Aktuelle smitsomme sygdomme

Background

Mycoplasma pneumoniae respiratory infections are transmitted by aerosol and droplets in close contact.

Aim

We investigated global M. pneumoniae incidence after implementation of non-pharmaceutical interventions (NPIs) against COVID-19 in March 2020.

Methods

We surveyed M. pneumoniae detections from laboratories and surveillance systems (national or regional) across the world from 1 April 2020 to 31 March 2021 and compared them with cases from corresponding months between 2017 and 2020. Macrolide-resistant M. pneumoniae (MRMp) data were collected from 1 April 2017 to 31 March 2021.

Results

Thirty-seven sites from 21 countries in Europe, Asia, America and Oceania submitted valid datasets (631,104 tests). Among the 30,617 M. pneumoniae detections, 62.39% were based on direct test methods (predominantly PCR), 34.24% on a combination of PCR and serology (no distinction between methods) and 3.37% on serology alone (only IgM considered). In all countries, M. pneumoniae incidence by direct test methods declined significantly after implementation of NPIs with a mean of 1.69% (SD ± 3.30) compared with 8.61% (SD ± 10.62) in previous years (p < 0.01). Detection rates decreased with direct but not with indirect test methods (serology) (–93.51% vs + 18.08%; p < 0.01). Direct detections remained low worldwide throughout April 2020 to March 2021 despite widely differing lockdown or school closure periods. Seven sites (Europe, Asia and America) reported MRMp detections in one of 22 investigated cases in April 2020 to March 2021 and 176 of 762 (23.10%) in previous years (p = 0.04).

Conclusions

This comprehensive collection of M. pneumoniae detections worldwide shows correlation between COVID-19 NPIs and significantly reduced detection numbers.…

Pneumonia -- United States…

Background

Respiratory syncytial virus (RSV) is the predominant cause of clinical pneumonia among infants and young children, often peaking during the winter months in temperate regions.

Aim

To describe RSV seasonality in 13 European countries and examine its association with meteorological factors.

Methods

We included weekly RSV seasonality data from 13 European countries between week 40 2010 and week 39 2019. Using local weighted regression method, we modelled weekly RSV activity with meteorological factors using data from the 2010/11 to the 2017/18 season. We predicted the weekly RSV activity of the 2018/19 season across 41 European countries and validated our prediction using empirical data.

Results

All countries had annual wintertime RSV seasons with a longitudinal gradient in RSV onset (Pearson’s correlation coefficient, r = 0.71, 95% CI: 0.60 to 0.80). The RSV season started 3.8 weeks later (95% CI: −0.5 to 8.0) in countries in the eastern vs western parts of Europe, and the duration ranged from 8–18 weeks across seasons and countries. Lower temperature and higher relative humidity were associated with higher RSV activity, with a 14-day lag time. Through external validation, the prediction error in RSV season onset was −2.4 ± 3.2 weeks. Similar longitudinal gradients in RSV onset were predicted by our model for the 2018/19 season (r = 0.45, 95% CI: 0.16 to 0.66).

Conclusion

Meteorological factors, such as temperature and relative humidity, could be used for early warning of RSV season onset. Our findings may inform healthcare services planning and optimisation of RSV immunisation strategies in Europe.…

Use of Gram stains to select antibiotics for ventilator-associated pneumonia offers similar clinical outcomes as guideline-based broad-spectrum treatment, study reports. …

Also on the top 10 list are healthcare workers' mental health, vaccine errors, non-ventilator-associated pneumonia, emergency use authorization, and telemetry monitoring. …

Treatment of uncomplicated pediatric community-acquired pneumonia with a short, 5-day course of antibiotics results in a superior clinical response compared to the standard 10-day course. …

Background

Intensive care units (ICU) constitute a high-risk setting for antimicrobial resistance (AMR).

Aim

We aimed to describe secular AMR trends including meticillin-resistant Staphylococcus aureus (MRSA), glycopeptide-resistant enterococci (GRE), extended-spectrum cephalosporin-resistant Escherichia coli (ESCR-EC) and Klebsiella pneumoniae (ESCR-KP), carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA) from Swiss ICU. We assessed time trends of antibiotic consumption and identified factors associated with CRE and CRPA.

Methods

We analysed patient isolate and antibiotic consumption data of Swiss ICU sent to the Swiss Centre for Antibiotic Resistance (2009–2018). Time trends were assessed using linear logistic regression; a mixed-effects logistic regression was used to identify factors associated with CRE and CRPA.

Results

Among 52 ICU, MRSA decreased from 14% to 6% (p = 0.005; n = 6,465); GRE increased from 1% to 3% (p = 0.011; n = 4,776). ESCR-EC and ESCR-KP increased from 7% to 15% (p < 0.001, n = 10,648) and 5% to 11% (p = 0.002; n = 4,052), respectively. CRE, mostly Enterobacter spp., increased from 1% to 5% (p = 0.008; n = 17,987); CRPA remained stable at 27% (p = 0.759; n = 4,185). Antibiotic consumption in 58 ICU increased from 2009 to 2013 (82.5 to 97.4 defined daily doses (DDD)/100 bed-days) and declined until 2018 (78.3 DDD/100 bed-days). Total institutional antibiotic consumption was associated with detection of CRE in multivariable analysis (odds ratio per DDD: 1.01; 95% confidence interval: 1.0–1.02; p = 0.004).

Discussion

In Swiss ICU, antibiotic-resistant Enterobacterales have been steadily increasing over the last decade. The emergence of CRE, associated with institutional antibiotic consumption, is of particular concern and calls for reinforced surveillance and antibiotic stewardship in this setting.

For mild to moderate pediatric community-acquired pneumonia (CAP), treatment can be reduced to 3 days with low-dose twice-a-day amoxicillin. …

Researchers found that a "breath print" identified patients with COVID-19 pneumonia with 88% accuracy upon admission to an ICU. Other researchers are developing breath tests as well. …

This report describes two instances of fatal anthrax pneumonia in welders.

The vaccine, which received FDA approval in July, protects against 15 strains of Streptococcus pneumoniae. …

Background

Vibrio spp. are aquatic bacteria that prefer warm seawater with moderate salinity. In humans, they can cause gastroenteritis, wound infections, and ear infections. During the summers of 2018 and 2019, unprecedented high sea surface temperatures were recorded in the German Baltic Sea.

Aim

We aimed to describe the clinical course and microbiological characteristics of Vibrio infections in Germany in 2018 and 2019.

Methods

We performed an observational retrospective multi-centre cohort study of patients diagnosed with domestically-acquired Vibrio infections in Germany in 2018 and 2019. Demographic, clinical, and microbiological data were assessed, and isolates were subjected to whole genome sequencing and antimicrobial susceptibility testing.

Results

Of the 63 patients with Vibrio infections, most contracted the virus between June and September, primarily in the Baltic Sea: 44 (70%) were male and the median age was 65 years (range: 2–93 years). Thirty-eight patients presented with wound infections, 16 with ear infections, six with gastroenteritis, two with pneumonia (after seawater aspiration) and one with primary septicaemia. The majority of infections were attributed to V. cholerae (non–O1/non-O139) (n = 30; 48%) or V. vulnificus (n = 22; 38%). Phylogenetic analyses of 12 available isolates showed clusters of three identical strains of V. vulnificus, which caused wound infections, suggesting that some clonal lines can spread across the Baltic Sea.

Conclusions

During the summers of 2018 and 2019, severe heatwaves facilitated increased numbers of Vibrio infections in Germany. Since climate change is likely to favour the proliferation of these bacteria, a further increase in Vibrio-associated diseases is expected.

Equine Herpes Virus -- United StatesHerpesvirus is highly contagious among horses and can cause a variety of ailments in equids, including rhinopneumonitis (a respiratory disease usually found in young horses), abortion in broodmares, and equine herpesvirus myeloencephalitis (EHM, the neurologic form).

In many horses, the 1st or only sign of EHV-1 infection is fever, which can go undetected. In addition to fever, other common signs of EHV-1 infection in young horses include cough, decreased appetite, depression, and a nasal…

Plague -- United StatesThe Wyoming Department of Health (WDH) announced today, [Wed 15 Sep 2021], the detection of a rare but serious case of pneumonic plague in a northern Fremont County resident. Plague is a bacterial infection that can be deadly to humans and other mammals, including pets, if not treated promptly with antibacterials. This disease can be transmitted to humans from sick animals or by fleas coming from infected animals; in this case, the person had contact with sick pet cats.

Plague can also be…

Plague -- MadagascarAccording to the European Centre for Disease Prevention and Control (ECDC) report issued on 10 Sep 2021, 30 cases of pneumonic plague have been reported in the Republic of Madagascar. Pneumonic plague, one of several forms of plague, is endemic in Madagascar. The WHO previously confirmed that 7 cases have been fatal, all of them in the municipality of Miandrandra. Madagascar's last major plague outbreak was in 2017, which resulted in 209 deaths; these were classified as pneumonic…

Plague -- MadagascarA total of 7 people, including a child, died from this pneumonic plague between [25 and 30 Aug 2021], according to a Russian media report citing the local Ministry of Health. 3 patients died in a medical facility, the rest of the disease was diagnosed during a postmortem examination. Currently, 22 patients are being treated.

Cases of pneumonic plague are concentrated near the capital, in the center of the island. According to the source, the last time pneumonic plague was recorded in…

Universal vaccines won't necessarily reduce antibiotic resistance in Streptococcus pneumoniae, but they may necessitate changes in vaccine policy. …

Legionnaires' -- CanadaPublic Health is reporting one new case of Legionnaires' disease in the Moncton region as part of an outbreak declared last Friday [6 Aug 2021]. The latest case brings the total number of people ill with the severe form of pneumonia to 7. Bruce Macfarlane, a spokesperson for the Health Department, told CBC News on Thursday [12 Aug 2021] that the latest case was a person who did not live in Moncton.

Macfarlane said officials are testing cooling towers in the western part of the city with…

Anthrax -- ChinaBeijing on [Mon 9 Aug 2021] reported an anthrax pneumonia patient, who comes from Chengde in North China's Hebei Province and had contact history with cattle and sheep, and products that come from those animals. The patient was transported to Beijing via an ambulance 4 days after showing symptoms, and was later quarantined and put under treatment, the Beijing Center for Disease Control and Prevention (Beijing CDC) announced on [Mon 9 Aug 2021].

Anthrax is highly deadly if not treated…

Equine Herpes Virus -- United StatesIdaho State Department of Agriculture (ISDA) officials have confirmed an Owyhee County mare with equine herpesvirus-1 (EHV-1). 40 other horses were exposed.

On 20 Jul 2021 the affected mare was recumbent (unable to stand) and by 23 Jul 2021, she had recovered the ability to stand and walk. No other horses on her farm have shown clinical signs.

Herpesvirus is highly contagious among horses and can cause a variety of ailments in equids, including rhinopneumonitis (a respiratory disease…

Q Fever -- Chile1. Lille RD, Perrin TL, Armstrong C: An institutional outbreak of pneumonitis. III. Histopathology in man and rhesus monkeys in the pneumonitis due to the virus of "Q" fever. Pub Hlth Rep 1941; 56(4): 149-55; .2. Maurin M, Raoult D: Q fever. Clin Microbiol Rev 1999; 12(4): 518-53; .3. Norlander L: Q fever epidemiology and pathogenesis. Microbes Infect 2000; 2(4): 417-24; .

A good recent review on Q fever can be found atMelgar TA, Bauler TJ, Lutwick LI. Q fever in man: a One Health…

Legionnaires' -- United StatesResidents at an apartment building in North Portland are still getting sick with Legionnaires' disease, a severe form of pneumonia or lung infection, despite efforts to fix the building's water system.

The outbreak at Rosemont Court has dragged on for more than 6 months, and health officials don't know why. "It's really hard to pinpoint a source in this case," explained Dr. Jennifer Vines, Multnomah County Health Officer. The most recent case was disclosed just last week.

Since January…

COVID-19 -- BrazilBackground"During the validation of a highly sensitive pan-species coronavirus (CoV) semi-nested RT-PCR assay, we found canine CoV (CCoV) RNA in nasopharyngeal swabs from 8 (2.5%) of 301 patients hospitalized with pneumonia during 2017-18 in Sarawak, Malaysia. Most patients were children living in rural areas with frequent exposure to domesticated animals and wildlife.

Methods"Specimens were further studied with universal and species-specific CoV and CCoV one-step RT-PCR assays, and…

Plague -- DR CongoIn a follow-up to a report on a plague outbreak in Ituri province in northeast Democratic Republic of the Congo (DRC), officials say they are investigating a cluster of deaths due to suspected pneumonic plague were recorded in the health zone of Fataki, Ituri province. The cluster, which began on 22 Apr 2021, has resulted in 19 suspected pneumonic plague cases, including 11 deaths were recorded in 2 health areas (Bu-Kachele and Bule) of the Fataki health zone.

The patients presented with…

Introduction

The contribution of healthcare-associated infections (HAI) to mortality can be estimated using statistical methods, but mortality review (MR) is better suited for routine use in clinical settings. The European Centre for Disease Prevention and Control recently introduced MR into its HAI surveillance.

Aim

We evaluate validity and reproducibility of three MR measures.

Methods

The on-site investigator, usually an infection prevention and control doctor, and the clinician in charge of the patient independently reviewed records of deceased patients with bloodstream infection (BSI), pneumonia, Clostridioides difficile infection (CDI) or surgical site infection (SSI), and assessed the contribution to death using 3CAT: definitely/possibly/no contribution to death; WHOCAT: sole cause/part of causal sequence but not sufficient on its own/contributory cause but unrelated to condition causing death/no contribution, based on the World Health Organization’s death certificate; QUANT: Likert scale: 0 (no contribution) to 10 (definitely cause of death). Inter-rater reliability was assessed with weighted kappa (wk) and intra-cluster correlation coefficient (ICC). Reviewers rated the fit of the measures.

Results

From 2017 to 2018, 24 hospitals (11 countries) recorded 291 cases: 87 BSI, 113 pneumonia , 71 CDI and 20 SSI. The inter-rater reliability was: 3CAT wk 0.68 (95% confidence interval (CI): 0.61–0.75); WHOCAT wk 0.65 (95% CI: 0.58–0.73); QUANT ICC 0.76 (95% CI: 0.71–0.81). Inter-rater reliability ranged from 0.72 for pneumonia to 0.52 for CDI. All three measures fitted ‘reasonably’ or ‘well’ in > 88%.

Conclusion

Feasibility, validity and reproducibility of these MR measures was acceptable for use in HAI surveillance.

Background

France is a low prevalence country for colistin resistance. Molecular and epidemiological events contributing to the emergence of resistance to colistin, one of the 'last-resort' antibiotics to treat multidrug-resistant Gram-negative infections, are important to investigate.

Aim

This retrospective (2014 to 2017) observational study aimed to identify risk factors associated with acquisition of colistin-resistant Klebsiella pneumoniae (CRKP) in hospitals in Marseille, France, and to molecularly characterise clinical isolates.

Methods

To identify risk factors for CRKP, a matched-case–control (1:2) study was performed in two groups of patients with CRKP or colistin-susceptible K. pneumoniae respectively. Whole-genome-sequences (WGS) of CRKP were compared with 6,412 K. pneumoniae genomes available at the National Center for Biotechnology Information (NCBI).

Results

Multivariate analysis identified male sex and contact with a patient carrying a CRKP as significant independent factors (p < 0.05) for CRKP acquisition, but not colistin administration. WGS of nine of 14 CRKP clinical isolates belonged to the same sequence type (ST)307. These isolates were from patients who had been hospitalised in the same wards, suggesting an outbreak. Comparison of the corresponding strains’ WGS to K. pneumoniae genomes in NCBI revealed that in chromosomal genes likely playing a role in colistin resistance, a subset of five specific mutations were significantly associated with ST307 (p < 0.001).

Conclusion

A ST307 CRKP clone was identified in this study, with specific chromosomal mutations in genes potentially implicated in colistin resistance. ST307 might have a propensity to be or become resistant to colistin, however confirming this requires further investigations.

The association between obesity and in-hospital death, severe pneumonia, and intubation among those with COVID-19 increases with BMI; the link is stronger for men than women. …

COVID-19 -- IndiaWHO region (no. countries/territories):Total confirmed cases (new cases in last 24 hours) / Total deaths (new deaths in last 24 hours)----------------------------------Western Pacific Region (19): 2 224 229 (18 541) / 35 103 (185)European Region (61): 49 364 480 (156 016) / 1 037 693 (2399)South East Asia Region (10): 17 981 667 (285 133) / 239 662 (1830)Eastern Mediterranean Region (22): 8 497 014 (52 320) / 171 552 (972)Region of the Americas (54): 59 757 984 (206 984) / 1 450…

Introduction

In contrast to countries where carbapenemase-producing Enterobacterales (CPE) are endemic, only sporadic cases were reported in Switzerland until 2013. An aggravation of the epidemiological situation in neighbouring European countries indicated the need for a surveillance study in Switzerland.

Aim

We aimed to describe CPE distributions in Switzerland and identify epidemiological factors associated with changes in incidence.

Methods

Data on all human CPE isolates from 2013 to 2018 were collected by the Swiss Centre for Antibiotic Resistance (ANRESIS) and analysed for temporal and regional trends by Generalised Poisson regression. Isolates associated with infection or colonisation were included in a primary analysis; a secondary analysis included invasive isolates only. Statistical detection of regional clusters was performed with WHONET/SaTScan.

Results

We analysed 731 CPE isolates, of which 325 (44.5%) were associated with screenings and 173 (23.7%) with infections. Yearly detection of CPE isolates increased considerably during the study period from 65 to 212. The most frequently isolated species were Klebsiella pneumoniae (54%) and Escherichia coli (28%). The most frequent genotypes were OXA-48 (43%), KPC (21%) and NDM (14%). In contrast to the French-speaking parts of Switzerland (West, Geneva) where OXA-48 were the predominant genotypes (around 60%), KPC was the most frequently detected genotype in the Italian-speaking region (63%). WHONET/SaTScan outbreak detection analysis identified seven clusters in five regions of Switzerland.

Conclusions

In a first continuous surveillance of CPE in Switzerland, we found that the epidemiological situation aggravated nationwide and that regional patterns of CPE genotypes mirrored the situation in neighbouring European countries.

Respiratory Syncytial Virus -- Australia"RSV typically circulates during winter in temperate climates, much like influenza.

"It's the major cause of lung infections in children, commonly causing bronchiolitis. Symptoms of RSV include a runny nose, cough, reduced feeding and fever. Complications include wheezing and difficulty breathing, which can develop into pneumonia.

"Severe cases occasionally lead to death, predominantly in very young infants.

"Almost all children have had an RSV infection by age 2, but infants in their…

This report describes death rates for influenza and pneumonia among urban and rural counties.

Avian Influenza H5N6 -- ChinaHong Kong health officials are monitoring a human case of avian influenza A(H5N6) in Guangxi in southern China. The case involved a 50-year-old man living in Hechi in Guangxi. He developed symptoms on [16 Feb 2021] and was admitted for treatment on [17 Feb 2021] due to severe pneumonia. The patient passed away on [2 Mar 2021].

From 2014 to date, 30 human cases of avian influenza A(H5N6) have been reported by China mainland health authorities.

Avian influenza is caused by those influenza…

Equine Herpes Virus -- SpainAlready 12 horses died because of the EHV-1 outbreak in Valencia. According to the latest FEI updates, 8 horses are German.

Three German horses died in Valencia. In Germany, another 4 horses died, related to the EHV-1 outbreak in Valencia.

--Communicated by:ProMED from HealthMap Alerts

******[2]Date: Wed 17 Mar 2021Source: Horsetalk [edited]

The official toll of the European EHV-1 outbreak is now 17, with the deaths of 3 more horses in Germany, 2 in Belgium, and an…

Equine Herpes Virus -- SpainIn recent days, many cases of the equine virus EHV-1 have been identified across Europe, leading to the cancellation of several equestrian competitions. It has since been confirmed that a case has been reported in the Grand Duchy.

The Luxembourg Ministry of Agriculture announced the discovery of the 1st case to be found in the Grand Duchy on Tue 9 Mar [2021]. The Administration of Veterinary Services has stated that the virus is not transmissible from animals to humans.

In the event of…

This report describes death rates from influenza and pneumonia among persons aged ≥65 years by sex and age group.

Maricopa County Department of Public Health in Arizona investigated a cluster of two genetically similar antibiotic-resistant bacterial infections in residents of the ventilator-capable unit of a skilled nursing facility to look for health care-associated bacterial spread.

Rapid identification of a suspected case of pneumonic plague in the remote West Nile region of Uganda and the timely response by well-trained Ugandan health officials in the form of contact tracing, antibiotic prophylaxis, and community education prevented any additional cases of plague from occurring.

In December of 2018, Wyoming identified the state's first case of carbapenem-resistant Enterobacteriaceae (CRE) containing mcr-1, which is a gene that can make bacteria resistant to colistin, a drug that can be the last resort for some multidrug-resistant infections like CRE.

During July and August 2019, five patients were identified at two hospitals in North Carolina with acute lung injury potentially associated with e-cigarette use.

On December 31, 2018, Public Health --- Seattle & King County (PHSKC) was notified by the Antibiotic Resistance Laboratory Network regarding a carbapenem-resistant Klebsiella pneumoniae (CR-Kp) isolate cultured from the urinary tract in a man aged 65 years.

In 2018, CDC was notified about students hospitalized for pneumonia of unknown etiology after returning from Mexico.