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Malaria Journal, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Malaria affects millions of Cameroonian children under 5 years of age living in the North and Far North regions. These regions bear the greatest burden, particularly for children under 5 years of age. To reduce the burden of disease in these regions, Cameroon adopted the Seasonal Malaria Chemoprevention (SMC) in 2016 and has implemented it each year since its adoption. However, no previous studies have systematically assessed the effects of this intervention in Cameroon. It is important to understand its effect and whether its implementation could be improved. This study aimed to assess the effect of SMC in Cameroon during the period 2016–2021 on malaria morbidity in children under 5 years of age using routine data. Methods Data on malaria cases were extracted from the Cameroon Health Monitoring Information System (HMIS) from January 1, 2011, to December 31, 2021. Health facilities report these data monthly on a single platform, the District Health Information System version 2 (DHIS2). Thus, a controlled interrupted time-series model in a Bayesian framework was used to evaluate the effects of the SMC on malaria morbidity. Results SMC implementation was associated with a reduction in the incidence of uncomplicated malaria cases during the high-transmission periods from 2016 to 2021. Regarding the incidence of severe malaria during the high-transmission period, a reduction was found over the period 2016–2019. The highest reduction was registered during the second year of implementation in 2017:15% (95% Credible Interval, 10–19) of uncomplicated malaria cases and 51% (47–54) of confirmed severe malaria cases. Conclusion The addition of SMC to the malaria intervention package in Cameroon decreased the incidence of uncomplicated and severe malaria among children under 5 years of age. Based on these findings, this study supports the wide implementation of SMC to reduce the malaria burden in Cameroon as well as the use of routine malaria data to monitor the efficiency of the strategy in a timely manner.
Læs mere Tjek på PubMedAsra Fazlollahi; Mahdi Zahmatyar; Ali Shamekh; Alireza Motamedi; Fatemeh Seyedi; Homa Seyedmirzaei; Seyed Ehsan Mousavi; Seyed Aria Nejadghaderi; Mark J. M. Sullman; Ali‐Asghar Kolahi; Shahnam Arshi; Saeid Safiri;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
A number of different neurological complications have been reported following vaccination against the coronavirus disease 2019 (COVID‐19). Electroencephalogram (EEG) is one of the modalities used to evaluate the neurological complications of diseases. The aim of the present study was to identify the EEG changes in participants vaccinated against COVID‐19. PubMed, Scopus, Web of Science, medRxiv, and Google Scholar were searched up to 1 September 2022, with terms related to COVID‐19 vaccines, EEG, neurological signs/symptoms, or neurological disorders. All case reports and case series were included if the participants had received at least one dose of a COVID‐19 vaccine and a post vaccination EEG report was also reported. We used the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for case reports and case series to appraise the methodological quality of the included studies. Thirty‐one studies were included, which were comprised of 24 case reports and seven case series and a total of 36 participants. Generalised slowing and non‐convulsive focal status epilepticus were the most common EEG findings post‐COVID‐19 vaccination. The most frequent symptoms were headache, fatigue, generalised weakness, and vomiting. In addition, the most common signs were encephalopathy, post‐ictal phases, and confusion. Encephalitis, acute disseminated encephalomyelitis, and post‐vaccinal encephalopathy were the most commonly diagnosed adverse events. Furthermore, most of the imaging studies appeared normal. The EEG reports mainly showed background slowing and epileptiform discharges, encephalitis, encephalopathies, and demyelinating disorders. Future studies with larger samples and more vaccine types may help to further unravel the potential neurological effects of COVID‐19 vaccinations on recipients.
Læs mere Tjek på PubMedAdane Adugna;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Hepatitis B virus (HBV)‐associated liver cancer is the third most prevalent cancer‐related cause of death worldwide. Different studies have been done on the histomolecular analysis of HBV induced‐liver cancer including epigenetics which are dynamic molecular mechanisms to control gene expression without altering the host deoxyribonucleic acid, genomics characterise the integration of the viral genome with host genome, proteomics characterise how gene modifies and results overexpression of proteins, glycoproteomics discover different glyco‐biomarker candidates and show glycosylation in malignant hepatocytes, metabolomics characterise how HBV impairs a variety of metabolic functions during hepatocyte immortalisation, exosomes characterise immortalised liver cells in terms of their differentiation and proliferation, and autophagy plays a role in the development of hepatocarcinogenesis linked to HBV infection.
Læs mere Tjek på PubMedBruno Azevedo Randi; Hermes Ryoiti Higashino; Vinícius Ponzio da Silva; Erick Menezes Xavier; Vanderson Rocha; Silvia Figueiredo Costa;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Patients who undergo hematopoietic stem‐cell transplantation (HSCT) are more susceptible to developing severe forms of COVID‐19 with an increased risk of mortality. The aim of this study was to analyze, by performing a systematic review and meta‐analysis, all studies that evaluated COVID‐19 in HSCT adult recipients and present clinical characteristics and outcomes. Studies were eligible for inclusion if they: (I) described the clinical characteristics of COVID‐19 in adult (aged 18 years old or above) HSCT recipients; (II) described outcomes of COVID‐19 in this population, mainly lethality; (III) were full‐text articles. We searched MedLine, Embase, SCOPUS, LILACS and Web of Science for full‐text studies that evaluated COVID‐19 in adult HSCT patients until 26 Apr 2023. Two independent reviewers screened the articles and extracted the data. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data was used to assess quality of the included studies. Meta‐analysis was performed and the pooled prevalence of severe/critical disease and of death with a 95% CI was calculated with the random‐effects model. Sixteen studies were included; seven (43.7%) were multicenter. Most of the studies were from Europe (37.5%). All of them had a low risk of bias using the JBI Checklist. A total of 1186 patients were included. Allogeneic HSCT patients were the majority in most studies, with a total of 861 patients (72.5%). The symptomatic rate was 79.4%. The pooled prevalence of severe/critical COVID‐19 was 24.0% (95% CI 0.13–0.36; = 94%; = 334/990). The pooled prevalence of death for the entire population was 17% (95% CI 0.13–0.22; = 76%; = 221/1117), 17% (95% CI 0.12–0.23; = 67%; = 152/822) for allogeneic‐HSCT and 14% (95% CI 0.08–0.22; = 65%; = 48/293) for autologous‐HSCT. In conclusion, frequently the infection of SARS‐CoV‐2 in HSCT was symptomatic and lethality is higher than in general population. Thus, it is essential to focus on the implementation of measures to mitigate the risk of SARS‐CoV‐2 infection in this population, as well as to carefully assess HSCT recipients who develop COVID‐19.
Læs mere Tjek på PubMedNicholas I. Nii‐Trebi; Thomas S. Mughogho; Anisa Abdulai; Francis Tetteh; Priscilla M. Ofosu; Mary‐Magdalene Osei; Akua K. Yalley;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Infectious diseases continue to be the leading cause of morbidity and mortality, and a formidable obstacle to the development and well‐being of people worldwide. Viruses account for more than half of infectious disease outbreaks that have plagued the world. The past century (1918/19–2019/20) has witnessed some of the worst viral disease outbreaks the world has recorded, with overwhelming impact especially in low‐ and middle‐income countries (LMIC). The frequency of viral disease outbreak appears to be increasing. Generally, although infectious diseases have afflicted the world for centuries and humankind has had opportunities to examine the nature of their emergence and mode of spread, almost every new outbreak poses a formidable challenge to humankind, beating the existing pandemic preparedness systems, if any, and causing significant losses. These underscore inadequacy in our understanding of the dynamics and preparedness against viral disease outbreaks that lead to epidemics and pandemics. Despite these challenges, the past 100 years of increasing frequencies of viral disease outbreaks have engendered significant improvements in response to epidemics and pandemics, and offered lessons to inform preparedness. Hence, the increasing frequency of emergence of viral outbreaks and the challenges these outbreaks pose to humankind, call for the continued search for effective ways to tackle viral disease outbreaks in real time. Through a PRISMA‐based approach, this systematic review examines the outbreak of viral diseases in retrospect to decipher the outbreak patterns, losses inflicted on humanity and highlights lessons these offer for meaningful preparation against future viral disease outbreaks and pandemics.
Læs mere Tjek på PubMedKiruthiga Mone; Jay Reddy;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Myocarditis can result from various infectious and non‐infectious causes that can lead to dilated cardiomyopathy (DCM) and heart failure. Among the infectious causes, viruses are commonly suspected. But the challenge is our inability to demonstrate infectious viral particles during clinical presentations, partly because by that point, the viruses would have damaged the tissues and be cleared by the immune system. Therefore, viral signatures such as viral nucleic acids and virus‐reactive antibodies may be the only readouts pointing to viruses as potential primary triggers of DCM. Thus, it becomes hard to explain persistent inflammatory infiltrates that might occur in individuals affected with chronic myocarditis/DCM manifesting myocardial dysfunctions. In these circumstances, autoimmunity is suspected, and antibodies to various autoantigens have been demonstrated, suggesting that immune therapies to suppress the autoimmune responses may be necessary. From this perspective, we endeavoured to determine whether or not the known viral causes are associated with development of autoimmune responses to cardiac antigens that include both cardiotropic and non‐cardiotropic viruses. If so, what their nature and significance are in developing chronic myocarditis resulting from viruses as primary triggers.
Læs mere Tjek på PubMedChang‐tai Zhu; Jian‐Yun Yin; Xiao‐hua Chen; Ming Liu; Shi‐gui Yang;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
This study aimed to clarify the beneficial effect and the clinical application value of Paxlovid in the treatment of coronavirus disease‐19 (COVID‐19) through a systematic review. Databases including PubMed, Cochrane Library, Chinese Clinical Trial Registry, and were systematically searched for interventional or observational studies on the efficacy and safety of Paxlovid in the treatment of SARS‐COV‐2. The relative and absolute effect sizes for the outcomes were calculated based on the data reported in the original intervention literature. The external applicability of the evidence was analysed in terms of clinical application scenarios, patient willingness, and cost utility. One interventional and three observational studies were conducted. Four studies published in 2022, had participation sample sizes ranging 1780–109,254. Based on the randomised controlled trial data, the risk of all‐cause mortality, all‐cause death, and hospitalisation was significantly reduced in the Paxlovid group. Serious adverse events were reduced during the study. Based on observational studies, Paxlovid can significantly reduce the risk of death and hospitalisation in older patients with COVID‐19 (moderate certainty) and improve in‐hospital disease progression, composite disease progression, and viral load (low certainty). Paxlovid did not improve the outcomes of death and hospitalisation (low certainty) in patients aged
Læs mere Tjek på PubMedMaría Belén Colazo Salbetti; Gabriel Amilcar Boggio; Laura Moreno; María Pilar Adamo;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Human bocaviruses were first described between 2005 and 2010, identified in respiratory and enteric tract samples of children. Screening studies have shown worldwide distribution. Based on phylogenetic analysis, they were classified into four genotypes (HBoV1‐4). From a clinical perspective, human bocavirus 1 (HBoV1) is considered the most relevant, since it can cause upper and lower acute respiratory tract infection, mainly in infants, including common cold, bronchiolitis, and pneumonia, as well as wheezing in susceptible patients. However, the specific processes leading to structural, biochemical, and functional changes resulting in the different clinical presentations have not been elucidated yet. This review surveys the interactions between the virus and target cells that can potentially explain disease‐causing mechanisms. It also summarises the clinical phenotype of cases, stressing the role of HBoV1 as an aetiological agent of lower acute respiratory infection in infants, together with laboratory tests for detection and diagnosis. By exploring the current knowledge on the epidemiology of HBoV1, insights into the complex scenario of paediatric respiratory infections are presented, as well as the potential effects that changes in the circulation can have on the dynamics of respiratory agents, spotlighting the benefits of comprehensively increase insights into incidence, interrelationships with co‐circulating agents and potential control of HBoV1.
Læs mere Tjek på PubMedGeorge M. Bwire; Belinda J. Njiro; Harieth P. Ndumwa; Castory G. Munishi; Bonaventura C. Mpondo; Mathew Mganga; Emmanuel Mang'ombe; Muhammad Bakari; Raphael Z. Sangeda; Christopher R. Sudfeld; Japthet Killewo;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Differentiated service delivery (DSD) models, such as adherence clubs (ACs), are client‐centred approaches where clinically stable people living with HIV (PLHIV) meet to receive various services, including psychosocial support, brief symptoms screening, and refills of antiretroviral medications, among others. We conducted a review to assess the impact of DSD models, including ACs, on sustaining retention in care (RC) and achieving viral suppression (VS) among PLHIV in sub‐Saharan Africa. The review protocol was registered in PROSPERO (CRD42023418988). We searched the literature from PubMed, Scopus, Web of Science, Embase and Google Scholar from their inception through May 2023. Eligible randomised controlled trials of adherence clubs were reviewed to assess impact on retention and viral suppression. Random effect models were used to estimate the risk ratios (RR) and 95% confidence intervals (CI). The literature search yielded a total of 1596 records of which 16 randomised clinical trials were determined to be eligible. The trials were conducted in diverse populations among adults and children with a total of 13,886 participants. The RR between any DSD models and standard of care (SoC) was 1.09 (95% CI: 1.08–1.11, : 0%, :
Læs mere Tjek på PubMedShivani Malvankar; Anjali Singh; Y. S. Ravi Kumar; Swetangini Sahu; Megha Shah; Yamini Murghai; Mahendra Seervi; Rupesh K. Srivastava; Bhupendra Verma;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) emerged in December 2019, causing a range of respiratory infections from mild to severe. This resulted in the ongoing global COVID‐19 pandemic, which has had a significant impact on public health. The World Health Organization declared COVID‐19 as a global pandemic in March 2020. Viruses are intracellular pathogens that rely on the host\'s machinery to establish a successful infection. They exploit the gene expression machinery of host cells to facilitate their own replication. Gaining a better understanding of gene expression modulation in SARS‐CoV2 is crucial for designing and developing effective antiviral strategies. Efforts are currently underway to understand the molecular‐level interaction between the host and the pathogen. In this review, we describe how SARS‐CoV2 infection modulates gene expression by interfering with cellular processes, including transcription, post‐transcription, translation, post‐translation, epigenetic modifications as well as processing and degradation pathways. Additionally, we emphasise the therapeutic implications of these findings in the development of new therapies to treat SARS‐CoV2 infection.
Læs mere Tjek på PubMedRaphael Udeh; Alberto Utrero‐Rico; Xenia Dolja‐Gore; Masoud Rahmati; Mark McEVoy; Tony Kenna;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
There\'s critical need for risk predictors in long COVID. This meta‐analysis evaluates the evidence for an association between plasma lactate dehydrogenase (LDH) and long COVID and explores the contribution of LDH to symptoms persistent across the distinct post‐acute sequelae of COVID‐19 (PASC) domains. PubMed, EMBASE, Web of Science, and Google Scholar were searched for articles published up to 20 March 2023 for studies that reported data on LDH levels in COVID‐19 survivors with and without PASC. Random‐effect meta‐analysis was employed to estimate the standardized mean difference (SMD) with corresponding 95% confidence interval of each outcome. There were a total of 8289 study participants (3338 PASC vs. 4951 controls) from 46 studies. Our meta‐analysis compared to the controls showed a significant association between LDH elevation and Resp‐PASC [SMD = 1.07, 95%CI = 0.72, 1.41, = 0.01] but not Cardio‐PASC [SMD = 1.79, 95%CI = −0.02, 3.61, = 0.05], Neuro‐PASC [SMD = 0.19, 95%CI = −0.24, 0.61, = 0.40], and Gastrointestinal‐PASC [SMD = 0.45, 95%CI = −1.08, 1.98, = 0.56]. This meta‐analysis suggests elevated LDH can be used for predicting Resp‐PASC, but not Cardio‐PASC, Neuro‐PASC or gastrointestinal‐PASC. Thus, elevated plasma LDH following COVID infection may be considered as a disease biomarker.
Læs mere Tjek på PubMedMarta Calado; David Pires; Carolina Conceição; Quirina Santos‐Costa; Elsa Anes; José Miguel Azevedo‐Pereira;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Despite the success of combined antiretroviral therapy in controlling viral load and reducing the risk of human immunodeficiency virus (HIV) transmission, an estimated 1.5 million new infections occurred worldwide in 2021. These new infections are mainly the result of sexual intercourse and thus involve cells present on the genital mucosa, such as dendritic cells (DCs), macrophages (Mø) and CD4+ T lymphocytes. Understanding the mechanisms by which HIV interacts with these cells and how HIV exploits these interactions to establish infection in a new human host is critical to the development of strategies to prevent and control HIV transmission. In this review, we explore how HIV has evolved to manipulate some of the physiological roles of these cells, thereby gaining access to strategic cellular niches that are critical for the spread and pathogenesis of HIV infection. The interaction of HIV with DCs, Mø and CD4+ T lymphocytes, and the role of the intercellular transfer of viral particles through the establishment of the infectious or virological synapses, but also through membrane protrusions such as filopodia and tunnelling nanotubes (TNTs), and cell fusion or cell engulfment processes are presented and discussed.
Læs mere Tjek på PubMedGeorgina. R. HurleJulii BrainardKevin. M. TylerNorwich Medical School, University of East Anglia, Norwich, UK
Virulence, 11.11.2023
Tilføjet 11.11.2023
Benjamin KazaHector C. Aguilara Department of Microbiology, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USAb Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
Virulence, 11.11.2023
Tilføjet 11.11.2023
Lóser, Meghan K.; Horowitz, Jennifer K.; England, Peter; Esteitie, Rania; Kaatz, Scott; McLaughlin, Elizabeth; Munroe, Elizabeth; Heath, Megan; Posa, Pat; Flanders, Scott A.; Prescott, Hallie C.
Critical Care Explorations, 11.11.2023
Tilføjet 11.11.2023
OBJECTIVES: To identify opportunities for improving hospital-based sepsis care and to inform an ongoing statewide quality improvement initiative in Michigan. DESIGN: Surveys on hospital sepsis processes, including a self-assessment of practices using a 3-point Likert scale, were administered to 51 hospitals participating in the Michigan Hospital Medicine Safety Consortium, a Collaborative Quality Initiative sponsored by Blue Cross Blue Shield of Michigan, at two time points (2020, 2022). Forty-eight hospitals also submitted sepsis protocols for structured review. SETTING: Multicenter quality improvement consortium. SUBJECTS: Fifty-one hospitals in Michigan. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the included hospitals, 92.2% (n = 47/51) were nonprofit, 88.2% (n = 45/51) urban, 11.8% (n = 6/51) rural, and 80.4% (n = 41/51) teaching hospitals. One hundred percent (n = 51/51) responded to the survey, and 94.1% (n = 48/51) provided a sepsis policy/protocol. All surveyed hospitals used at least one quality improvement approach, including audit/feedback (98.0%, n = 50/51) and/or clinician education (68.6%, n = 35/51). Protocols included the Sepsis-1 (18.8%, n = 9/48) or Sepsis-2 (31.3%, n = 15/48) definitions; none (n = 0/48) used Sepsis-3. All hospitals (n = 51/51) used at least one process to facilitate rapid sepsis treatment, including order sets (96.1%, n = 49/51) and/or stocking of commonly used antibiotics in at least one clinical setting (92.2%, n = 47/51). Treatment protocols included guidance on antimicrobial therapy (68.8%, n = 33/48), fluid resuscitation (70.8%, n = 34/48), and vasopressor administration (62.5%, n = 30/48). On self-assessment, hospitals reported the lowest scores for peridischarge practices, including screening for cognitive impairment (2.0%, n = 1/51 responded “we are good at this”) and providing anticipatory guidance (3.9%, n = 2/51). There were no meaningful associations of the Centers for Medicare and Medicaid Services’ Severe Sepsis and Septic Shock: Management Bundle performance with differences in hospital characteristics or sepsis policy document characteristics. CONCLUSIONS: Most hospitals used audit/feedback, order sets, and clinician education to facilitate sepsis care. Hospitals did not consistently incorporate organ dysfunction criteria into sepsis definitions. Existing processes focused on early recognition and treatment rather than recovery-based practices.
Læs mere Tjek på PubMedLawler, Patrick R.; Manvelian, Garen; Coppi, Alida; Damask, Amy; Cantor, Michael N.; Ferreira, Manuel A. R.; Paulding, Charles; Banerjee, Nilanjana; Li, Dadong; Jorgensen, Susan; Attre, Richa; Carey, David J.; Krebs, Kristi; Milani, Lili; Hveem, Kristian; Damås, Jan K.; Solligård, Erik; Stender, Stefan; Tybjærg-Hansen, Anne; Nordestgaard, Børge G.; Hernandez-Beeftink, Tamara; Rogne, Tormod; Flores, Carlos; Villar, Jesús; Walley, Keith R.; Liu, Vincent X.; Fohner, Alison E.; Lotta, Luca A.; Kyratsous, Christos A.; Sleeman, Mark W.; Scemama, Michel; DelGizzi, Richard; Pordy, Robert; Horowitz, Julie E.; Baras, Aris; Martin, Greg S.; Steg, Philippe Gabriel; Schwartz, Gregory G.; Szarek, Michael; Goodman, Shaun G.
Critical Care Explorations, 11.11.2023
Tilføjet 11.11.2023
OBJECTIVES: Treatments that prevent sepsis complications are needed. Circulating lipid and protein assemblies—lipoproteins play critical roles in clearing pathogens from the bloodstream. We investigated whether early inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) may accelerate bloodstream clearance of immunogenic bacterial lipids and improve sepsis outcomes. DESIGN: Genetic and clinical epidemiology, and experimental models. SETTING: Human genetics cohorts, secondary analysis of a phase 3 randomized clinical trial enrolling patients with cardiovascular disease (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab [ODYSSEY OUTCOMES]; NCT01663402), and experimental murine models of sepsis. PATIENTS OR SUBJECTS: Nine human cohorts with sepsis (total n = 12,514) were assessed for an association between sepsis mortality and PCSK9 loss-of-function (LOF) variants. Incident or fatal sepsis rates were evaluated among 18,884 participants in a post hoc analysis of ODYSSEY OUTCOMES. C57BI/6J mice were used in Pseudomonas aeruginosa and Staphylococcus aureus bacteremia sepsis models, and in lipopolysaccharide-induced animal models. INTERVENTIONS: Observational human cohort studies used genetic PCSK9 LOF variants as instrumental variables. ODYSSEY OUTCOMES participants were randomized to alirocumab or placebo. Mice were administered alirocumab, a PCSK9 inhibitor, at 5 mg/kg or 25 mg/kg subcutaneously, or isotype-matched control, 48 hours prior to the induction of bacterial sepsis. Mice did not receive other treatments for sepsis. MEASUREMENTS AND MAIN RESULTS: Across human cohort studies, the effect estimate for 28-day mortality after sepsis diagnosis associated with genetic PCSK9 LOF was odds ratio = 0.86 (95% CI, 0.67–1.10; p = 0.24). A significant association was present in antibiotic-treated patients. In ODYSSEY OUTCOMES, sepsis frequency and mortality were infrequent and did not significantly differ by group, although both were numerically lower with alirocumab vs. placebo (relative risk of death from sepsis for alirocumab vs. placebo, 0.62; 95% CI, 0.32–1.20; p = 0.15). Mice treated with alirocumab had lower endotoxin levels and improved survival. CONCLUSIONS: PCSK9 inhibition may improve clinical outcomes in sepsis in preventive, pretreatment settings.
Læs mere Tjek på PubMedZhenlu Sun, Peihua Niu, Miao Jin, Ruiqing Zhang, Qiao Gao, Hongtao Wang, Xuejun Ma, Ji Wang
Journal of Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Ya‐Ni Zhang, Guang‐Hao Zhu, Wei Liu, Xi‐Xiang Chen, Yuan‐Yuan Xie, Jian‐Rong Xu, Mei‐Fang Jiang, Xiao‐Yu Zhuang, Wei‐Dong Zhang, Hong‐Zhuan Chen, Guang‐Bo Ge
Journal of Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Chia-Jung Kuo, Ngoc-Niem Bui, Jun-Nong Ke, Cheng- Yu Lin, Wey-Ran Lin, Ming-Ling Chang, Hui- Yu Wu, Mei-Zi Huang, Cheng-Hsun Chiu, Cheng-Tang Chiu, Chih-Ho Lai
International Journal of Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
H. pylori eradication has been recommended to prioritize first-line treatment options such as bismuth quadruple therapy or concomitant therapy, which includes a proton pump inhibitor (PPI), clarithromycin, amoxicillin, and metronidazole. However, this treatment regimen may fail to address infections in up to 20% of patients [1].
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
Man is associated with the atmosphere throughout his life. He breathes the air every minute of the day, and is more or less bathed by it. Accordingly, he has become adjusted to its chemical composition and physical properties under a variety of atmospheric conditions. Nevertheless, there are times when even to an organism so well adapted as is the animal body to its environment the air acquires properties that are commonly designated “bad.” The explanations of what constitutes “badness” in the air have gradually undergone changes with the progress of scientific inquiry. It is not so long ago that malaria was ascribed to objectionable conditions of the atmosphere per se. Only a few years since, the occasional “badness” of inside air, as in crowded rooms or meeting places, was attributed to an accumulation of an organic poison exhaled from the lungs. Carbon dioxid, an eliminated product of respiration, has also been charged with responsibility for harmful contamination of the atmosphere by occurring in supposedly excessive amounts; but neither the hypothetic respiratory poison nor the ever present carbon dioxid has sustained its acquired reputation as the dangerous factor in bad air.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
Challenging conventional wisdom is important and frequently useful. Septic shock is a form of distributive shock in which hypotension results from vasodilation. Although myocardial performance may not always be entirely normal, a phenomenon termed septic cardiomyopathy, cardiac output is usually preserved, in part by increased heart rate. Therapy of septic shock refractory to fluid administration entails administration of vasopressor agents; norepinephrine is generally preferred as an initial agent. In those cases in which cardiac output is felt to be low enough to compromise perfusion, inotropic agents may be used. In this context, use of β-blockers may well be regarded as counterintuitive inasmuch as their hemodynamic effects would tend to decrease arterial pressure and cardiac output. Despite this, investigators have challenged conventional wisdom and evaluated the effects of β-blockade for treating sepsis.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
This clinical trial assesses whether landiolol for patients with tachycardia and established septic shock requiring prolonged vasopressor support reduces the risk of organ failure.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
About 63% of COVID-19-related hospitalizations between January and August 2023 were among people aged 65 years or older, based on data collected by the US Centers for Disease Control and Prevention (CDC). The proportion had been declining through mid-July but increased again by the end of August.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
Prior infection with COVID-19 was tied to a higher risk of autoimmune and autoinflammatory connective tissue disorders, according to results from 354 527 people with an average age of about 52 years. The chance of developing antineutrophil cytoplasmic antibody-associated vasculitis was the highest after infection, followed by alopecia totalis, Crohn disease, and sarcoidosis, among other conditions.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
More pregnant women in the US were hesitant to receive common vaccinations in 2022 to 2023 compared with 2021 to 2022, researchers reported in the Morbidity and Mortality Weekly Report. Women who reported being “very hesitant” to receive the influenza vaccine increased from 17% to 25% during that period, while hesitancy to receive the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine rose from 15% to 20%, according to survey data from 1814 pregnant women aged 18 to 49 years.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
In the US, new cases of 6 major types of cancer—colorectal, female breast, lung, pancreas, prostate, and thyroid—fell relative to the number of expected diagnoses during early 2020, when many health care facilities limited preventive cancer screening to help control the spread of SARS-CoV-2. The decline in diagnoses was greatest for early-stage cases, according to the second installment of the Annual Report to the Nation on the Status of Cancer, which included data from the North American Association of Central Cancer Registries.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
This Viewpoint discusses Hospital Sepsis Program Core Elements, a set of guidance provided by the Centers for Disease Control and Prevention to help hospitals develop multiprofessional programs that monitor and optimize management and outcomes of sepsis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background The organ most commonly invaded in echinococcosis is the liver; the lungs, brain, kidneys, heart, and spleen are rarely invaded, and multi-organ involvement in echinococcosis is even rarer. No studies have reported renal invasion after liver transplantation for hepatic alveolar echinococcosis. Case presentation We report here a case of renal invasion 2 years after allogeneic liver transplantation in a 53-year-old female patient with hepatic alveolar echinococcosis combined with lung metastases. At the time of the first consultation, the lesion had been found to involve the second hepatic hilum combined with lung metastases, but the patient requested conservative treatment, and the lesion was not controlled by taking albendazole for 3 years. After discussion in the treatment group, it was decided to use allogeneic liver transplantation and lung segmental resection for surgical treatment, after which the patient was put on long-term oral immunosuppression. She was hospitalized 2 years later for low back pain and diagnosed with renal alveolar echinococcosis. Due to significant compression and left-sided renal insufficiency, the final option was to remove the diseased kidney. It is worth mentioning that signs of unexplained urinary tract infection were present throughout the course of treatment. Conclusion This study suggests that extra attention should be paid to the presence of cryptogenic lesions in patients with hepatic alveolar echinococcosis who already have definite metastatic lesions. Immunosuppressive drugs after liver transplantation in patients with hepatic echinococcosis may cause occult lesions to develop into active ones. In clinical practice, particular attention should be paid to patients with hepatic alveolar echinococcosis with long-term concomitant signs of unexplained urinary tract infections, which may be a precursor clinical feature of cryptogenic renal alveolar echinococcosis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background To compare the triage performance of HPV viral loads reflected by cycle threshold values (CtV) from two different HPV testing assays: the PCR based Cobas4800 and the isothermal amplification based AmpFire assay. Methods We used the data from a sub-study of The Chinese Multi-Center Screening Trial and analyzed the data of the cases positive in both Cobas4800 and AmpFire assays with recorded CtV. Spearman’s correlation was applied to analyze the association between CtV from AmpFire and Cobas4800 assays, as well as the correlation between CtV and the histological lesion grades. The 50th percentile of CtV was used as the cutoff to construct triage algorithms for HPV-positive cases. McNemar’s test was used to analyze the differences in sensitivity and specificity for detecting CIN2 + and CIN3 + in different triage algorithms. Results Four hundred forty-six HPV positive women who had consistent HPV results from Cobas4800 and AmpFire in terms of the HPV genotype and reported Ct values were included in the analysis. The mean CtV of hrHPV tested by Cobas4800 and AmpFire were linear correlated. Direct association were showed between the severity of cervical lesions and the HPV viral loads reflected by CtV of hrHPV, HPV16, non-16/18 hrHPV and A9 group from both assays. HPV16/18 genotyping combined with low-CtV for non-16/18 hrHPV, especially A9 group, were demonstrated to be satisfactory in the sensitivity and specificity for detecting CIN2 + or CIN3 + . Conclusion Ct value represented a good triage marker in both PCR-based and isothermal amplification HPV detection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Young students infected with HIV have become a significant public health issue in China, this study aimed to understand the factors influencing the choice of having multiple sexual partners among male college students who had casual heterosexual sex in Zhejiang Province and to scientifically justify developing HIV/AIDS intervention strategies among them. Methods A stratified cluster sampling method was used for the survey of students from 13 colleges or universities in Zhejiang Province between October and November 2018. The questionnaire collected information on general demographic characteristics, knowledge of HIV/AIDS prevention and treatment, sexual attitudes and risk awareness, sexual behavioural characteristics, and acceptance of interventions. The univariable and multivariable analyses were conducted in this study. Results Study participants included 362 male college students who exhibited casual heterosexual sex and were aware of the number of sexual partners they had. Among them, 222 students engaged in casual heterosexual sex with multiple sexual partners (61.33%). The results of the multivariable analysis revealed several factors associated with male students’ choice to have multiple sexual partners: monthly living expenses greater than or equal to 1501 CNY (adjusted OR = 2.24, 95% CI = 1.21–4.16), sexual behavior after consuming alcohol (adjusted OR = 2.19, 95% CI = 1.32–3.63), whose casual partner types were non-student (adjusted OR = 2.51, 95% CI = 1.45–4.22), and those who discussed using condoms during sexual intercourse (adjusted OR = 0.50, 95% CI = 0.28–0.89). Conclusion The choice to engage in casual heterosexual sex with multiple partners was found to be associated with several factors among male college students, including economic status, engaging in sexual behavior after consuming alcohol, the type of the casual partner, and using condoms. These findings highlight the significance of implementing targeted interventions and comprehensive sexual health education programs within college settings in order to encourage safer sexual practices among students.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Leptospirosis is a zoonotic disease that afflicts both humans and animals. It progresses from flu-like symptoms to more severe hepatic and renal failure, and may also lead to aseptic meningitis. Individuals with autoimmune diseases (ADs) are potentially more susceptible to Leptospirosis. Thus far, limited data has documented the association between Leptospirosis and autoimmune disorders. Case presentation The patient had a definitive pathological diagnosis of Sjögren’s syndrome (SS). Due to recurrent headaches, the patient sought consultation with a neurologist. Lumbar puncture revealed elevated white blood cells and protein levels in the cerebrospinal fluid, along with decreased glucose. Tuberculous meningitis was suspected. Radiographic imaging exhibited meningeal enhancement, ventricular enlargement, and hydrocephalus. The patient commenced treatment with anti-tuberculosis therapy and corticosteroids. Subsequently, high-throughput sequencing (HTS) of cerebrospinal fluid identified the presence of Leptospira interrogans. The patient was ultimately diagnosed with Leptospiral meningitis, and underwent antimicrobial and immunosuppressive therapy, resulting in stabilization of the condition and gradual symptom recovery. Conclusions The case highlights the challenges in diagnosing and managing leptospirosis-related meningitis in the presence of ADs and emphasizes the importance of utilizing HTS for accurate pathogen detection. The potential correlation between leptospirosis and SS warrants further investigation, as does the need for multidisciplinary involvement in treatment strategies for such complex cases.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Ciswomen constitute a disproportionately low percentage of pre-exposure prophylaxis for HIV prevention (PrEP) users compared to men. Despite PrEP’s effectiveness, women are 5.25 times less likely to take PrEP than men. Identifying women who have increased reasons for HIV prevention and educating and offering PrEP to these women is crucial to reducing HIV transmission and overall health equity. However, the best method of identifying women at highest risk of acquiring HIV remains unknown. This study aimed to identify common HIV risk factors and data sources for identifying these common factors (e.g., electronic medical record data, open source neighborhood data), as well as potential intervention points and missed opportunities for PrEP linkage. Methods We conducted an evaluation of multiple data sources: semi-structured qualitative interviews, electronic medical record (EMR) chart abstraction, and open source data abstraction. We accessed EMRs for enrolled participants and all participants signed a standard release of medical information (ROI) form for all institutions at which they had received medical care for the five-year period preceding their HIV diagnosis. Data were abstracted using a standardized procedure. Both structured and unstructured fields (i.e., narrative text of free notes) within the EMR were examined and included for analysis. Finally, open data sources (e.g., STI cases, HIV prevalence) were examined by community area of Chicago. Open data sources were used to examine several factors contributing to the overall Economic Hardship Index (EHI) score. We used these calculated scores to assess the economic hardship within participants’ neighborhoods. Results A total of 18 cisgender women with HIV participated in our study. Participants were mostly Black/African American (55.6%) and young (median age of 34). Our analysis identified two main themes influencing HIV risk among participants: contextual factors and relationship factors. Further, potential pre-diagnosis intervention points and missed opportunities were identified during reproductive health/prenatal visits, behavioral/mental health visits, and routine STI testing. Our evaluation of multiple data sources included investigating the presence or absence of information in the EMR (STI history, HIV testing, substance use, etc.) as well as whether pertinent information could be gathered from open access sources. Conclusion Ciswomen recently diagnosed with HIV identified many shared experiences, including syndemic conditions like mental illness and substance abuse, sex with men who have sex with men, and frequent moving in areas with high HIV incidence prior to their diagnosis. It is imperative that providers ask patients about social history, information about partners, and other key variables, in addition to the standardized questions. Findings can be used to better recognize ciswomen most vulnerable to HIV and offer PrEP to them, reducing HIV transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background The efficacy of antiviral drugs that neutralize antibody drugs and fight against SARS-COV-2 is reported to be attenuated by genetic mutations of the virus in vitro. When B-cell immunocompromised patients are infected with SARS-COV-2, the infection can be prolonged, and genetic mutations can occur during the course of treatment. Therefore, for refractory patients with persistent COVID-19 infection, genomic analysis was performed to obtain data on drug resistance mutations as a reference to determine which antiviral drugs and antibody therapies might be effective in their treatment. Methods This was a descriptive analysis with no controls. Patients were diagnosed as having COVID-19, examined, and treated in the Kansai Medical University General Medical Center between January 2022 and January 2023. The subjects of the study were B-cell immunocompromised patients in whom genome analysis of SARS-CoV-2 was performed. Results During the study period, 984 patients with COVID-19 were treated at our hospital. Of those, 17 refractory cases underwent genomic analysis. All 17 patients had factors related to immunodeficiency, such as malignant lymphoma or post-organ transplantation. Eleven patients started initial treatment for COVID-19 at our hospital, developed persistent infection, and underwent genomic analysis. Six patients who were initially treated for COVID-19 at other hospitals became persistently infected and were transferred to our hospital. Before COVID-19 treatment, genomic analysis showed no intrahost mutations in the NSP5, the NSP12, and the RBD regions. After COVID-19 treatment, mutations in these regions were found in 12 of 17 cases (71%). Sixteen patients survived the quarantine, but one died of sepsis. Conclusions In genomic analysis, more mutations were found to be drug-resistant after COVID-19 treatment than before COVID-19 treatment. Although it was not possible to demonstrate the usefulness of genome analysis for clinical application, the change of the treatment drug with reference to drug resistance indicated by genomic analysis may lead to good outcome of immunocompromised COVID-19 patients.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Patients presenting to the emergency department with community-acquired pneumonia (CAP) are characterized by advanced age, comorbidities, critical illness and less-than-typical symptoms, posing a diagnostic challenge. Plasma heparin-binding protein (HBP) and the heparin-binding protein-to-albumin ratio (HBP/Alb) have not been adequately studied in the early diagnosis of CAP. This study assessed the diagnostic value of plasma HBP, HBP/Alb, and conventional inflammatory markers in emergency department patients with CAP. Methods We enrolled 103 patients with CAP, retrospectively analyzed the patients’ clinical data, and divided the CAP patients into antibiotic (n = 79) and non-antibiotic (n = 24) groups based on whether antibiotics were administered prior to blood sampling and laboratory tests. The control group was comprised of 52 non-infected patients admitted during the same period. Within 24 h of admission, plasma HBP, serum procalcitonin (PCT), white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR) and HBP/Alb levels were collected separately and compared. The receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of each indicator for CAP patients. Utilizing the Kappa test, the consistency of each indicator used to evaluate CAP and clinical diagnosis was analyzed. Spearman correlation was used to analyze the correlation between plasma HBP and clinical indicators of CAP patients. Results Plasma HBP, serum PCT, WBC, NLR and HBP/Alb were all elevated in the CAP group in comparison to the control group (P 0.05). Plasma HBP and HBP/Alb had the highest diagnostic accuracy for CAP, the area under the ROC curve (AUC) were 0.931 and 0.938 (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Parasitological investigation of bone marrow, splenic or lymph node aspirations is the gold standard for the diagnosis of visceral leishmaniasis (VL). However, this invasive test requires skilled clinical and laboratory staff and adequate facilities, and sensitivity varies depending on the tissue used. The direct agglutination test (DAT) is a serological test that does not need specialised staff, with just minimal training required. While previous meta-analysis has shown DAT to have high sensitivity and specificity when using parasitology as the reference test for diagnosis, meta-analysis of DAT compared to other diagnostic techniques, such as PCR and ELISA, that are increasingly used in clinical and research settings, has not been done. Methods We conducted a systematic review to determine the diagnostic performance of DAT compared to all available tests for the laboratory diagnosis of human VL. We searched electronic databases including Medline, Embase, Global Health, Scopus, WoS Science Citation Index, Wiley Cochrane Central Register of Controlled Trials, Africa-Wide Information, LILACS and WHO Global Index. Three independent reviewers screened reports and extracted data from eligible studies. A meta-analysis estimated the diagnostic sensitivity and specificity of DAT. Results Of 987 titles screened, 358 were selected for full data extraction and 78 were included in the analysis, reporting on 32,822 participants from 19 countries. Studies included were conducted between 1987–2020. Meta-analysis of studies using serum and DAT compared to any other test showed pooled sensitivity of 95% (95%CrI 90–98%) and pooled specificity of 95% (95%CrI 88–98%). Results were similar for freeze-dried DAT and liquid DAT when analysed separately. Sensitivity was lower for HIV-positive patients (90%, CrI 59–98%) and specificity was lower for symptomatic patients (70%, CrI 43–89%). When comparing different geographical regions, the lowest median sensitivity (89%, CrI 67–97%) was in Western Asia (five studies). Conclusions This systematic review and meta-analysis demonstrates high estimated pooled sensitivity and specificity of DAT for diagnosis of VL, although sensitivity and specificity were lower for different patient groups and geographical locations. This review highlights the lack of standardisation of DAT methods and preparations, and the lack of data from some important geographical locations. Future well-reported studies could provide better evidence to inform test implementation for different patient populations and use cases. PROSPERO registration CRD42021240830
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. Method This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records. Results There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. Conclusion Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Clinical evidence suggests that pregnant women are more vulnerable to COVID-19, since they are at increased risk for disease progression and for obstetric complications, such as premature labor, miscarriage, preeclampsia, cesarean delivery, fetal growth restriction and perinatal death. Despite this evidence, pregnant women are often excluded from clinical trials, resulting in limited knowledge on COVID-19 management. The aim of this systematic review and meta-analysis is to provide better evidence on the efficacy and safety of available COVID-19 treatment in pregnant women. Methods Four authors searched major electronic databases from inception until 1 st November-2022 for controlled trials/observational studies, investigating outcomes after the administration of anti-SARS-CoV-2 treatments in pregnant women affected by COVID-19. The analyses investigated the cumulative incidence of delivery and maternal outcomes in pregnant women, comparing those taking active medication vs standard care. Risk ratios (RRs) with 95% confidence intervals were calculated. Statistical significance was assessed using the random effects model and inverse-variance method. This systematic review and meta-analysis was conducted in accordance with the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in Prospero (number registration: CRD42023397445). Results From initially 937 non duplicate records, we assessed the full texts of 40 articles, finally including ten studies. In six studies, including 1627 patients, the use of casirivimab/imdevimab (CAS/IMD), remdesivir, and IFN-alpha 2b significantly decreased the need of cesarean section ((RR = 0.665; 95%CI: 0.491–0.899; p = 0.008; I 2 = 19.5%;) (Table 1, (Fig. 1). Treatments did not decrease the risk of preterm delivery, admission to neonatal ICU, or stillbirth/perinatal loss (p-values > 0.50 for all these outcomes) and did not prevent the progression of disease towards severe degrees (k = 8; 2,374 pregnant women; RR = 0.778; 95%CI: 0.550–1.099; p = 0.15; I 2 = 0%). Moreover, the use of medications during pregnancy did not modify the incidence of maternal death in two studies (Table 2). Conclusions To our analysis, CAS/IMD, remdesivir, and IFN alpha 2b reduced the number of cesarean sections but demonstrated no effect on disease progression and other obstetric and COVID-19 related outcomes. The inability to evaluate the influence of viral load on illness development in pregnant women was attributed to lack of data. In our systematic review, no major side effects were reported. Though, it is essential for the medical community to focus more on clinical trials and less on episodic case reports and case series, with standardization of fetal and maternal outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Human papillomavirus (HPV) infection is an essential cause of oropharyngeal squamous cell carcinoma that is increasing in incidence worldwide. However, little is known about the epidemiology of oral HPV infection among healthy adults in China. Methods A study in northern China was conducted in 2021 as baseline data of Diverse Life-Course Cohort (DLCC). Residents who aged above 20 were eligible to participate. Oral swab specimens and questionnaires were collected from 4226 participants. HPV DNA in oral exfoliated cells was tested by Nested Polymerase Chain Reaction approach and sequencing. Univariate and multivariate analyses were performed to assess the associations between exposure factors and oral HPV infection. Results Overall prevalence of oral HPV infection was 4.08% (95%CI, 3.69%-4.68%). The most prevalent HPV type detected was HPV-81 (1.35%; 95% CI, 1.00%–1.70%), followed by HPV-16 (0.64%; 95% CI, 0.40%–0.88%). Oral HPV infection presented a bimodal pattern with respect to age in male and female participants. Oral HPV prevalence of male participants was significantly higher than prevalence of female participants (5.0% versus 3.6%, P = 0.041). Prevalence of oral HPV was higher among current smokers (OR = 1.59; 95% CI, 1.11–2.29; P = 0.039) and current drinkers (OR = 1.60; 95% CI, 1.14–2.25; P = 0.023). Current alcohol consumption was independently associated with oral HPV infection (OR = 1.74; 95% CI, 1.22–2.50; P = 0.010). Conclusions Among healthy adults aged above 20 in Hebei, China, the prevalence of high-risk HPV infection was 1.92% (95%CI, 1.51%-2.34%). Oral HPV prevalence was independently associated with alcohol consumption. More tailored prevention strategies are needed to prevent oral HPV infection through smoking cessation, reduction of alcohol consumption, and HPV vaccination.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Objective As an opportunistic pathogen, Nocardia often occurring in the immunocompromised hosts. As the unspecifc clinical presentation and low identification rate of the culture dependent methods, Nocardia infection may be under-diagnosis. Recent study have reported physicians could benefit from metagenomic next-generation sequencing (mNGS) in Nocardia diagnosis. Herein, we present patients with a positive detection of nocardiosis in mNGS, aiming to provide useful information for an differential diagnosis and patients management. Methods A total of 3756 samples detected for mNGS from March 2019 to April 2022 at the Fifth Affifiliated Hospital of Sun Yat-sen University, were screened. Clinical records, laboratory finding, CT images and mNGS results were reviewed for 19 patients who were positive for Nocardia genus. Results Samples from low respiratory tract obtained by bronchoscope took the major part of the positive (15/19). 12 of 19 cases were diagnosis as Nocardiosis Disease (ND) and over half of the ND individuals (7/12) were geriatric. Nearly all of them (10/12) were immunocompetent and 2 patients in ND group were impressively asymptomatic. Cough was the most common symptom. Nocardia cyriacigeorgica (4/12) was more frequently occurring in ND, followed by Nocardia abscessus (3/12). There are 3 individuals detected more than one kind of Nocardia species (Supplementary table 1). Except one with renal failure and one allergic to sulfamethoxazole, all of them received co-sulfonamide treatment and relieved eventually. Conclusion Our study deciphered the clinical features of patients with positive nocardiosis detected by mNGS. Greater attention should be paid to the ND that occurred in the immunocompetent host and the geriatric. Due to the difficulties in establishing diagnosis of Nocardiosis disease, mNGS should play a much more essential role for a better assessment in those intractable cases. Co-sulfonamide treatment should still be the first choice of Nocardiosis disease.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background The investigation of the presence of extended-spectrum beta-lactamase (ESBL) within Enterobacteriaceae in both fecal carriers and patients is an essential matter. Furthermore, the assessment of distinct characteristics exhibited by resistant bacteria obtained from fecal carriers and patients, as well as the comparison of these characteristics between the two groups, could provide a deeper understanding of how the resistant isolates can remain concealed within a dormant reservoir and intensify antimicrobial resistance. The aim of the present study was to concentrate on the comparison of the antimicrobial resistance pattern and molecular features between strains obtained from clinical and carrier sources. Material and methods A total of 142 clinical samples and 120 rectal swabs were collected from June to October 2016. ESBL screening was performed using the double-disk synergy test. PCR was done for the detection of ESBL genes. Assessment of biofilm formation, virulence factor genes, and MLVA was performed for K. pneumonae isolates. Phylogroup typing was performed for E. coli isolates. Results Of 146 samples, 67.6% were E. coli, and 32.4% were K. pneumoniae. The rate of blaCTXM-15 was 89.4%. In K. pneumoniae type D, ompk35 and fimH were the highest. All the K. pneumoniae isolates were classified into 12 mini clusters and the clinical isolates were characterized into 7 mini clusters. The phylogroup B2 in ESBL-EC was the highest (56.2%). Discussion Comparison of molecular characteristics and clonal relatedness between fecal carriers and patients showed noticeable relatedness and similarity which may indicate that ESBL-KP can be colonized with the same profiles in different settings and, therefore, may be widely distributed in both community and hospital settings. Therefore, implementation of control protocols, including surveillance of the fecal carriers, could impressively reduce silent reservoirs without clinical symptoms as well as patient rates.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. Methods This study was a longitudinal cohort study conducted between April 2021 and September 2022 in Belgium. In total, 8,238 adults with a confirmed SARS-CoV-2 infection were followed up between the time of their infection and three months later. The primary outcomes were the PCC status three months post infection and seven PCC symptoms categories (neurocognitive, autonomic, gastrointestinal, respiratory, musculoskeletal, anosmia and/or dysgeusia, and other manifestations). The main exposure variable was the type of SARS-CoV-2 variants (i.e. Alpha, Delta, and Omicron), extracted from national surveillance data. The association between the different SARS-CoV-2 variants and PCC as well as PCC symptoms categories was assessed using multivariable logistic regression. Results The proportion of PCC among participants infected during the Alpha, Delta, and Omicron-dominant periods was significantly different and respectively 50%, 50%, and 37%. Participants infected during the Alpha- and Delta-dominant periods had a significantly higher odds of having PCC than those infected during the Omicron-dominant period (OR = 1.61, 95% confidence interval [CI] = 1.33–1.96 and OR = 1.73, 95%CI = 1.54–1.93, respectively). Participants infected during the Alpha and Delta-dominant periods were more likely to report neurocognitive, respiratory, and anosmia/dysgeusia symptoms of PCC. Conclusions People infected during the Alpha- and Delta-dominant periods had a higher probability of having PCC three months after infection than those infected during the Omicron-dominant period. The lower probability of PCC with the Omicron variant must also be interpreted in absolute figures. Indeed, the number of infections with the Omicron variant being higher than with the Alpha and Delta variants, it is possible that the overall prevalence of PCC in the population increases, even if the probability of having a PCC decreases.
Læs mere Tjek på PubMedIvan Barilar, Tatiana Fernando, Christian Utpatel, Cláudio Abujate, Carla Maria Madeira, Benedita José, Claudia Mutaquiha, Katharina Kranzer, Tanja Niemann, Nalia Ismael, Leonardo de Araujo, Thierry Wirth, Stefan Niemann, Sofia Viegas
Lancet Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Pre-XDR resistance is highly prevalent among MDR Mtbc strains in Mozambique and so is bedaquiline resistance; and the frequency of bedaquiline resistance quadrupled over time and was found even in Mtbc strains without fluoroquinolone resistance. Importantly, strains with Ile491Phe mutation were frequent, accounting for 31% (n=10) of MDR plus bedaquiline-resistant strains and 54% (n=13) of XDR Mtbc strains. Given the current diagnostic algorithms and treatment regimens, both the emergence of rifampicin resistance due to Ile491Phe and bedaquiline resistance might jeopardise MDR tuberculosis prevention and care unless sequencing-based technology is rolled out.
Læs mere Tjek på PubMedJake M. Robinson, Emily F. Wissel, Martin F. Breed
Trends in Microbiology, 11.11.2023
Tilføjet 11.11.2023
The microbiota–gut–brain axis facilitates communication between the gut microbiota and the brain. It has implications for health and environmental policy. Microbiota are linked to neurological and metabolic disorders, and our exposure to health-promoting microbiota depends on environmental quality. Microbiota–gut–brain axis interventions could inform policy initiatives to address systemic health issues.
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