current smoking, and sequencing batch.ResultsParticipants with oral HPV (n=68) compared to those without HPV had similar oral microbiome alpha-diversity yet different beta-diversity (Bray-Curtis distance for bacterial taxa: p=0.009; functional pathways: p=0.02). Participants with oral HPV had higher abundance of Actinomycetaceae, Prevotellaceae, Veillonellaceae, Campylobacteraceae, Bacteroidetes, and lower abundance of Gemellaceae (false discovery rate<0.10). We also found differential functional potential of oral microbiome by oral HPV status: xenobiotic biodegradation-related pathways were less abundant among participants with oral HPV, suggesting potential xenobiotic-induced toxic effects with implications for HPV susceptibility.ConclusionsOur findings suggest a shift in oral microbiome community structure, composition and functional potential between individuals with and without oral HPV.
Læs mere Tjek på PubMedHuang Y, Zhu W, Wiener J, et al.
Clinical Infectious Diseases, 18.01.2022
Tilføjet 20.01.2022
AbstractBackgroundUptake of HIV preexposure prophylaxis (PrEP) has been increasing in the United States since its FDA approval in 2012; however, the COVID-19 pandemic may have affected this trend. Our objective was to assess the impact of the COVID-19 pandemic on PrEP prescriptions in the United States.MethodsWe analyzed data from a national pharmacy database from January 2017 through March 2021 to fit an interrupted time-series model that predicted PrEP prescriptions and new PrEP users had the pandemic not occurred. Observed PrEP prescriptions and new users were compared with those predicted by the model. Main outcomes were weekly numbers of PrEP prescriptions and new PrEP users based on a previously developed algorithm. The impact of the COVID-19 pandemic was quantified by computing rate ratios and percent decreases between the observed and predicted counts during 3/15/2020 – 3/31/2021.ResultsIn the absence of the pandemic, our model predicted that there would have been 1,058,162 PrEP prescriptions during 3/15/2020 – 3/31/2021. We observed 825,239 PrEP prescriptions, a 22.0% reduction (95% CI: 19.1%-24.8%) after the emergency declaration. The model predicted 167,720 new PrEP users during the same period; we observed 125,793 new PrEP users, a 25.0% reduction (95% CI: 20.9%-28.9%). The COVID-19 impact was greater among younger persons and those with commercial insurance. The impact of the pandemic varied markedly across states.ConclusionThe COVID-19 pandemic disrupted an increasing trend in PrEP prescriptions in the United States, highlighting the need for innovative interventions to maintain access to HIV prevention services during similar emergencies.
Læs mere Tjek på PubMedPilz S.
Clinical Infectious Diseases, 17.01.2022
Tilføjet 20.01.2022
Samuel M. S. Cheng, Chris Ka Pun Mok, Yonna W. Y. Leung, Susanna S. Ng, Karl C. K. Chan, Fanny W. Ko, Chunke Chen, Karen Yiu, Bosco H. S. Lam, Eric H. Y. Lau, Ken K. P. Chan, Leo L. H. Luk, John K. C. Li, Leo C. H. Tsang, Leo L. M. Poon, David S. C. Hui, Malik Peiris
Nature, 20.01.2022
Tilføjet 20.01.2022
Nature Medicine, Published online: 20 January 2022; doi:10.1038/s41591-022-01704-7Serum neutralizing antibody titers against the SARS-CoV-2 Omicron variant markedly increase following a third dose of BNT162b2 in individuals who had previously received either two doses of the BNT162b2 vaccine or two doses of the CoronaVac vaccine.
Læs mere Tjek på PubMedEddy Pérez-Then, Carolina Lucas, Valter Silva Monteiro, Marija Miric, Vivian Brache, Leila Cochon, Chantal B. F. Vogels, Amyn A. Malik, Elena De la Cruz, Aidelis Jorge, Margarita De los Santos, Patricia Leon, Mallery I. Breban, Kendall Billig, Inci Yildirim, Claire Pearson, Randy Downing, Emily Gagnon, Anthony Muyombwe, Jafar Razeq, Melissa Campbell, Albert I. Ko, Saad B. Omer, Nathan D. Grubaugh, Sten H. Vermund, Akiko Iwasaki
Nature, 20.01.2022
Tilføjet 20.01.2022
Nature Medicine, Published online: 20 January 2022; doi:10.1038/s41591-022-01705-6BNT162b2 booster vaccination in individuals who had previously received two doses of the CoronaVac vaccine elevates neutralizing antibodies against the Omicron variant, but titers remain reduced as compared to those against the ancestral SARS-CoV-2 virus and the Delta variant.
Læs mere Tjek på PubMedLong Chi Nguyen, Dongbo Yang, Vlad Nicolaescu, Thomas J. Best, Haley Gula, Divyasha Saxena, Jon D. Gabbard, Shao-Nong Chen, Takashi Ohtsuki, John Brent Friesen, Nir Drayman, Adil Mohamed, Christopher Dann, Diane Silva, Lydia Robinson-Mailman, Andrea Valdespino, Letícia Stock, Eva Suárez, Krysten A. Jones, Saara-Anne Azizi, Jennifer K. Demarco, William E. Severson, Charles D. Anderson, James Michael Millis, Bryan C. Dickinson, Savaş Tay, Scott A. Oakes, Guido F. Pauli, Kenneth E. Palmer, The National COVID Cohort Collaborative Consortium, David O. Meltzer, Glenn Randall, Marsha Rich Rosner
Science, 20.01.2022
Tilføjet 20.01.2022
Dhiraj Mannar, James W. Saville, Xing Zhu, Shanti S. Srivastava, Alison M. Berezuk, Katharine S. Tuttle, Ana Citlali Marquez, Inna Sekirov,, Sriram Subramaniam,
Science, 20.01.2022
Tilføjet 20.01.2022
Sunggyun Park, Soon Hee Chang, Jae Hee Lee, Jong Ho Lee, Ji Yeon Ham, Yu Kyung Kim, Sang-Gyung Kim, Nam Hee Ryoo
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Sunggyun Park, Soon Hee Chang, Jae Hee Lee, Jong Ho Lee, Ji Yeon Ham, Yu Kyung Kim, Sang-Gyung Kim, Nam Hee Ryoo
Background Early and accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to prevent spread of the infection. Understanding of the antibody response to SARS-CoV-2 in patients with coronavirus disease 2019 (COVID-19) is insufficient, particularly in relation to those whose responses persist for more than 1 month after the onset of symptoms. We conducted a SARS-CoV-2 antibody test to identify factors affecting the serological response and to evaluate its diagnostic utility in patients with COVID-19. Methods and finding We collected 1,048 residual serum samples from 396 patients with COVID-19 confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. The samples had been used for routine admission tests in six healthcare institutions in Daegu. Antibody to SARS-CoV-2 was analyzed and the cutoff index (COI) was calculated for quantitative analysis. The patients’ information was reviewed to evaluate the relationship between antibody positivity and clinical characteristics. The anti-SARS-CoV-2 antibody positivity rate was 85% and the average COI was 24·3. The positivity rate and COI increased with time elapsed since symptom onset. Anti-SARS-CoV-2 antibody persisted for at least 13 weeks after symptom onset at a high COI. There was a significant difference in anti-SARS-CoV-2 antibody positivity rate between patients with and without symptoms, but not according to sex or disease course. The descending COI pattern at weeks 1 to 5 after symptom onset was significantly more frequent in patients who died than in those who recovered. Conclusions Anti-SARS-CoV-2 antibody persisted for at least 13 weeks at a high COI in patients with COVID-19. A decreasing COI pattern up to fifth week may be associated with a poor prognosis of COVID-19. As new treatments and vaccines are introduced, it is important to monitor continuously the usefulness of anti-SARS-CoV-2 antibody assays.
Læs mere Tjek på PubMedNoori Akhtar-Danesh, Andrea Baumann, Mary Crea-Arsenio, Valentina Antonipillai
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Noori Akhtar-Danesh, Andrea Baumann, Mary Crea-Arsenio, Valentina Antonipillai
The coronavirus disease 2019 (COVID-19) has had devastating consequences worldwide, including a spike in global mortality. Residents of long-term care homes have been disproportionately affected. We conducted a retrospective cohort study to determine the scale of pandemic-related deaths of long-term care residents in the province of Ontario, Canada, and to estimate excess mortality due to a positive COVID-19 test adjusted for demographics and regional variations. Crude mortality rates for 2019 and 2020 were compared, as were predictors of mortality among residents with positive and negative tests from March 2020 to December 2020. We found the crude mortality rates were higher from April 2020 to June 2020 and from November 2020 to December 2020, corresponding to Wave 1 and Wave 2 of the pandemic in Ontario. There were also substantial increases in mortality among residents with a positive COVID-19 test. The significant differences in excess mortality observed in relation to long-term care home ownership category and geographic region may indicate gaps in the healthcare system that warrant attention from policymakers. Further investigation is needed to identify the most relevant factors in explaining these differences.
Læs mere Tjek på PubMedPaulraj Kanmani, Hojun Kim
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Paulraj Kanmani, Hojun Kim
Hepatic fibrosis is caused by the increased accumulation and improper degradation of extracellular matrix (ECM) proteins in the liver. Hepatic stellate cells (HSCs) activation is a key process in initiating hepatic fibrosis and can be ameliorated by the administration of probiotic strains. This study hypothesized that LAB strains (Lactiplantibacillus plantarum, Lactobacillus brevis, and Weissella cibaria) might attenuate pro-fibrogenic cytokine TGF-β mediated HSCs activation and induce collagen deposition, expression of other fibrogenic/inflammatory markers, autophagy, and apoptotic processes in vitro. Few studies have evaluated the probiotic effects against fibrogenesis in vitro. In this study, TGF-β exposure increased collagen deposition in LX-2 cells, but this increase was diminished when the cells were pretreated with LAB strains before TGF-β stimulation. TGF-β not only increased collagen deposition, but it also significantly upregulated the mRNA levels of Col1A1, alpha-smooth muscle actin (α-SMA), matrix metalloproteinases-2 (MMP-2), IL-6, CXCL-8, CCL2, and IL-1β in LX-2 cells. Pretreatment of the cells with LAB strains counteracted the TGF-β-induced pro-fibrogenic and inflammatory markers by modulating SMAD-dependent and SMAD-independent TGF-β signaling. In addition, LX-2 cells exposed to TGF-β induced the autophagic and apoptotic associated proteins that were also positively regulated by the LAB strains. These findings suggest that LAB can attenuate TGF-β signaling that is associated with liver fibrogenesis.
Læs mere Tjek på PubMedDilaram Acharya, Antoine Lewin, Amaury Gaussen, Gilles Lambert, Christian Renaud, Karlitaj Nawej, Thomas G. Poder
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Dilaram Acharya, Antoine Lewin, Amaury Gaussen, Gilles Lambert, Christian Renaud, Karlitaj Nawej, Thomas G. Poder
Background and objective Assessment criteria for septic transfusion reactions (STRs) are variable around the world. A scoping review will be carried out to find out, explore and map existing literature on STRs associated criteria. Methods This scoping review will include indexed and grey literatures available in English or French language from January 1, 2000, to December 31, 2021. Literature search will be conducted using four electronic databases (i.e., MEDLINE via PubMed, Web of Science, Science Direct, and Embase via Ovid), and grey literatures accompanying the research questions and objectives. Based on the inclusion criteria, studies will be independently screened by two reviewers for title, abstract, and full text. Extracted data will be presented in tabular form followed by a narrative description of inputs corresponding to research objectives and questions.
Læs mere Tjek på PubMedKarina Takesaki Miyaji, Vanessa Infante, Camila de Melo Picone, José Eduardo Levi, Ana Carolina Soares de Oliveira, Amanda Nazareth Lara, Maricy Tacla, Joakim Dillner, Hanna Kann, Carina Eklund, Cristina Paula Castanheira, Philippe Mayaud, Ana Marli Christovam Sartori, the Study group on HPV vaccine in immunosuppressed persons
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Karina Takesaki Miyaji, Vanessa Infante, Camila de Melo Picone, José Eduardo Levi, Ana Carolina Soares de Oliveira, Amanda Nazareth Lara, Maricy Tacla, Joakim Dillner, Hanna Kann, Carina Eklund, Cristina Paula Castanheira, Philippe Mayaud, Ana Marli Christovam Sartori, the Study group on HPV vaccine in immunosuppressed persons
Introduction Solid organ transplant (SOT) recipients are at increased risk of Human Papillomavirus (HPV) persistent infection and disease. This study aimed to evaluate HPV seroprevalence, cervical HPV prevalence, genotype distribution, and frequency of HPV-related cervical lesions in SOT recipients in comparison to immunocompetent women. Methods Cross-sectional study including SOT and immunocompetent women aged 18 to 45 years who denied previous HPV-related lesions. Cervical samples were screened for HPV-DNA by a polymerase chain reaction (PCR)-based DNA microarray system (PapilloCheck®) and squamous intraepithelial lesions (SIL) by liquid-based cytology. A multiplexed pseudovirion-based serology assay (PsV-Luminex) was used to measure HPV serum antibodies. Results 125 SOT and 132 immunocompetent women were enrolled. Cervical samples were collected from 113 SOT and 127 immunocompetent women who had initiated sexual activity. HPV-DNA prevalence was higher in SOT than in immunocompetent women (29.6% vs. 20.2%, p = 0.112), but this difference was not statistically significant. High-risk (HR)-HPV was significantly more frequent in SOT than in immunocompetent women (19.4% vs. 7.9%, p = 0.014). Simultaneous infection with ≥2 HR-HPV types was found in 3.1% of SOT and 0.9% of immunocompetent women. HPV seropositivity for at least one HPV type was high in both groups: 63.8% of 105 SOT and 69.7% of 119 immunocompetent women (p = 0.524). Low-grade (LSIL) and high-grade SIL (HSIL) were significantly more frequent in SOT (9.7% and 5.3%, respectively) than in immunocompetent women (1.6% and 0.8%, respectively) (p = 0.001). Conclusions These results may reflect the increased risk of HPV persistent infection and disease progression in SOT women due to chronic immunosuppression.
Læs mere Tjek på PubMedTania Regina Tozetto-Mendoza, Maria C. Mendes-Correa, Antonio F. Moron, Larry J. Forney, Iara M. Linhares, Almir Ribeiro da Silva Jr., Layla Honorato, Steven S. Witkin
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Tania Regina Tozetto-Mendoza, Maria C. Mendes-Correa, Antonio F. Moron, Larry J. Forney, Iara M. Linhares, Almir Ribeiro da Silva Jr., Layla Honorato, Steven S. Witkin
Torquetenovirus (TTV) is a nonpathogenic endogenous virus whose abundance varies with the extent of immune system activation. We determined if the TTV titer in the vagina of pregnant women was associated with vaginal microbiota composition and levels of compounds in vaginal secretions. Vaginal TTV and microbiota composition in 494 second trimester pregnant women were identified by gene amplification and analysis. Vaginal matrix metalloproteinases (MMPs), tissue inhibitors of MMP (TIMP) and lactic acid isomers were measured by ELISA. Dominance was defined as the relative abundance of a specific bacterium or species at >50% of the total number of bacteria identified. Clinical data were obtained by chart review. The median log10 TTV titer was lowest when Lactobacillus species other than L. iners were dominant (
Læs mere Tjek på PubMedLaura Vierbaum, Nathalie Wojtalewicz, Hans-Peter Grunert, Vanessa Lindig, Ulf Duehring, Christian Drosten, Victor Corman, Daniela Niemeyer, Sandra Ciesek, Holger F. Rabenau, Annemarie Berger, Martin Obermeier, Andreas Nitsche, Janine Michel, Martin Mielke, Jim Huggett, Denise O’Sullivan, Eloise Busby, Simon Cowen, Peter M. Vallone, Megan H. Cleveland, Samreen Falak, Andreas Kummrow, Thomas Keller, Ingo Schellenberg, Heinz Zeichhardt, Martin Kammel
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Laura Vierbaum, Nathalie Wojtalewicz, Hans-Peter Grunert, Vanessa Lindig, Ulf Duehring, Christian Drosten, Victor Corman, Daniela Niemeyer, Sandra Ciesek, Holger F. Rabenau, Annemarie Berger, Martin Obermeier, Andreas Nitsche, Janine Michel, Martin Mielke, Jim Huggett, Denise O’Sullivan, Eloise Busby, Simon Cowen, Peter M. Vallone, Megan H. Cleveland, Samreen Falak, Andreas Kummrow, Thomas Keller, Ingo Schellenberg, Heinz Zeichhardt, Martin Kammel
SARS-CoV-2, the cause of COVID-19, requires reliable diagnostic methods to track the circulation of this virus. Following the development of RT-qPCR methods to meet this diagnostic need in January 2020, it became clear from interlaboratory studies that the reported Ct values obtained for the different laboratories showed high variability. Despite this the Ct values were explored as a quantitative cut off to aid clinical decisions based on viral load. Consequently, there was a need to introduce standards to support estimation of SARS-CoV-2 viral load in diagnostic specimens. In a collaborative study, INSTAND established two reference materials (RMs) containing heat-inactivated SARS-CoV-2 with SARS-CoV-2 RNA loads of ~107 copies/mL (RM 1) and ~106 copies/mL (RM 2), respectively. Quantification was performed by RT-qPCR using synthetic SARS-CoV-2 RNA standards and digital PCR. Between November 2020 and February 2021, German laboratories were invited to use the two RMs to anchor their Ct values measured in routine diagnostic specimens, with the Ct values of the two RMs. A total of 305 laboratories in Germany were supplied with RM 1 and RM 2. The laboratories were requested to report their measured Ct values together with details on the PCR method they used to INSTAND. This resultant 1,109 data sets were differentiated by test system and targeted gene region. Our findings demonstrate that an indispensable prerequisite for linking Ct values to SARS-CoV-2 viral loads is that they are treated as being unique to an individual laboratory. For this reason, clinical guidance based on viral loads should not cite Ct values. The RMs described were a suitable tool to determine the specific laboratory Ct for a given viral load. Furthermore, as Ct values can also vary between runs when using the same instrument, such RMs could be used as run controls to ensure reproducibility of the quantitative measurements.
Læs mere Tjek på PubMedAsmaa M. Zahran, Amal Rayan, Zeinab Albadry M. Zahran, Wael M. Y. Mohamed, Dalia O. Mohamed, Mona H. Abdel-Rahim, Omnia El-Badawy
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Asmaa M. Zahran, Amal Rayan, Zeinab Albadry M. Zahran, Wael M. Y. Mohamed, Dalia O. Mohamed, Mona H. Abdel-Rahim, Omnia El-Badawy
Background and aim Growing evidence highlighted the primary role of the immune system in the disease course of triple-negative breast cancer (TNBC). The study aim was to investigate the expression of PD-1 and CD39 on CD4+ and CD8+ cells infiltrating tumor tissue compared to their counterparts in peripheral blood and explore its association with tumor characteristics, disease progression, and prognosis in females with TNBC. Patients and methods The study included 30 TNBC patients and 20 healthy controls. Cancer and normal breast tissue and peripheral blood samples were collected for evaluation of the expression of PD-1 and CD39 on CD4+ and CD8+T cells by flow cytometry. Results A marked reduction in the percentage of CD8+ T lymphocytes and a significant increase in the frequencies of CD4+ T lymphocytes and CD4+ and CD8+ T lymphocytes expressing PD1 and CD39 were evident in tumor tissue in comparison with the normal breast tissue. The DFS was inversely related to the cancer tissue PD1+CD8+ and CD39+CD8+ T lymphocytes. Almost all studied cells were significantly increased in the tumor tissue than in peripheral blood. Positive correlations were detected among peripheral PD1+CD4+T lymphocytes and each of cancer tissue PD1+CD4+, PD1+CD8+and CD39+CD8+T cells, and among peripheral and cancer tissue CD39+CD4+and CD39+CD8+ T cells. Conclusions The CD39 and PD1 inhibitory pathways are synergistically utilized by TNBC cells to evade host immune response causing poor survival. Hence, combinational immunotherapy blocking these pathways might be a promising treatment strategy in this type of cancer.
Læs mere Tjek på PubMedWorkeabeba Abebe, Mahlet Gebremariam, Mitike Molla, Solomon Teferra, Larry Wissow, Andrea Ruff
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Workeabeba Abebe, Mahlet Gebremariam, Mitike Molla, Solomon Teferra, Larry Wissow, Andrea Ruff
Background Vertical transmission of HIV remains one of the most common transmission modes. Antiretroviral therapy (ART) decreases the risk of transmission to less than 2%, but maintaining adherence to treatment remains a challenge. Some of the commonly reported barriers to adherence to ART include stress (physical and emotional), depression, and alcohol and drug abuse. Integrating screening and treatment for psychological problem such as depression was reported to improve adherence. In this study, we sought to determine the prevalence of depression and its association with adherence to ART among HIV-positive pregnant women attending antenatal care (ANC) clinics in Addis Ababa, Ethiopia. Methods We conducted a cross-sectional survey from March through November 2018. Participants were conveniently sampled from 12 health institutions offering ANC services. We used the Patient Health Questionnaire-9 (PHQ-9) to screen for depression and the Center for Adherence Support Evaluation (CASE) Adherence index to evaluate adherence to ART. Descriptive statistics was used to estimate the prevalence of depression during third-trimester pregnancy and nonadherence to ART. A bivariate logistic regression analysis was used to get significant predictors for each of the two outcome measures. The final multivariable logistic regression analysis included variables with a P
Læs mere Tjek på PubMedJeongmin Seo, Juwon Lim
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Jeongmin Seo, Juwon Lim
Background Annual vaccination for influenza is recommended for high-risk populations for its high morbidity and mortality. South Korea provides free influenza vaccination to some target groups under the National Immunization Program (NIP), and discrepantly high vaccination rates are observed in such populations. In this study, we analyzed the trends in influenza vaccination rates and evaluated the impact of the recent expansion of financial coverage to children ≤12 years and pregnant women. Methods We conducted a cross-sectional study with nationwide survey data from Korea National Health and Nutrition Examination Survey (KNHANES). From 2010 to 2019, we evaluated the trends in influenza vaccination rates of the following four target groups: children ≤12 years, adults ≥65 years, pregnant women, and people with chronic diseases. Results In total, 80,861 individuals were analyzed. From 2017 to 2019, the vaccination coverage of children ≤12 years increased from 66.2% to 83.1%; pregnant women from 44.1% to 68.5% (comparing the mean of 2010–2017 and 2018–2019, P
Læs mere Tjek på PubMedMabel Duarte Alves Gomides, Astrídia Marília de Souza Fontes, Amanda Oliveira Soares Monteiro Silveira, Daniel Chadud Matoso, Anderson Luiz Ferreira, Geraldo Sadoyama
PLoS One Infectious Diseases, 20.01.2022
Tilføjet 20.01.2022
by Mabel Duarte Alves Gomides, Astrídia Marília de Souza Fontes, Amanda Oliveira Soares Monteiro Silveira, Daniel Chadud Matoso, Anderson Luiz Ferreira, Geraldo Sadoyama
Objective This study aimed to demonstrate the importance of active carbapenem-resistant Enterobacterales (CRE) surveillance and evaluate the prevalence of invasive infections, risk factors, and mortality risk in CRE-colonized patients. Methods Retrospective cohort study analyzing 1,920 patients identified using an active CRE surveillance protocol, admitted to an adult intensive care unit in southeastern Brazil from January 2014 to December 2018. Results There were 297 (15.47%) CRE colonized patients, with one colonized for every six control patients. CRE-colonized patients demonstrated an increased chance of infection (odds ratio [OR] 7.967, p < 0.001). Overall, 20.54% of the colonized patients presented invasive infection (81.96% due to Klebsiella pneumoniae). The colonization and infection ratio demonstrated the important role of the active CRE surveillance protocol. There were identified multiple risk factors for CRE colonization, including long-term mechanical ventilation (OR 1.624, p = 0.019) and previous exposure to aminopenicillins (OR 5.204, p < 0.001), carbapenems (OR 3.703, p = 0.017), cephalosporins (OR 12.036, p < 0.001), and fluoroquinolones (OR 5.238, p = 0.012). The mortality risk was significantly higher among colonized (OR 2.356, p < 0.001) and colonized-infected (OR 2.000, p = 0.009) patients and in those with Enterobacter cloacae colonization (OR 5.173, p < 0,001) and previous aminopenicillins exposure (OR 3.452, p = 0.007). Conclusions Early detection of CRE colonization through screening testing proved to be an important tool to control CRE spread. However, observation over the years has shown no effective control of colonization and infection. The prevalence rates of CRE colonization and colonization-infection were high, as were the mortality rates. In conclusion, an active CRE surveillance protocol is essential, but its impact depends on the effective implementation of preventive measures and feedback between team members.
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