47 ud af 47 tidsskrifter valgt, søgeord (pneumoni) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
325 emner vises.
151
Ceragenin-coated endotracheal tubes for the reduction of ventilator-associated pneumonia: a prospective, longitudinal, cross-over, interrupted time, implementation study protocol (CEASE VAP study)
Symonds, N. E., Meng, E. X. M., Boyd, J. G., Boyd, T., Day, A., Hobbs, H., Maslove, D. M., Norman, P. A., Semrau, J. S., Sibley, S., Muscedere, J.
BMJ Open, 3.02.2024
Tilføjet 3.02.2024
BackgroundCritically ill patients are at high risk of acquiring ventilator-associated pneumonia (VAP), which occurs in approximately 20% of mechanically ventilated patients. VAP results either from aspiration of pathogen-contaminated oropharyngeal secretions or contaminated biofilms that form on endotracheal tubes (ETTs) after intubation. VAP results in increased duration of mechanical ventilation, increased intensive care unit and hospital length of stay, increased risk of death and increased healthcare costs. Because of its impact on patient outcomes and the healthcare system, VAP is regarded as an important patient safety issue and there is an urgent need for better evidence on the efficacy of prevention strategies. Modified ETTs that reduce aspiration of oropharyngeal secretions with subglottic secretion drainage or reduce the occurrence of biofilm with a coating of ceragenins (CSAs) are available for clinical use in Canada. In this implementation study, we will evaluate the efficacy of these two types of Health Canada-licensed ETTs on the occurrence of VAP, and impact on patient-centred outcomes. MethodsIn this ongoing, pragmatic, prospective, longitudinal, interrupted time, cross-over implementation study, we will compare the efficacy of a CSA-coated ETT (CeraShield N8 Pharma) with an ETT with subglottic secretion drainage (Taper Guard, Covidien). The study periods consist of four alternating time periods of 11 or 12 weeks or a total of 23 weeks for each ETT. All patients intubated with the study ETT in each time period will be included in an intention-to-treat analysis. Outcomes will include VAP incidence, mortality and health services utilisation including antibiotic use and length of stay. Ethics and disseminationThis study has been approved by the Health Sciences Research Ethics Board at Queen’s University. The results of this study will be actively disseminated through manuscript publication and conference presentations. Trial registration numberNCT05761613.
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152
Right Atrial Angiosarcoma with Embolic Lung Metastases Masquerading as Atypical Pneumonitis
Chung-Fu Lin, Yu-Wei Wu, Wei-An Liao, Chia-Ying Lin, Ying-Tzu Huang, Tang-Hsiu Huang
American Journal of Respiratory and Critical Care Medicine , 2.02.2024
Tilføjet 2.02.2024
American Journal of Respiratory and Critical Care Medicine, Volume 209, Issue 3, Page 325-328, February 1, 2024.
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153
A regimen based on the combination of trimethoprim/sulfamethoxazole with caspofungin and corticosteroids as a first-line therapy for patients with severe non-HIV-related pneumocystis jirovecii pneumonia: a retrospective study in a tertiary hospital
BMC Infectious Diseases, 1.02.2024
Tilføjet 1.02.2024
Abstract Background Pneumocystis jirovecii pneumonia (PJP) is a life-threatening and severe disease in immunocompromised hosts. A synergistic regimen based on the combination of sulfamethoxazole-trimethoprim (SMX-TMP) with caspofungin and glucocorticosteroids (GCSs) may be a potential first-line therapy for PJP. Therefore, it is important to explore the efficacy and safety of this synergistic therapy for treating non-HIV-related PJP patients. Methods We retrospectively analysed the data of 38 patients with non-HIV-related PJP at the First Affiliated Hospital of Xi’an Jiaotong University. Patients were divided into two groups: the synergistic therapy group (ST group, n = 20) and the monotherapy group (MT group, n = 18). All patients were from the ICU and were diagnosed with severe PJP. In the ST group, all patients were treated with SMX-TMP (TMP 15–20 mg/kg per day) combined with caspofungin (70 mg as the loading dose and 50 mg/day as the maintenance dose) and a GCS (methylprednisolone 40–80 mg/day). Patients in the MT group were treated only with SMX-TMP (TMP 15–20 mg/kg per day). The clinical response, adverse events and mortality were compared between the two groups. Results The percentage of patients with a positive clinical response in the ST group was significantly greater than that in the MT group (100.00% vs. 66.70%, P = 0.005). The incidence of adverse events in the MT group was greater than that in the ST group (50.00% vs. 15.00%, P = 0.022). Furthermore, the dose of TMP and duration of fever in the ST group were markedly lower than those in the MT group (15.71 mg/kg/day vs. 18.35 mg/kg/day (P = 0.001) and 7.00 days vs. 11.50 days (P = 0.029), respectively). However, there were no significant differences in all-cause mortality or duration of hospital stay between the MT group and the ST group. Conclusions Compared with SMZ/TMP monotherapy, synergistic therapy (SMZ-TMP combined with caspofungin and a GCS) for the treatment of non-HIV-related PJP can increase the clinical response rate, decrease the incidence of adverse events and shorten the duration of fever. These results indicate that synergistic therapy is effective and safe for treating severe non-HIV-related PJP.
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154
Clinical use of tigecycline may contribute to the widespread dissemination of carbapenem-resistant hypervirulent Klebsiella pneumoniae strains
Miaomiao XieLianwei YeKaichao ChenQi XuChen YangXiangnan ChenEdward Wai-Chi ChanFuyong LiSheng Chena Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kongb Department of Food Science and Nutrition, Faculty of Science, The Hong Kong Polytechnic University, Kowloon, Hong Kongc State Key Lab of Chemical Biology and Drug Discovery, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Kowloon, Hong Kong
Emerg Microbes Infect, 31.01.2024
Tilføjet 31.01.2024
155
Assessment of BlaTEM, BlaSHV, and BlaCTX-M genes of antibiotic resistance in Gram-negative bacilli causing urinary tract infections in Khartoum State: a cross-sectional study
BMC Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
Abstract Background Gram-negative bacilli are the most common etiological agents responsible for urinary tract infections. The prevalence of antibiotic resistance in Gram-negative bacilli is increasing at a rapid pace globally, which is constraining the available choices for UTI treatment. The objectives of this study are to identify the most common causal organisms of urinary tract infections (UTIs), and to determine their drug resistance patterns. Materials and methods This was a cross-sectional hospital-based study conducted at El-Amal Hospital, Bahri Teaching Hospital, and Al-Baraha Hospital, Khartoum State, from March to October 2022. Urine samples from patients suspected to have UTI were collected, and patients with confirmed UTI by laboratory investigations and yielded culture growth were enrolled. Antibiotic sensitivity testing and PCR testing of the blaTEM, blaSHV, and blaCTX-M genes were done. Results This study included 50 patients with UTI out of 229 suspected patients (21.8%). The most prominent group of patients was older than 60 years (40%); the majority were females (70%). Escherichia coli was the most prevalent isolated organism (50%), followed by Klebsiella oxytoca (24%), Klebsiella pneumoniae (20%), Pseudomonas aeruginosa (4%), and Citrobacter freundii (2%). A small percentage of organisms were resistant to colistin (17%). However, 77% were resistant to amikacin, 97.6% to cefotaxime, 96.8% to ceftazidime, 97.6% to ceftriaxone, 96.8% to cefixime, 87.6% to ciprofloxacin, 88.4% to gentamycin, 62% to imipenem, 67.6% to meropenem, 87.6% to norfloxacin, and 95.6% to trimethoprim. The overall resistance of isolated gram-negative organisms was 81%. The most prevalent gene for the resistance was blaTEM (100%), followed by blaCTX-M (94%), and then blaSHV (84%). Conclusion Escherichia coli and Klebsiella species were the most commonly isolated uropathogens in this study, and the majority were highly resistant to most of the antimicrobial agents tested. Resistance genes blaTEM, blaCTX-M, and blaSHV are very common in uropathogens.
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156
In vivo evolution of a Klebsiella pneumoniae capsule defect with wcaJ mutation promotes complement-mediated opsono-phagocytosis during recurrent infection
Journal of Infectious Diseases, 29.01.2024
Tilføjet 29.01.2024
Abstract Background Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) bloodstream infections are associated with high mortality. We studied clinical bloodstream KPC-Kp isolates to investigate mechanisms of resistance to complement, a key host defense against bloodstream infection.Methods We tested growth of KPC-Kp isolates in human serum. In serial isolates from a single patient, we performed whole genome sequencing and tested for complement resistance and binding by mixing study, direct ELISA, flow cytometry, and electron microscopy. We utilized an isogenic deletion mutant in phagocytosis assays and an acute lung infection model.Results We found serum resistance in 16 of 59 (27%) KPC-Kp clinical bloodstream isolates. In five genetically-related bloodstream isolates from a single patient, we noted a loss-of-function mutation in the capsule biosynthesis gene, wcaJ. Disruption of wcaJ was associated with decreased polysaccharide capsule, resistance to complement-mediated killing, and surprisingly, increased binding of complement proteins. Furthermore, an isogenic wcaJ deletion mutant exhibited increased opsono-phagocytosis in vitro and impaired in vivo control in the lung after airspace macrophage depletion in mice.Conclusions Loss of function in wcaJ led to increased complement resistance, complement binding, and opsono-phagocytosis, which may promote KPC-Kp persistence by enabling co-existence of increased bloodstream fitness and reduced tissue virulence.
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157
Clinical relevance, mechanisms and evolution of polymyxin B heteroresistance carbapenem-resistant Klebsiella pneumoniae: a genomic, retrospective cohort study
Qixia Luo, Linna Xu, Yuan Wang, Hao Fu, Tingting Xiao, Wei Yu, Wangxiao Zhou, Kanghui Zhang, Jiaying Shen, Jinru Ji, Chaoqun Ying, Yonghong Xiao
Clinical Microbiology and Infection, 29.01.2024
Tilføjet 29.01.2024
To study the clinical relevance, mechanisms, and evolution of polymyxin B (POLB) heteroresistance in carbapenem-resistant Klebsiella pneumoniae (PHR-CRKP), potentially leading to a significant rise in POLB full resistant (FR) CRKP.
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158
Carbapenem-resistant Klebsiella pneumoniae bloodstream infections in haematological malignances and hematopoietic stem cell transplantation: Clinical impact of combination therapy in a 10-year Brazilian cohort
Ingvar Ludwig Augusto de Souza, Paola Cappellano, Diogo Boldim Ferreira, Maria Daniela Bergamasco, Thomas Cardoso das Chagas Neto, Fabio Rodrigues Kerbauy, Otavio Carvalho Guimarães Baiocchi, Antonio Carlos Campos Pignatari
PLoS One Infectious Diseases, 27.01.2024
Tilføjet 27.01.2024
by Ingvar Ludwig Augusto de Souza, Paola Cappellano, Diogo Boldim Ferreira, Maria Daniela Bergamasco, Thomas Cardoso das Chagas Neto, Fabio Rodrigues Kerbauy, Otavio Carvalho Guimarães Baiocchi, Antonio Carlos Campos Pignatari Bacterial bloodstream infections (BSI) are a common threat among patients with haematological malignancies (HM) and hematopoietic stem cell transplant recipients (HSCT). The purpose of this research was to describe clinical and microbiological aspects of BSI caused by carbapenem-resistant Klebsiella pneumoniae (CRKp) and assess risk factors associated with 30-day mortality in a 10-year cohort of haematological patients. A total of 65 CRKp-BSI episodes occurring in HM patients and HSCT recipients and CRKp-BSI between January 2010 and December 2019 were retrospectively studied. Acute leukemias were the most frequently observed underlying disease (87.7%) and 18 patients (27.7%) received HSCT. Mucosal barrier injury in the gastrointestinal tract was the primary cause of bacteremia (86.1%). Also, 14 individuals (21.6%) had an Invasive Fungal Disease (IFD) throughout the episode. Regarding treatment, in 31 patients (47.7%) empirical therapy was deemed appropriate, whereas 33 (50.8%) patients received a combination therapy. Microbiological data revealed that the majority of isolates (53–58%) had the Polymyxin B co-resistance phenotype, while amikacin resistance was less common (16 samples, or 24.7%). The mortality rates at 14 and 30 days were 32.3% and 36.9%, respectively. In a multivariate Cox regression analysis, prompt appropriate antibiotic administration within three days was associated with a better outcome (Adjusted Hazard Ratio [aHR]: 0.33; 95% Confidence Interval [CI]: 0.14–0.76; p = 0.01), whereas hypotension at presentation (aHR: 3.88; 95% CI: 1.40–10.74; p = 0.01) and concurrent IFD (aHR: 2.97; 95% CI: 1.20–7.37; p = 0.02) were independently associated with death within 30 days. Additionally, a favorable correlation between combination therapy and overall survival was found (aHR: 0.18; 95%CI: 0.06–0.56; p = 0.002). In conclusion, 30-day mortality CRKp-BSI was elevated and most of the isolates were polymyxin B resistant. Early appropriate antimicrobial treatment and the use of combination therapy were linked to a better outcome.
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159
Volatile organic compounds in headspace characterize isolated bacterial strains independent of growth medium or antibiotic sensitivity
Kim F. H. Hintzen, Lionel Blanchet, Agnieszka Smolinska, Marie-Louise Boumans, Ellen E. Stobberingh, Jan W. Dallinga, Tim Lubbers, Frederik-Jan van Schooten, Agnes W. Boots
PLoS One Infectious Diseases, 27.01.2024
Tilføjet 27.01.2024
by Kim F. H. Hintzen, Lionel Blanchet, Agnieszka Smolinska, Marie-Louise Boumans, Ellen E. Stobberingh, Jan W. Dallinga, Tim Lubbers, Frederik-Jan van Schooten, Agnes W. Boots Introduction Early and reliable determination of bacterial strain specificity and antibiotic resistance is critical to improve sepsis treatment. Previous research demonstrated the potential of headspace analysis of volatile organic compounds (VOCs) to differentiate between various microorganisms associated with pulmonary infections in vitro. This study evaluates whether VOC analysis can also discriminate antibiotic sensitive from resistant bacterial strains when cultured on varying growth media. Methods Both antibiotic-sensitive and -resistant strains of Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella pneumonia were cultured on 4 different growth media, i.e. Brain Heart Infusion, Marine Broth, Müller-Hinton and Trypticase Soy Agar. After overnight incubation at 37°C, the headspace air of the cultures was collected on stainless steel desorption tubes and analyzed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). Statistical analysis was performed using regularized multivariate analysis of variance and cross validation. Results The three bacterial species could be correctly recognized based on the differential presence of 14 VOCs (p
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160
Multiplex real-time PCR FilmArray performance in the diagnosis of meningoencephalitis: lights and shadows
Infection, 27.01.2024
Tilføjet 27.01.2024
Abstract Purpose We aimed to evaluate the performance of the FilmArray (FA) meningitis/encephalitis (ME) panel. Secondarily, we analyzed the false positive (FP) and false negative (FN) results, as well as the predictive values of the technique, regarding the cerebrospinal fluid (CSF) characteristics. Methods FA is a multiplex real-time PCR detecting 14 of the most common ME pathogens in CSF. All FA performed at our hospital (2018–2022) were retrospectively reviewed. FA was compared to conventional techniques and its performance was assessed based on the final diagnosis of the episode. Results FA was performed in 313 patients with suspicion of ME. Most patients had altered mental status (65.2%) and fever (61%). Regarding CSF characteristics, 49.8% and 53.7% presented high CSF proteins and pleocytosis, respectively. There were 84 (26.8%) positive FA results, mainly for HSV-1 (10.9%), VZV (5.1%), Enterovirus (2.6%), and S. pneumoniae (1.9%). In the 136 cases where both FA and routine methods were performed, there was a 25.7% lack of agreement. We identified 6.6% FN results, but 28.6% FP, mainly due to HSV-1. This resulted in a high negative predictive value (NPV) of 93.4%, but a positive predictive value (PPV) of 73%. Remarkably, PPV as low as 36.9%, and 70.2%, were found in cases without pleocytosis, or lack of high CSF protein levels, respectively. Conclusion FA was associated with high NPV, but frequent FP results and low PPV, particularly for HSV-1, and especially in patients without high CSF protein levels or pleocytosis.
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161
2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia
Chaudhuri, Dipayan; Nei, Andrea M.; Rochwerg, Bram; Balk, Robert A; Asehnoune, Karim; Cadena, Rhonda; Carcillo, Joseph A.; Correa, Ricardo; Drover, Katherine; Esper, Annette M.; Gershengorn, Hayley B.; Hammond, Naomi E.; Jayaprakash, Namita; Menon, Kusum; Nazer, Lama; Pitre, Tyler; Qasim, Zaffer A.; Russell, James A.; Santos, Ariel P.; Sarwal, Aarti; Spencer-Segal, Joanna; Tilouche, Nejla; Annane, Djillali; Pastores, Stephen M.
Critical Care Medicine, 27.01.2024
Tilføjet 27.01.2024
Rationale: New evidence is available examining the use of corticosteroids in sepsis, acute respiratory distress syndrome (ARDS) and community-acquired pneumonia (CAP), warranting a focused update of the 2017 guideline on critical illness-related corticosteroid insufficiency. Objectives: To develop evidence-based recommendations for use of corticosteroids in hospitalized adults and children with sepsis, ARDS, and CAP. Panel Design: The 22-member panel included diverse representation from medicine, including adult and pediatric intensivists, pulmonologists, endocrinologists, nurses, pharmacists, and clinician-methodologists with expertise in developing evidence-based Clinical Practice Guidelines. We followed Society of Critical Care Medicine conflict of interest policies in all phases of the guideline development, including task force selection and voting. Methods: After development of five focused Population, Intervention, Control, and Outcomes (PICO) questions, we conducted systematic reviews to identify the best available evidence addressing each question. We evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach and formulated recommendations using the evidence-to-decision framework. Results: In response to the five PICOs, the panel issued four recommendations addressing the use of corticosteroids in patients with sepsis, ARDS, and CAP. These included a conditional recommendation to administer corticosteroids for patients with septic shock and critically ill patients with ARDS and a strong recommendation for use in hospitalized patients with severe CAP. The panel also recommended against high dose/short duration administration of corticosteroids for septic shock. In response to the final PICO regarding type of corticosteroid molecule in ARDS, the panel was unable to provide specific recommendations addressing corticosteroid molecule, dose, and duration of therapy, based on currently available evidence. Conclusions: The panel provided updated recommendations based on current evidence to inform clinicians, patients, and other stakeholders on the use of corticosteroids for sepsis, ARDS, and CAP.
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162
Executive Summary: Guidelines on Use of Corticosteroids in Critically Ill Patients With Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia Focused Update 2024
Chaudhuri, Dipayan; Nei, Andrea M.; Rochwerg, Bram; Balk, Robert A.; Asehnoune, Karim; Cadena, Rhonda S.; Carcillo, Joseph A.; Correa, Ricardo; Drover, Katherine; Esper, Annette M.; Gershengorn, Hayley B.; Hammond, Naomi E.; Jayaprakash, Namita; Menon, Kusum; Nazer, Lama; Pitre, Tyler; Qasim, Zaffer A.; Russell, James A.; Santos, Ariel P.; Sarwal, Aarti; Spencer-Segal, Joanna; Tilouche, Nejla; Annane, Djillali; Pastores, Stephen M.
Critical Care Medicine, 27.01.2024
Tilføjet 27.01.2024
163
Multiplex real-time PCR FilmArray performance in the diagnosis of meningoencephalitis: lights and shadows
Infection, 25.01.2024
Tilføjet 25.01.2024
Abstract Purpose We aimed to evaluate the performance of the FilmArray (FA) meningitis/encephalitis (ME) panel. Secondarily, we analyzed the false positive (FP) and false negative (FN) results, as well as the predictive values of the technique, regarding the cerebrospinal fluid (CSF) characteristics. Methods FA is a multiplex real-time PCR detecting 14 of the most common ME pathogens in CSF. All FA performed at our hospital (2018–2022) were retrospectively reviewed. FA was compared to conventional techniques and its performance was assessed based on the final diagnosis of the episode. Results FA was performed in 313 patients with suspicion of ME. Most patients had altered mental status (65.2%) and fever (61%). Regarding CSF characteristics, 49.8% and 53.7% presented high CSF proteins and pleocytosis, respectively. There were 84 (26.8%) positive FA results, mainly for HSV-1 (10.9%), VZV (5.1%), Enterovirus (2.6%), and S. pneumoniae (1.9%). In the 136 cases where both FA and routine methods were performed, there was a 25.7% lack of agreement. We identified 6.6% FN results, but 28.6% FP, mainly due to HSV-1. This resulted in a high negative predictive value (NPV) of 93.4%, but a positive predictive value (PPV) of 73%. Remarkably, PPV as low as 36.9%, and 70.2%, were found in cases without pleocytosis, or lack of high CSF protein levels, respectively. Conclusion FA was associated with high NPV, but frequent FP results and low PPV, particularly for HSV-1, and especially in patients without high CSF protein levels or pleocytosis.
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164
Research - Multiple Introductions of Yersinia pestis during Urban Pneumonic Plague Epidemic, Madagascar, 2017
Emerging Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
Research - Multiple Introductions of Yersinia pestis during Urban Pneumonic Plague Epidemic, Madagascar, 2017
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165
Study protocol: infectious diseases consortium (I3D) for study on integrated and innovative approaches for management of respiratory infections: respiratory infections research and outcome study (RESPIRO)
BMC Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
Abstract Background Community-acquired respiratory infections are a leading cause of illness and death globally. The aetiologies of community-acquired pneumonia remain poorly defined. The RESPIRO study is an ongoing prospective observational cohort study aimed at developing pragmatic logistical and analytic platforms to accurately identify the causes of moderate-to-severe community-acquired pneumonia in adults and understand the factors influencing disease caused by individual pathogens. The study is currently underway in Singapore and has plans for expansion into the broader region. Methods RESPIRO is being conducted at three major tertiary hospitals in Singapore. Adults hospitalised with acute community-acquired pneumonia or lower respiratory tract infections, based on established clinical, laboratory and radiological criteria, will be recruited. Over the course of the illness, clinical data and biological samples will be collected longitudinally and stored in a biorepository for future analysis. Discussion The RESPIRO study is designed to be hypothesis generating, complementary to and easily integrated with other research projects and clinical trials. The detailed clinical database and biorepository will yield insights into the epidemiology and outcomes of community-acquired lower respiratory tract infections in Singapore and the surrounding region and offers the opportunity to deeply characterise the microbiology and immunopathology of community-acquired pneumonia.
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166
An analysis of differences in Carbapenem-resistant Enterobacterales in different regions: a multicenter cross-sectional study
BMC Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
Abstract Objective This study aimed to explore the characteristics of carbapenem-resistant Enterobacterales (CRE) patients in the intensive care unit (ICU) in different regions of Henan Province to provide evidence for the targeted prevention and treatment of CRE. Methods This was a cross-sectional study. CRE screening was conducted in the ICUs of 78 hospitals in Henan Province, China, on March 10, 2021. The patients were divided into provincial capital hospitals and nonprovincial capital hospitals for comparative analysis. Results This study involved 1009 patients in total, of whom 241 were CRE-positive patients, 92 were in the provincial capital hospital and 149 were in the nonprovincial capital hospital. Provincial capital hospitals had a higher rate of CRE positivity, and there was a significant difference in the rate of CRE positivity between the two groups. The body temperature; immunosuppressed state; transfer from the ICU to other hospitals; and use of enemas, arterial catheters, carbapenems, or tigecycline at the provincial capital hospital were greater than those at the nonprovincial capital hospital (P
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167
Effect of COVID-19 on infections associated with medical devices in critical care
BMC Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
Abstract Objectives This study explores the hypothesis that COVID-19 patients are at a heightened risk of healthcare-associated infections (HAIs) associated with medical device usage compared to non-COVID-19 patients. Our primary objective was to investigate the correlation between COVID-19 infection in ICU patients and subsequent HAIs following invasive medical device insertion. Additionally, we aim to assess the impact of SARS-CoV-2 infection on onset times concerning specific microorganisms and the type of medical device, providing valuable insights into this intricate relationship in intensive care settings. Methodology A retrospective cohort study was conducted using ICU patient records at our hospital from 2020 to 2022. This investigation entailed evaluating the timing of HAIs while distinguishing between patients with and without SARS-CoV-2 infection. We identified and analyzed the type of isolation and infection attributed to the medical device while controlling for ICU duration and ventilator days using Cox regression. Results Our study included 127 patients without SARS-CoV-2 infection and 140 patients with SARS-CoV-2 infection. The findings indicated a higher incidence of HAI caused by various microorganisms associated with any medical device in patients with SARS-CoV-2 (HR = 6.86; 95% CI-95%: 3.26–14.43; p
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168
Daptomycin pharmacokinetic/pharmacodynamic target in staphylococcal infections
Clinical Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
169
Is a high baseline inflammatory burden the major driver in causing daptomycin-induced eosinophilic pneumonia and muscular toxicity?
Clinical Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
170
Pathology and monkeypox virus localization in tissues from immunocompromised patients with severe or fatal mpox
Journal of Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
Abstract Background Pathology and monkeypox virus (MPXV) tissue tropism in severe and fatal human mpox is not thoroughly described but can help elucidate the disease pathogenesis and the role of coinfections in immunocompromised patients.Methods We analyzed biopsy and autopsy tissues from 22 patients with severe or fatal outcomes to characterize pathology and viral antigen and DNA distribution in tissues by immunohistochemistry and in situ hybridization. Tissue-based testing for coinfections was also performed.Results Mucocutaneous lesions showed necrotizing and proliferative epithelial changes. Deceased patients with autopsy tissues evaluated had digestive tract lesions, and half had systemic tissue necrosis with thrombotic vasculopathy in lymphoid tissues, lung, or other solid organs. Half also had bronchopneumonia, and one-third had acute lung injury. All cases had MPXV antigen and DNA detected in tissues. Coinfections were identified in 5/16 (31%) biopsy and 4/6 (67%) autopsy cases.Discussion Severe mpox in immunocompromised patients is characterized by extensive viral infection of tissues and viremic dissemination that can progress despite available therapeutics. Digestive tract and lung involvement are common and associated with prominent histopathological and clinical manifestations. Coinfections may complicate mpox diagnosis and treatment. Significant viral DNA (likely correlating to infectious virus) in tissues necessitates enhanced biosafety measures in healthcare and autopsy settings.
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171
Uncovering the burden of Influenza in children in Portugal, 2008–2018
BMC Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
Abstract Background Despite their higher risk of developing severe disease, little is known about the burden of influenza in Portugal in children aged
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172
Cost-effectiveness of linezolid to ventilator-associated pneumonia in Colombia
BMC Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
Introduction Ventilator-associated pneumonia (VAP) is a prominent cause of morbidity and mortality in intensive care unit (ICU) patients. Due to the increase in Methicillin resistant Staphylococcus aureus infection, it is important to consider other more effective and safer alternatives compared to vancomycin. This motivates evaluating whether the use of an apparently more expensive drug such as linezolid can be cost-effective in Colombia. Methods A decision tree was used to simulate the results in terms of the cost and proportion of cured patients. In the simulation, patients can receive antibiotic treatment with linezolid (LZD 600 mg IV/12 h) or vancomycin (VCM 15 mg/kg iv/12 h) for 7 days, patients they can experience events adverse (renal failure and thrombocytopenia). The model was analyzed probabilistically, and a value of information analysis was conducted to inform the value of conducting further research to reduce current uncertainties in the evidence base. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of US$5180. Results The mean incremental cost of LZD versus VCM is US$-517. This suggests that LZD is less costly. The proportion of patients cured when treated with LZD compared with VCM is 53 vs. 43%, respectively. The mean incremental benefit of LZD versus VCM is 10 This position of absolute dominance (LZD has lower costs and higher proportion of clinical cure than no supplementation) is unnecessary to estimate the incremental cost-effectiveness ratio. There is uncertainty with a 0.999 probability that LZD is more cost-effective than VCM. Our base‐case results were robust to variations in all assumptions and parameters. Conclusion LNZ is a cost-effective strategy for patients, ≥ 18 years of age, with VAP in Colombia- Our study provides evidence that can be used by decision-makers to improve clinical practice guidelines.
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173
Pneumocystis jirovecii pneumonia in people living with HIV: a review
Emily G. McDonaldAvideh AfsharBander AssiriTom BoylesJimmy M. HsuNinh KhuongConnor ProstyMiranda SoZahra N. SohaniGuillaume Butler-LaporteTodd C. Lee1Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada2Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada3Canadian Medication Appropriateness and Deprescribing Network, Montreal, Quebec, Canada4Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada5Right to Care, NPC, Centurion, South Africa6London School of Hygiene and Tropical Medicine, London, United Kingdom7Sinai Health System-University Health Network Antimicrobial Stewardship Program, University of Toronto, Toronto, Canada8Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada9Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada, Graeme N. Forrest
Clinical Microbiology Reviews, 18.01.2024
Tilføjet 18.01.2024
174
D-dimer levels to exclude pulmonary embolism and reduce the need for CT angiography in COVID-19 in an outpatient population
Anita Kovács, Dóra Hantosi, Nikoletta Szabó, Annamária Letoha, Csaba Lengyel, Imre Földesi, Katalin Burián, András Palkó, Dániel Veréb, Zsigmond Tamás Kincses
PLoS One Infectious Diseases, 18.01.2024
Tilføjet 18.01.2024
by Anita Kovács, Dóra Hantosi, Nikoletta Szabó, Annamária Letoha, Csaba Lengyel, Imre Földesi, Katalin Burián, András Palkó, Dániel Veréb, Zsigmond Tamás Kincses Objectives Emerging results indicate that, in COVID-19, thromboembolic complications contribute to the high mortality and morbidity. Previous research showed that the prevalence of pulmonary embolism (PE) is between 25–50% in COVID-19 patients, however, most of these reports are based on data from patients with severe pneumonia, treated in intensive care units. Materials and methods We conducted a retrospective, single-center, observational study to estimate the prevalence of PE in COVID-19 patients who underwent CT angiography and to identify the most important predictors.Adult outpatients with COVID-19, who presented at our COVID Outpatient Clinic between 1st and 31st of March in 2021 and underwent CTA examination were included in this study. Multiple linear regression analysis was used to identify predictors of PE in COVID-19 patients. The predictors were: age, gender, disease duration, CT severity index and log-transformed quantitative D-dimer (logQDDIM) value. Results 843 COVID-19 patients were included into the study. 82.56% (693 patients) of the infected patients had a pulmonary CTA examination and D-dimer levels (mean age: 59.82 years ± 15.66). 7.61% (53 patients) of the patients had PE. 2.02% (14 patients) of the patients had main branch or lobar PE.The multiple regression analysis found that only logQDDIM was a significant predictor. A logQDDIM cut-off value of 0.0169 (1.0171 ug/ml serum D-dimer) predicted PE with 99% sensitivity (p
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175
A Phase 3 Randomized Study to Evaluate Safety and Immunogenicity of 20-Valent Pneumococcal Conjugate Vaccine in Healthy Japanese Infants
Yasunori Ishihara, Mitsuru Fukazawa, Shinya Enomoto, Richard de Solom, Masako Yamaji, Mary Kline, Masakazu Aizawa, Yahong Peng, Osamu Kogawara, Peter C. Giardina, Noor Tamimi, William C. Gruber, Wendy Watson
International Journal of Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
Streptococcus pneumoniae is a leading cause of bacteremia, bacterial meningitis, pneumonia, and acute otitis media [1–3]. Serious pneumococcal disease may occur at any age; however, children
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176
Occurrence and characteristics of extended-spectrum-β-lactamase- and pAmpC-producing Klebsiella pneumoniae isolated from companion animals with urinary tract infections
Megan Min Yi Lee, Nan-Ling Kuan, Zhi-Yi Li, Kuang-Sheng Yeh
PLoS One Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
by Megan Min Yi Lee, Nan-Ling Kuan, Zhi-Yi Li, Kuang-Sheng Yeh This study examined 70 Klebsiella pneumoniae isolates derived from companion animals with urinary tract infections in Taiwan. Overall, 81% (57/70) of the isolates carried extended-spectrum β-lactamase (ESBL) and/or plasmid-encoded AmpC (pAmpC) genes. ESBL genes were detected in 19 samples, with blaCTX-M-1, blaCTX-M-9, and blaSHV being the predominant groups. pAmpC genes were detected in 56 isolates, with blaCIT and blaDHA being the predominant groups. Multilocus sequence typing revealed that sequence types (ST)11, ST15, and ST655 were prevalent. wabG, uge, entB, mrkD, and fimH were identified as primary virulence genes. Two isolates demonstrated a hypermucoviscosity phenotype in the string test. Antimicrobial susceptibility testing exhibited high resistance to β-lactams and fluoroquinolones in ESBL-positive isolates but low resistance to aminoglycosides, sulfonamides, and carbapenems. Isolates carrying pAmpC genes exhibited resistance to penicillin-class β-lactams. These findings provide valuable insights into the role of K. pneumoniae in the context of the concept of One Health.
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177
Streptococcus pneumoniae secretion chaperones PrsA, SlrA, and HtrA are required for competence, antibiotic resistance, colonization, and invasive disease
Jada L. GeorgeCharles AgbavorLeah F. CaboLaty A. Cahoon1Department of Biological Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, Kimberly A. Kline
Infection and Immunity, 16.01.2024
Tilføjet 16.01.2024
178
Publisher Correction: Psittacosis caused severe community-acquired pneumonia accompanied by acute hypoxic respiratory failure: a multicenter retrospective cohort study from China
BMC Infectious Diseases, 15.01.2024
Tilføjet 15.01.2024
179
Shorter antitubercular therapy for extrapulmonary tuberculosis - a case report
BMC Infectious Diseases, 15.01.2024
Tilføjet 15.01.2024
Abstract Introduction Extrapulmonary tuberculosis (EPTB) adds to India’s significant economic burden, with pericardial effusion being a potentially fatal complication. This case report highlights the need for early diagnosis and the feasibility of shorter-duration treatment for EPTB in developing countries. Presentation This case report describes a 19-year-old male from Southeast Asia who had a history of bronchiectasis involving the left lower lobe and the right middle lobe, which was cystic in nature, as well as multiple episodes of non-tuberculous pneumonia. Currently, he presented with fever, hypotension, tachycardia, and acute kidney injury. Echocardiogram showed left ventricular dysfunction with a left ventricular ejection fraction (LVEF) of 45% and moderate pericardial effusion. Early signs of cardiac tamponade were noted, specifically the absence of respiratory variation in the right ventricle and left ventricle collapse. Emergent pericardiocentesis was performed, and hemorrhagic pericardial fluid was aspirated. Fluid analysis revealed high levels of LDH (5000 U/L), polymorphonuclear leukocytosis, and acid-fast bacilli that were visualized on microscopy, which led to the diagnosis of pericardial tuberculosis. A CT of the abdomen showed hepatosplenomegaly and polyserositis. Empirically, antitubercular therapy consisting of isoniazid, rifampin, pyrazinamide, and ethambutol was administered for 2 months and isoniazid along with rifampicin was given for the next 4 months. Serial echocardiograms in the following months showed an improvement in LVEF (55%) and decreased effusion. However, during this treatment period, due to frequent episodes of pneumonia, the evaluation of immunodeficiency disorders was performed and revealed low levels of IgG (4.741 g/L), IgA (0.238 g/L), and IgM (0.098 g/L). He was diagnosed with common variable immunodeficiency disease and received intravenous immunoglobulin therapy. Conclusion This report emphasizes the timely identification of cardiac tamponade and the effective management of EPTB through a shorter-than-recommended course of antitubercular therapy, resulting in the alleviation of symptoms and better overall health outcomes.
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180
Retrospective database analysis for clinical diagnoses commonly associated with pneumococcal diseases in the Malaysian healthcare system over a 3-year period (2013–2015)
BMC Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
Abstract Background Pneumococcal disease caused by Streptococcus pneumoniae is an important cause of morbidity and mortality across all ages, particularly in younger children and older adults. Here, we describe pneumococcal disease hospitalizations at Ministry of Health (MoH) facilities in Malaysia between 2013 and 2015. Methods This was a retrospective databases analysis. Tabular data from the Malaysian Health Data Warehouse (MyHDW) were used to identify microbiologically confirmed, pneumococcal disease hospitalizations and deaths during hospitalization, using hospital-assigned ICD-10 codes (i.e., classified as meningitis, pneumonia, or non-meningitis non-pneumonia). Case counts, mortality counts, and case fatality rates were reported by patient age group and by Malaysian geographic region. Results A total of 683 pneumococcal disease hospitalizations were identified from the analysis: 53 pneumococcal meningitis hospitalizations (5 deaths and 48 discharges), 413 pneumococcal pneumonia hospitalizations (24 deaths and 389 discharges), and 205 non-meningitis non-pneumonia pneumococcal disease hospitalizations (58 deaths and 147 discharges). Most hospitalizations occurred in children aged
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181
Pseudomonas fluorescens pneumonia
Hiroshi Ishii, Hisako Kushima, Yohei Koide, Yoshiaki Kinoshita
International Journal of Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Pseudomonas fluorescens (P. fluorescens) is a Gram-negative rod that is widely distributed in moist environments. P. fluorescens is less virulent than Pseudomonas aeruginosa (P. aeruginosa) and is thought to be non-pathogenic to healthy individuals [1]. Although P. fluorescens can be repeatedly cultured from respiratory specimens [2–5], its pathological significance is unknown. Although there have been reports of opportunistic infections caused by P. fluorescens in immunosuppressed patients, including those with advanced cancer, most of these have been bloodstream infections [1,6,7], with very few reports of pneumonia alone [8,9].
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182
Infectious complications following major heart surgery from the day of the surgery to hospital discharge
BMC Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Background At some point in their lives, many people will require major heart surgery (MHS). Patients are generally older adults with various risk factors for infection. However, the incidence of infection after MHS is poorly known, as reported infection data are frequently biased due to different factors like the surgical procedure, postoperative timing, and infectious syndromes or etiologic agents, among others. In addition, most patient data are retrospectively obtained. Purpose and methods Data were prospectively collected regarding the incidence of all nosocomial infections produced from the time of surgery to hospital discharge in a cohort of 800 adults consecutively undergoing a MHS procedure. Results During postoperative hospitalization, 124 of the 800 participants developed one or more infections (15.5%): during their ICU stay in 68 patients (54.8%), during their stay on the general ward post ICU in 50 (40.3%), and during their stay in both wards in 6 (4.8%). The most common infections were pneumonia (related or not to mechanical ventilation), surgical site and bloodstream. As etiological agents, 193 pathogens were isolated: mostly Gram-negative bacilli (54.4%), followed by Gram-positive bacteria (30%), viruses (4.6%) and fungi (1.5%). In our cohort, all-cause mortality was recorded in 33 participants (4.1%) and 9 infection-related deaths (1.1%) were produced. Among subjects who developed infections, overall mortality was 13.7% and in those who did not, this was only 2.3%. Conclusion Infection following MHS remains frequent and severe. Our data suggest that hospital-acquired infection studies should consider episodes of infection in all populations during their entire hospital stay and not only those related to specific clinical syndromes or acquired while the patient is in intensive care.
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183
Moderate Exercise Modulates Inflammatory Responses and Improves Survival in a Murine Model of Acute Pneumonia
Vermeersch, Veronique; Léon, Karelle; Caillard, Anais; Szczesnowski, Amandine; Albacete, Gaëlle; Marec, Nadege; Tissier, Florine; Gilbert, Guillaume; Droguet, Mickael; Marcorelles, Pascale; Giroux-Metges, Marie-Agnes; Huet, Olivier
Critical Care Medicine, 12.01.2024
Tilføjet 12.01.2024
Objectives: An association between physical inactivity and worse outcome during infectious disease has been reported. The effect of moderate exercise preconditioning on the immune response during an acute pneumonia in a murine model was evaluated. Setting: Laboratory experiments. Subjects: C57BL6/j male mice. Interventions: Six-week-old C57BL/6J mice were divided in two groups: an exercise group and a control group. In the exercise group, a moderate, progressive, and standardized physical exercise was applied for 8 weeks. It consisted in a daily treadmill training lasting 60 minutes and with an intensity of 65% of the maximal theoretical oxygen uptake. Usual housing recommendation were applied in the control group during the same period. After 8 weeks, pneumonia was induced in both groups by intratracheal instillation of a fixed concentration of a Klebsiella pneumoniae (5 × 103 colony-forming unit) solution. Measurements and Main Results: Mice preconditioned by physical exercise had a less sever onset of pneumonia as shown by a significant decrease of the Mouse Clinical Assessment Severity Score and had a significantly lower mortality compared with the control group (27% vs. 83%; p = 0.019). In the exercise group, we observed a significantly earlier but transient recruitment of inflammatory immune cells with a significant increase of neutrophils, CD4+ cells and interstitial macrophages counts compared with control group. Lung tumor necrosis factor-α, interleukin (IL)-1β, IL-6, and IL-10 were significantly decreased at 48 hours after pneumonia induction in the exercise group compared with the control group. Conclusions: In our model, preconditioning by moderate physical exercise improves outcome by reducing the severity of acute pneumonia with an increased but transient activation of the innate immune response.
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184
Nasopharyngeal carriage of Streptococcus pneumoniae among children
Dodi Safari, Wa Ode Dwi Daningrat, Jennifer L. Milucky, Miftahuddin Majid Khoeri, Wisiva Tofriska Paramaiswari, Wisnu Tafroji, Korrie Salsabila, Yayah Winarti, Amin Soebandrio, Sri Rezeki Hadinegoro, Ari Prayitno, Lana Childs, Fabiana C. Pimenta, Maria da Gloria Carvalho, Tamara Pilishvili
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Dodi Safari, Wa Ode Dwi Daningrat, Jennifer L. Milucky, Miftahuddin Majid Khoeri, Wisiva Tofriska Paramaiswari, Wisnu Tafroji, Korrie Salsabila, Yayah Winarti, Amin Soebandrio, Sri Rezeki Hadinegoro, Ari Prayitno, Lana Childs, Fabiana C. Pimenta, Maria da Gloria Carvalho, Tamara Pilishvili Pneumococcal conjugate vaccines (PCVs) prevent nasopharyngeal colonization with vaccine serotypes of Streptococcus pneumoniae, leading to reduced transmission of pneumococci and stronger population-level impact of PCVs. In 2017 we conducted a cross-sectional pneumococcal carriage study in Indonesia among children aged
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185
Nasopharyngeal carriage of Streptococcus pneumoniae among children
Dodi Safari, Wa Ode Dwi Daningrat, Jennifer L. Milucky, Miftahuddin Majid Khoeri, Wisiva Tofriska Paramaiswari, Wisnu Tafroji, Korrie Salsabila, Yayah Winarti, Amin Soebandrio, Sri Rezeki Hadinegoro, Ari Prayitno, Lana Childs, Fabiana C. Pimenta, Maria da Gloria Carvalho, Tamara Pilishvili
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Dodi Safari, Wa Ode Dwi Daningrat, Jennifer L. Milucky, Miftahuddin Majid Khoeri, Wisiva Tofriska Paramaiswari, Wisnu Tafroji, Korrie Salsabila, Yayah Winarti, Amin Soebandrio, Sri Rezeki Hadinegoro, Ari Prayitno, Lana Childs, Fabiana C. Pimenta, Maria da Gloria Carvalho, Tamara Pilishvili Pneumococcal conjugate vaccines (PCVs) prevent nasopharyngeal colonization with vaccine serotypes of Streptococcus pneumoniae, leading to reduced transmission of pneumococci and stronger population-level impact of PCVs. In 2017 we conducted a cross-sectional pneumococcal carriage study in Indonesia among children aged
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186
Nasopharyngeal carriage of Streptococcus pneumoniae among children
Dodi Safari, Wa Ode Dwi Daningrat, Jennifer L. Milucky, Miftahuddin Majid Khoeri, Wisiva Tofriska Paramaiswari, Wisnu Tafroji, Korrie Salsabila, Yayah Winarti, Amin Soebandrio, Sri Rezeki Hadinegoro, Ari Prayitno, Lana Childs, Fabiana C. Pimenta, Maria da Gloria Carvalho, Tamara Pilishvili
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Dodi Safari, Wa Ode Dwi Daningrat, Jennifer L. Milucky, Miftahuddin Majid Khoeri, Wisiva Tofriska Paramaiswari, Wisnu Tafroji, Korrie Salsabila, Yayah Winarti, Amin Soebandrio, Sri Rezeki Hadinegoro, Ari Prayitno, Lana Childs, Fabiana C. Pimenta, Maria da Gloria Carvalho, Tamara Pilishvili Pneumococcal conjugate vaccines (PCVs) prevent nasopharyngeal colonization with vaccine serotypes of Streptococcus pneumoniae, leading to reduced transmission of pneumococci and stronger population-level impact of PCVs. In 2017 we conducted a cross-sectional pneumococcal carriage study in Indonesia among children aged
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187
Aerobic glycolysis of bronchial epithelial cells rewires Mycoplasma pneumoniae pneumonia and promotes bacterial elimination
Jun HeFeichen XiuYiwen ChenYan YangHongwei LiuYixuan XiLu LiuXinru LiYueyue WuHaodang LuoLiesong ChenNan DingJun HuEn ChenXiaoxing You1Department of Clinical Laboratory, The Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang, China2Institute of Pathogenic Biology, Hengyang Medical College, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hengyang, China3Department of Clinical Laboratory, Shanghai Putuo People's Hospital, Tongji University, Shanghai, China4Department of Epidemiology and Health Statistics, School of Public Health, University of South China, Hengyang, China5Department of Cardiothoracic Surgery, The Second Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China6Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China, Kimberly A. Kline
Infection and Immunity, 11.01.2024
Tilføjet 11.01.2024
188
Correction: Nutritional analysis and characterization of carbapenemase producing-Klebsiella pneumoniae resistant genes associated with bovine mastitis infected cow’s milk
Mr. Saddam, Muddasir Khan, Muhsin Jamal, Sadeeq Ur Rahman, Abdul Qadeer, Imad Khan, Mohamed H. Mahmoud, Gaber El-Saber Batiha, Syed Hussain Shah
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Mr. Saddam, Muddasir Khan, Muhsin Jamal, Sadeeq Ur Rahman, Abdul Qadeer, Imad Khan, Mohamed H. Mahmoud, Gaber El-Saber Batiha, Syed Hussain Shah
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189
Factors associated with an increased risk of developing pneumonia during acute ischemic stroke hospitalization
Pornpong Jitpratoom, Adhiratha Boonyasiri
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Pornpong Jitpratoom, Adhiratha Boonyasiri Stroke-associated pneumonia (SAP) is a common complication of acute ischemic stroke (AIS). This single-center retrospective observational study aimed to identify factors associated with SAP and predictors of poor outcomes in hospitalized patients with AIS. The study included patients admitted to Chumphon Khet Udomsakdi Hospital in Thailand within 7 days of the onset of AIS between July 2019 and July 2020. The patients were divided according to whether they were diagnosed with SAP during hospitalization into a pneumonia group and a non-pneumonia (control) group. Factors associated with SAP were identified. After 3 months, the patients with AIS were divided into those with a poor outcome (modified Rankin scale [mRS] score ≥4) and those with a non-poor outcome (mRS score
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190
Cytomegalovirus detection is associated with ICU admission in non-AIDS and AIDS patients with Pneumocystis jirovecii pneumonia
Alexandre Perret, Marion Le Marechal, Raphaele Germi, Daniele Maubon, Cécile Garnaud, Johan Noble, Aude Boignard, Loïc Falque, Mathieu Meunier, Théophile Gerster, Olivier Epaulard
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Alexandre Perret, Marion Le Marechal, Raphaele Germi, Daniele Maubon, Cécile Garnaud, Johan Noble, Aude Boignard, Loïc Falque, Mathieu Meunier, Théophile Gerster, Olivier Epaulard Objectives Cytomegalovirus (CMV) is frequently detected in lung and/or blood samples of patients with Pneumocystis jirovecii pneumonia (PJP), although this co-detection is not precisely understood. We aimed to determine whether PJP was more severe in case of CMV detection. Methods We retrospectively included all patients with a diagnosis of PJP between 2009 and 2020 in our centre and with a measure of CMV viral load in blood and/or bronchoalveolar lavage (BAL). PJP severity was assessed by the requirement for intensive care unit (ICU) admission. Results The median age of the 249 patients was 63 [IQR: 53–73] years. The main conditions were haematological malignancies (44.2%), solid organ transplantations (16.5%), and solid organ cancers (8.8%). Overall, 36.5% patients were admitted to ICU. CMV was detected in BAL in 57/227 patients; the 37 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (78.4% vs 28.4%, p
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191
Characterising respiratory infections among hospitalised children during the COVID-19 pandemic in southeastern China: a cross-sectional study of pathogens and clinical association
Huang, H., Wu, B., Lin, W.
BMJ Open, 10.01.2024
Tilføjet 10.01.2024
ObjectiveChildren with acute respiratory tract infections (ARTIs) pose significantly burden on healthcare facilities due to high hospitalisation rates and mortality. However, limited epidemiological and clinical characteristics data on ARTIs in southeastern China during the COVID-19 pandemic exists. DesignCross-sectional. SettingTertiary hospital associated with the First Affiliated Hospital, Fujian Medical University, China. Participants1007 hospitalised children diagnosed with ARTIs, aged 30 days to 15 years, were enrolled in this study from 1 January 2020 to 31 December 2021. Outcome measureThe primary outcomes are the rate of pathogen infections in children with ARTIs. Secondary outcomes are the description of risk factors associated with ARTIs in children. ResultsOf the 1007 enrolled children, 28.2%, 42.2%, 21.8% and 7.7% were diagnosed with upper respiratory tract infection, bronchopneumonia, bronchitis and pneumonia, respectively. Mycoplasma pneumoniae (MP) was the most prevalent pathogen (31.9%), followed by influenza B virus (IFVB; 29.1%) and influenza A virus (IFVA; 19.1%). The study found that children under 1 year old (older than 30 days: ORIFVB=12.50; ORMP=8.53), children aged 1–3 years (ORMP=1.62), the winter season (ORIFVA=1.36), the time from symptoms onset to hospitalisation (ORMP=1.10) and increased precipitation (ORLP=1.01) were high-risk factors for ARTIs. ConclusionThis investigation offers significant insights into the prevalence and distribution of common pathogens among children experiencing ARTIs in the context of the COVID-19 pandemic. The discernment of high-risk factors linked to these pathogens enhances our understanding of the epidemiological characteristics of ARTIs in children.
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192
Comment on Shao et al.'s “Risk factors associated with COVID‐19 pneumonia in Chinese patients with pre‐existing interstitial lung disease during the SARS‐CoV‐2 pandemic”
Hsiu‐Ming Lee, Po‐Cheng Shih, James Cheng‐Chung Wei
Journal of Medical Virology, 6.01.2024
Tilføjet 6.01.2024
193
Association between timed up-and-go test and subsequent pneumonia: A cohort study
Hyo Jin Lee, Sohee Oh, Hyun Woo Lee, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Tae Yun Park
PLoS One Infectious Diseases, 5.01.2024
Tilføjet 5.01.2024
by Hyo Jin Lee, Sohee Oh, Hyun Woo Lee, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Tae Yun Park Background Sarcopenia is a risk factor for pneumonia in the elderly, and the timed up-and-go test (TUG) can be used as a screening tool for sarcopenia in this population. This study aimed to evaluate the association between TUG test results and future pneumonia or ventilator care. Materials and methods From the National Health Insurance Service-Senior Cohort database, we identified 19,804 people without neurological diseases who underwent the TUG test in the National Screening Program for Transitional Ages at the age of 66 years during 2007–2008. Gait abnormality was defined as taking 10 s or longer to perform the TUG test. Pneumonia occurrence was defined using the International Classification of Diseases 10th Revision (ICD-10) code for pneumonia (J12–J18, J69), and ventilator care was defined by procedure codes (M5830, M5850, M5867, M5858, M5860, M5859) according to the Healthcare Common Procedure Coding system codes from 2007 to 2015. Results The mean follow-up period was 7.4 years (standard error, SE 0.02). The incidence rates of pneumonia in the normal and slow TUG groups were 38 and 39.5/1000 person-years, respectively. The slow TUG group did not show a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.042; 95% confidence interval [95% CI], 0.988–1.107]). Regarding ventilator care, the incidence was 4.7 and 5.2 cases per 1,000 person-years in the normal and slow TUG groups, respectively. Slow TUG groups also did not show an increased risk of ventilator occurrence (aHR, 1.136, [95% CI = 0.947–1.363]). Conclusion The TUG test result was not associated with future pneumonia or ventilator care and may not be useful for predicting pneumonia in community-dwelling elderly individuals. Further studies are needed to identify additional functional tools for sarcopenia associated with future pneumonia occurrences.
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194
ICU Utilization After Implementation of Minor Severe Pneumonia Criteria in Real-Time Electronic Clinical Decision Support
Carr, Jason R.; Knox, Daniel B.; Butler, Allison M.; Lum, Marija M.; Jacobs, Jason R.; Jephson, Al R.; Jones, Barbara E.; Brown, Samuel M.; Dean, Nathan C.
Critical Care Medicine, 4.01.2024
Tilføjet 4.01.2024
Objectives: To determine if the implementation of automated clinical decision support (CDS) with embedded minor severe community-acquired pneumonia (sCAP) criteria was associated with improved ICU utilization among emergency department (ED) patients with pneumonia who did not require vasopressors or positive pressure ventilation at admission. Design: Planned secondary analysis of a stepped-wedge, cluster-controlled CDS implementation trial. Setting: Sixteen hospitals in six geographic clusters from Intermountain Health; a large, integrated, nonprofit health system in Utah and Idaho. Patients: Adults admitted to the hospital from the ED with pneumonia identified by: 1) discharge International Classification of Diseases, 10th Revision codes for pneumonia or sepsis/respiratory failure and 2) ED chest imaging consistent with pneumonia, who did not require vasopressors or positive pressure ventilation at admission. Interventions: After implementation, patients were exposed to automated, open-loop, comprehensive CDS that aided disposition decision (ward vs. ICU), based on objective severity scores (sCAP). Measurements and Main Results: The analysis included 2747 patients, 1814 before and 933 after implementation. The median age was 71, median Elixhauser index was 17, 48% were female, and 95% were Caucasian. A mixed-effects regression model with cluster as the random effect estimated that implementation of CDS utilizing sCAP increased 30-day ICU-free days by 1.04 days (95% CI, 0.48–1.59; p < 0.001). Among secondary outcomes, the odds of being admitted to the ward, transferring to the ICU within 72 hours, and receiving a critical therapy decreased by 57% (odds ratio [OR], 0.43; 95% CI, 0.26–0.68; p < 0.001) post-implementation; mortality within 72 hours of admission was unchanged (OR, 1.08; 95% CI, 0.56–2.01; p = 0.82) while 30-day all-cause mortality was lower post-implementation (OR, 0.71; 95% CI, 0.52–0.96; p = 0.03). Conclusions: Implementation of electronic CDS using minor sCAP criteria to guide disposition of patients with pneumonia from the ED was associated with safe reduction in ICU utilization.
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195
Corticosteroid Use Exhibit Different Benefits in Pneumonia: A Sensitivity Analysis
Clinical Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
To theEditor—In a recent meta-analysis [1], Bergmann et al investigated the efficacy and safety of corticosteroid therapy in community-acquired pneumonia (CAP). They found that adjunctive corticosteroid therapy in patients hospitalized with CAP was associated with a reduction in the all-cause mortality rate by day 30. In addition, the benefits were more significant in patients with severe CAP. This study is well designed. However, several points should be noted.
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196
Corticosteroids Demonstrate Efficacy Solely in Severe Cases of Community-acquired Pneumonia, With Hydrocortisone Showing Notable Effectiveness
Clinical Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
Project of Young and Middle Medical Distinguished Team in Chongqing, China020291Science and Technology Department of Chongqing
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197
Revisiting the Evidence: Corticosteroid Efficacy in Patients With Moderate and Severe Community-Acquired Pneumonia
Clinical Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
ToTheEditor—We thank Li et al and Zhu et al for their interest in this topic and the meticulous review of our meta-analysis, which found a survival benefit of corticosteroids in patients with community-acquired pneumonia (CAP).
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198
Clinical testing guidance for histoplasmosis in patients with community-acquired pneumonia for primary and urgent care providers: Commentary on Enzyme Immunoassay Histoplasma Antibody Testing
Clinical Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
199
Clinical testing guidance for histoplasmosis in patients with community-acquired pneumonia for primary and urgent care providers: Role of enzyme immunoassay Histoplasma-specific immunoglobulin G and immunoglobulin M testing
Clinical Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
200
Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia
Eric D. McCollum, John P. McCracken, Miles A. Kirby, Laura M. Grajeda, Shakir Hossen, Lawrence H. Moulton, Suzanne M. Simkovich, Dina Goodman-Palmer, Ghislaine Rosa, Alexie Mukeshimana, Kalpana Balakrishnan, Gurusamy Thangavel, Sarada S. Garg, Adly Castañaza, Lisa M. Thompson, Anaite Diaz-Artiga, Aris T. Papageorghiou, Victor G. Davila-Roman, Lindsay J. Underhill, Stella M. Hartinger, Kendra N. Williams, Laura Nicolaou, Howard H. Chang, Amy E. Lovvorn, Joshua P. Rosenthal, Ajay Pillarisetti, Wenlu Ye, Luke P. Naeher, Michael A. Johnson, Lance A. Waller, Shirin Jabbarzadeh, Jiantong Wang, Yunyun Chen, Kyle Steenland, Thomas F. Clasen, Jennifer L. Peel, William Checkley
New England Journal of Medicine, 4.01.2024
Tilføjet 4.01.2024