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Alice Alberti, Stefano Corbella, Silvio Taschieri, Luca Francetti, Kausar Sadia Fakhruddin, Lakshman Perera Samaranayake
PLoS One Infectious Diseases, 22.07.2021
Tilføjet 23.07.2021
by Alice Alberti, Stefano Corbella, Silvio Taschieri, Luca Francetti, Kausar Sadia Fakhruddin, Lakshman Perera Samaranayake
Fungal infections are common on oral mucosae, but their role in other oral sites is ill defined. Over the last few decades, numerous studies have reported the presence of fungi, particularly Candida species in endodontic infections, albeit in relatively small numbers in comparison to its predominant anaerobic bacteriome. Here, we review the fungal biome of primary and secondary endodontic infections, with particular reference to the prevalence and behavior of Candida species. Meta-analysis of the available data from a total of 39 studies fitting the inclusion criteria, indicate the overall weighted mean prevalence (WMP) of fungal species in endodontic infections to be 9.11% (from a cumulative total of 2003 samples), with 9.0% in primary (n = 1341), and 9.3% in secondary infections (n = 662). Nevertheless, WMP for fungi in primary and secondary infections which were 6.3% and 7.5% for culture-based studies, increased to 12.5% and 16.0% in molecular studies, respectively. The most prevalent fungal species was Candida spp. The high heterogeneity in the reported fungal prevalence suggests the need for standardized sampling, and speciation methods. The advent of the new molecular biological analytical platforms, such as the next generation sequencing (NGS), and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF), that enables identification and quantitation of a broad spectrum of hitherto unknown organisms in endodontic infections should radically alter our understanding of the endodontic mycobiome in the future. Candida spp. appear to be co-pathogens with bacteria in approximately one in ten patients with endodontic infections. Hence, clinicians should comprehend the importance and the role of fungi in endodontic infections and be cognizant of the need to eradicate both bacteria and fungi for successful therapy.
Læs mere Tjek på PubMedHyo-In Rhyou, Young-Hee Nam, Su-Chin Kim, Go-Eun Doo, Chae-Yeon Ha, Hee-Joo Nam, Sung-Dae Woo, Youngsoo Lee, Jae-Hyuk Jang, Hyun-Young Lee, Young-Min Ye
PLoS One Infectious Diseases, 22.07.2021
Tilføjet 23.07.2021
by Hyo-In Rhyou, Young-Hee Nam, Su-Chin Kim, Go-Eun Doo, Chae-Yeon Ha, Hee-Joo Nam, Sung-Dae Woo, Youngsoo Lee, Jae-Hyuk Jang, Hyun-Young Lee, Young-Min Ye
Cefaclor, a second-generation oral cephalosporin, is the most frequently prescribed cephalosporin in Korea. Studies, however, have yet to analyze the incidence of cefaclor-associated adverse drug reactions (ADRs), including hypersensitivity (HS), according to total national usage rates. This study aimed to investigate the incidence rates and clinical features of cefaclor ADRs reported to the Korean Adverse Event Reporting System (KAERS) and Health Insurance Review and Assessment Service (HIRA) database for the most recent 5 years. Reviewing the HIRA database, which contains information on all insurance claims, including prescribed medications and patient demographics, we identified the total number of individuals who had been prescribed cefaclor and other cephalosporins including 2nd generation without cefaclor and 3rd generation antibiotics from January 2014 to December 2018. Additionally, we retrospectively analyzed all ADRs reported to the KAERS for these drugs over the same study period. Incidence rates for ADRs, HS, and anaphylaxis to cefaclor were 1.92/10,000 persons, 1.17/10,000 persons, and 0.38/10,000 persons, respectively, lower than those to other 2nd and 3rd cephalosporins. Among all ADRs, HS (60.9% vs. 43.6% vs. 44.8%, P
Læs mere Tjek på PubMedZaw Myo Tun, Dale A. Fisher, Sharon Salmon, Clarence C. Tam
PLoS One Infectious Diseases, 22.07.2021
Tilføjet 23.07.2021
by Zaw Myo Tun, Dale A. Fisher, Sharon Salmon, Clarence C. Tam
Background Methicillin-Resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide. Intrahospital transfers may impact MRSA acquisition risk experienced by patients. In this study, we investigated ward characteristics and connectivity that are associated with MRSA acquisition.
Methods We analysed electronic medical records on patient transfers and MRSA screening of in-patients at an acute-care tertiary hospital in Singapore to investigate whether ward characteristics and connectivity within a network of in-patient wards were associated with MRSA acquisition rates over a period of four years.
Results Most patient transfers concentrated in a stable core network of wards. Factors associated with increased rate of MRSA acquisition were MRSA prevalence among patients transferred from other wards (rate ratio (RR): 7.74 [95% confidence interval (CI): 3.88, 15.44], additional 5 percentage point), critical care ward (RR: 1.72 [95% CI: 1.09, 2.70]) and presence of MRSA cohorting beds (RR: 1.39 [95% CI: 1.03, 1.90]. Oncology ward (RR: 0.66 [95% CI: 0.46, 0.94]) (compared to medical ward), and median length of stay (RR: 0.70 [95% CI: 0.55, 0.90], additional 1.5 days) were associated with lower acquisition rates. In addition, we found evidence of interaction between MRSA prevalence among patients transferred from other wards and weighted in-degree although the latter was not associated with MRSA acquisition after controlling for confounders.
Conclusion Wards with higher MRSA prevalence among patients transferred from other wards were more likely to have higher MRSA acquisition rate. Its effect further increased in wards receiving greater number of patients. In addition, critical care ward, presence of MRSA cohorting beds, ward specialty, and median length of stay were associated with MRSA acquisition.
Læs mere Tjek på PubMedMichal Shauly-Aharonov, Asher Shafrir, Ora Paltiel, Ronit Calderon-Margalit, Rifaat Safadi, Roee Bicher, Orit Barenholz-Goultschin, Joshua Stokar
PLoS One Infectious Diseases, 22.07.2021
Tilføjet 23.07.2021
by Michal Shauly-Aharonov, Asher Shafrir, Ora Paltiel, Ronit Calderon-Margalit, Rifaat Safadi, Roee Bicher, Orit Barenholz-Goultschin, Joshua Stokar
Importance Patients with diabetes are known to be at increased risk for infections including severe coronavirus disease 2019 (COVID-19) but the relationship between COVID-19 severity and specific pre-infection glucose levels is not known.
Objective To assess the differential effects of pre-infection glucose levels on the risk for severe COVID-19 amongst patients with and without diabetes.
Design Population based historical cohort study.
Setting National state-mandated HMO.
Patients All adult patients with a positive SARS-COV2 test between March-October 2020.
Exposure Recent fasting blood glucose (FBG) and glycated hemoglobin (HBA1C), age, gender, body mass index (BMI) and diagnoses of diabetes, hypertension, ischemic heart disease.
Outcome Risk for severe COVID-19, defined as resulting in ≥10 hospitalization days, ICU admission or death.
Results 37,121 patients with a positive SARS-COV2 test were identified; 707 defined as severe (1.9%). Unadjusted risk factors for severe disease were age (OR = 1.1 for every year increase; 95% CI 1.09–1.11, p < 0.001), male gender (OR = 1.34, 95% CI 1.06–1.68, p = 0.012); BMI (OR = 1.02 for 1 kg/m2 increase, 95% CI 1.00–1.04, p = 0.025). Controlling for these factors, we found an association between pre-infection FBG and the risk of severe COVID-19, with a differential effect in patients with and without a diagnosis of diabetes. For patients without diabetes, elevated FBG in the pre-diabetes range (106–125 mg/dl) was associated with severe COVID-19 (OR 1.55 95% CI 1.04–2.26 p = 0.027). For patients with a diagnosis of diabetes, we found a J-shaped association between pre-infection glucose control and the risk for severe COVID-19 where the lowest risk for was for patients with FBG 106–125 mg/dl; the risk increased with higher pre-infection glucose levels but strikingly also for patients with a low pre-infection FBG (
Læs mere Tjek på PubMedPh.D. Mollie M. Van Gordon, Ph.D. Kevin A. McCarthy, Ph.D. Joshua L. Proctor, MBA Brittany L. Hagedorn
International Journal of Infectious Diseases, 22.07.2021
Tilføjet 22.07.2021
Whitfield, T., Fernandez, C., Davies, K., Defres, S., Griffiths, M., Hooper, C., Tangney, R., Burnside, G., Rosala- Hallas, A., Moore, P., Das, K., Zuckerman, M., Parkes, L., Keller, S., Roberts, N., Easton, A., Touati, S., Kneen, R., Stahl, J. P., Solomon, T.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Introduction
Herpes simplex virus (HSV) encephalitis is a rare severe form of brain inflammation that commonly leaves survivors and their families with devastating long-term consequences. The virus particularly targets the temporal lobe of the brain causing debilitating problems in memory, especially verbal memory. It is postulated that immunomodulation with the corticosteroid, dexamethasone, could improve outcomes by reducing brain swelling. However, there are concerns (so far not observed) that such immunosuppression might facilitate increased viral replication with resultant worsening of disease. A previous trail closed early because of slow recruitment.
Method
DexEnceph is a pragmatic multicentre, randomised, controlled, open-label, observer-blind trial to determine whether adults with HSV encephalitis who receive dexamethasone alongside standard antiviral treatment with aciclovir for have improved clinical outcomes compared with those who receive standard treatment alone. Overall, 90 patients with HSV encephalitis are being recruited from a target of 45 recruiting sites; patients are randomised 1:1 to the dexamethasone or control arms of the study. The primary outcome measured is verbal memory as assessed by the Weschler Memory Scale fourth edition Auditory Memory Index at 26 weeks after randomisation. Secondary outcomes are measured up to 72 weeks include additional neuropsychological, clinical and functional outcomes as well as comparison of neuroimaging findings. Patient safety monitoring occurs throughout and includes the detection of HSV DNA in cerebrospinal fluid 2 weeks after randomisation, which is indicative of ongoing viral replication. Innovative methods are being used to ensure recrutiment targets are met for this rare disease.
Discussion
DexEnceph aims to be the first completed randomised controlled trial of corticosteroid therapy in HSV encephalitis. The results will provide evidence for future practice in managing adults with the condition and has the potential to improve outcomes .
Ethics and dissemination
The trial has ethical approval from the UK National Research Ethics Committee (Liverpool Central, REF: 15/NW/0545, 10 August 2015). Protocol V.2.1, July 2019. The results will be published and presented as soon as possible on completion.
Trial registration numbers
ISRCTN11774734, EUDRACT 2015-001609-16.
Læs mere Tjek på PubMedMangal, T., Whittaker, C., Nkhoma, D., Ng'ambi, W., Watson, O., Walker, P., Ghani, A., Revill, P., Colbourn, T., Phillips, A., Hallett, T., Mfutso-Bengo, J.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Background
COVID-19 mitigation strategies have been challenging to implement in resource-limited settings due to the potential for widespread disruption to social and economic well-being. Here we predict the clinical severity of COVID-19 in Malawi, quantifying the potential impact of intervention strategies and increases in health system capacity.
Methods
The infection fatality ratios (IFR) were predicted by adjusting reported IFR for China, accounting for demography, the current prevalence of comorbidities and health system capacity. These estimates were input into an age-structured deterministic model, which simulated the epidemic trajectory with non-pharmaceutical interventions and increases in health system capacity.
Findings
The predicted population-level IFR in Malawi, adjusted for age and comorbidity prevalence, is lower than that estimated for China (0.26%, 95% uncertainty interval (UI) 0.12%–0.69%, compared with 0.60%, 95% CI 0.4% to 1.3% in China); however, the health system constraints increase the predicted IFR to 0.83%, 95% UI 0.49%–1.39%. The interventions implemented in January 2021 could potentially avert 54 400 deaths (95% UI 26 900–97 300) over the course of the epidemic compared with an unmitigated outbreak. Enhanced shielding of people aged ≥60 years could avert 40 200 further deaths (95% UI 25 300–69 700) and halve intensive care unit admissions at the peak of the outbreak. A novel therapeutic agent which reduces mortality by 0.65 and 0.8 for severe and critical cases, respectively, in combination with increasing hospital capacity, could reduce projected mortality to 2.5 deaths per 1000 population (95% UI 1.9–3.6).
Conclusion
We find the interventions currently used in Malawi are unlikely to effectively prevent SARS-CoV-2 transmission but will have a significant impact on mortality. Increases in health system capacity and the introduction of novel therapeutics are likely to further reduce the projected numbers of deaths.
Læs mere Tjek på PubMedWei, Q., Zhou, M., Liu, J., Zhang, S., Gao, F., Lin, H., Chen, Z.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Introduction
Osteonecrosis (ON) is characterised by the destruction of the normal blood supply to the bone tissue. ON is the main cause of disability in patients with systemic lupus erythematosus (SLE). Studies have reported the existence of many risk factors for SLE complicated by ON, including the use of high-dose glucocorticoids and high disease activity. The correlation between antiphospholipid antibodies (aPLs) and ON in SLE has been controversial. We aim to conduct a systematic review of the literature related to SLE, aseptic ON and aPLs, to provide a reference for the clinical screening of high-risk patients and for early prevention.
Methods and analysis
The following six databases will be searched: MEDLINE/PubMed, Embase, Web of Science, Chinese Biomedical Literature Database, Wan-Fang Database and China National Knowledge Infrastructure. The database searches will not be restricted by date. Case–control studies, cohort studies or observational studies that compare aPLs between SLE patients with and without ON will be considered eligible. Articles published in English and Chinese will be included. Two researchers will independently perform the processes of study selection, data extraction and study quality assessment. The Newcastle–Ottawa Quality Assessment Scale will be used to assess the quality of the retrieved studies. A meta-analysis will be performed after screening the studies. Data will be analysed using ORs for dichotomous data.
Ethics and dissemination
Ethical approval is not required because this systematic review will use published data. The systematic review will be electronically disseminated through a peer-reviewed publication or conference presentations.
PROSPERO registration number
CRD42020209637.
Læs mere Tjek på PubMedIslam, S. J., Nayak, A., Hu, Y., Mehta, A., Dieppa, K., Almuwaqqat, Z., Ko, Y.-A., Patel, S. A., Goyal, A., Sullivan, S., Lewis, T. T., Vaccarino, V., Morris, A. A., Quyyumi, A. A.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Background
The COVID-19 pandemic adversely affected the socially vulnerable and minority communities in the USA initially, but the temporal trends during the year-long pandemic remain unknown.
Objective
We examined the temporal association of county-level Social Vulnerability Index (SVI), a percentile-based measure of social vulnerability to disasters, its subcomponents and race/ethnic composition with COVID-19 incidence and mortality in the USA in the year starting in March 2020.
Methods
Counties (n=3091) with ≥50 COVID-19 cases by 6 March 2021 were included in the study. Associations between SVI (and its subcomponents) and county-level racial composition with incidence and death per capita were assessed by fitting a negative-binomial mixed-effects model. This model was also used to examine potential time-varying associations between weekly number of cases/deaths and SVI or racial composition. Data were adjusted for percentage of population aged ≥65 years, state-level testing rate, comorbidities using the average Hierarchical Condition Category score, and environmental factors including average fine particulate matter of diameter ≥2.5 μm, temperature and precipitation.
Results
Higher SVI, indicative of greater social vulnerability, was independently associated with higher COVID-19 incidence (adjusted incidence rate ratio per 10 percentile increase: 1.02, 95% CI 1.02 to 1.03, p<0.001) and death per capita (1.04, 95% CI 1.04 to 1.05, p<0.001). SVI became an independent predictor of incidence starting from March 2020, but this association became weak or insignificant by the winter, a period that coincided with a sharp increase in infection rates and mortality, and when counties with higher proportion of white residents were disproportionately represented (‘third wave’). By spring of 2021, SVI was again a predictor of COVID-19 outcomes. Counties with greater proportion of black residents also observed similar temporal trends in COVID-19-related adverse outcomes. Counties with greater proportion of Hispanic residents had worse outcomes throughout the duration of the analysis.
Conclusion
Except for the winter ‘third wave’, when majority of the white communities had the highest incidence of cases, counties with greater social vulnerability and proportionately higher minority populations experienced worse COVID-19 outcomes.
Læs mere Tjek på PubMedMathews, M., Spencer, S., Hedden, L., Marshall, E. G., Lukewich, J., Meredith, L., Ryan, D., Buote, R., Liu, T., Volpe, E., Gill, P. S., Ryan, B., Schacter, G., Wickett, J., Freeman, T. R., Sibbald, S. L., Wong, E., McKay, M., McCracken, R., Brown, J. B.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Introduction
Given the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing pandemic plans in Canada, however, do not adequately incorporate family physicians’ roles and perspectives. This policy and planning oversight has become increasingly evident with the emergence of the novel coronavirus disease, COVID-19, pandemic. This study is designed to inform the development of pandemic plans for primary care through evidence from four provinces in Canada: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario.
Methods and analysis
We will employ a multiple-case study of regions in four provinces. Each case consists of a mixed methods design which comprises: (1) a chronology of family physician roles in the COVID-19 pandemic response; (2) a provincial policy analysis; and (3) qualitative interviews with family physicians. Relevant policy and guidance documents will be identified through targeted, snowball and general search strategies. Additionally, these policy documents will be analysed to identify gaps and/or emphases in existing policies and policy responses. Interviews will explore family physicians’ proposed, actual and potential roles during the pandemic, the facilitators and barriers they have encountered throughout and the influence of gender on their professional roles. Data will be thematically analysed using a content analysis framework, first at the regional level and then through cross-case analyses.
Ethics and dissemination
Approval for this study has been granted by the Research Ethics of British Columbia, the Health Research Ethics Board of Newfoundland and Labrador, the Nova Scotia Health Authority Research Ethics Board and the Western University Research Ethics Board. Findings will be disseminated via conferences and peer-reviewed publications. Evidence and lessons learnt will be used to develop tools for government ministries, public health units and family physicians for improved pandemic response plans for primary care.
Læs mere Tjek på PubMedOrtega, E., Corcoy, R., Gratacos, M., Cos Claramunt, F. X., Mata-Cases, M., Puig-Treserra, R., Real, J., Vlacho, B., Castelblanco, E., Domingo, P., Khunti, K., Franch-Nadal, J., Mauricio, D.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Aim
This study’s objective was to assess the risk of severe in-hospital complications of patients admitted for COVID-19 and diabetes mellitus (DM).
Design
This was a cross-sectional study.
Settings
We used pseudonymised medical record data provided by six general hospitals from the HM Hospitales group in Spain.
Outcome measures
Multiple logistic regression analyses were used to identify variables associated with mortality and the composite of mortality or invasive mechanical ventilation (IMV) in the overall population, and stratified for the presence or absence of DM. Spline analysis was conducted on the entire population to investigate the relationship between glucose levels at admission and outcomes.
Results
Overall, 1621 individuals without DM and 448 with DM were identified in the database. Patients with DM were on average 5.1 years older than those without. The overall in-hospital mortality was 18.6% (N=301), and was higher among patients with DM than those without (26.3% vs 11.3%; p<0.001). DM was independently associated with death, and death or IMV (OR=2.33, 95% CI: 1.7 to 3.1 and OR=2.11, 95% CI: 1.6 to 2.8, respectively; p<0.001). In subjects with DM, the only variables independently associated with both outcomes were age >65 years, male sex and pre-existing chronic kidney disease. We observed a non-linear relationship between blood glucose levels at admission and risk of in-hospital mortality and death or IMV. The highest probability for each outcome (around 50%) was at random glucose of around 550 mg/dL (30.6 mmol/L), and the risks flattened above this value.
Conclusion
The results confirm the high burden associated with DM in patients hospitalised with COVID-19 infection, particularly among men, the elderly and those with impaired kidney function. Moreover, hyperglycaemia on admission was strongly associated with poor outcomes, suggesting that personalised optimisation could help to improve outcome during the hospital stay.
Læs mere Tjek på PubMedDun, Y., Ripley-Gonzalez, J. W., Zhou, N., You, B., Li, Q., Li, H., Zhang, W., Thomas, R. J., Olson, T. P., Liu, J., Dong, Y., Liu, S.
BMJ Open, 22.07.2021
Tilføjet 22.07.2021
Objectives
To observe the weight change in Chinese youth during a 4-month COVID-19 lockdown, and the association between weight change and mental health, physical activity and sedentary time changes, and dietary habits.
Design
A retrospective observational study.
Settings
Two universities located in Zhejiang and Hunan provinces, China.
Participants
This study enrolled 12 889 college students whose body weight was measured before the lockdown (1 December 2019–20 January 2020) at the two universities, and reported their weight measured at home or community after the end of the lockdown (1–23 May 2020) via an online follow-up questionnaire.
Primary and secondary outcome measures
The primary outcome was the weight change in Chinese youth during a 4-month lockdown resulting from the COVID-19 pandemic. The secondary outcomes were the relationships of weight change to COVID-19-related stress, depression, anxiety, physical activity and sedentary time changes, and dietary habits.
Results
Participants’ ages ranged from 17 to 27 years (M=19, SD=1) with 80.2% identified as female. The average absolute and relative changes in body weight were 2.6 (95% CI 2.0 to 3.2)) kg and 4.2% (95% CI 4.0% to 4.3%) for men, and 2.1 (1.9 to 2.4) kg and 4.2% (95% CI 3.9% to 4.4%) for women. An increase in overweight and obese individuals according to Asian cut-off points as a demographic percentage by 4.5% and 2.7% and 4.8% and 3.4% in men and women, respectively (P<0.001), was observed. Weight gain was significantly associated with increased sedentary time and an increase in COVID-19-related stress and depression score.
Conclusion
The present study’s results suggest that the risk of weight gain in Chinese youth during the lockdown increased and that strategies to decrease sedentary time and improve mental health may be warranted to mitigate weight gain during and after the COVID-19 pandemic.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.07.2021
Tilføjet 22.07.2021
Abstract
Background
Predicting hospital length of stay (LoS) for patients with COVID-19 infection is essential to ensure that adequate bed capacity can be provided without unnecessarily restricting care for patients with other conditions. Here, we demonstrate the utility of three complementary methods for predicting LoS using UK national- and hospital-level data.
Method
On a national scale, relevant patients were identified from the COVID-19 Hospitalisation in England Surveillance System (CHESS) reports. An Accelerated Failure Time (AFT) survival model and a truncation corrected method (TC), both with underlying Weibull distributions, were fitted to the data to estimate LoS from hospital admission date to an outcome (death or discharge) and from hospital admission date to Intensive Care Unit (ICU) admission date. In a second approach we fit a multi-state (MS) survival model to data directly from the Manchester University NHS Foundation Trust (MFT). We develop a planning tool that uses LoS estimates from these models to predict bed occupancy.
Results
All methods produced similar overall estimates of LoS for overall hospital stay, given a patient is not admitted to ICU (8.4, 9.1 and 8.0 days for AFT, TC and MS, respectively). Estimates differ more significantly between the local and national level when considering ICU. National estimates for ICU LoS from AFT and TC were 12.4 and 13.4 days, whereas in local data the MS method produced estimates of 18.9 days.
Conclusions
Given the complexity and partiality of different data sources and the rapidly evolving nature of the COVID-19 pandemic, it is most appropriate to use multiple analysis methods on multiple datasets. The AFT method accounts for censored cases, but does not allow for simultaneous consideration of different outcomes. The TC method does not include censored cases, instead correcting for truncation in the data, but does consider these different outcomes. The MS method can model complex pathways to different outcomes whilst accounting for censoring, but cannot handle non-random case missingness. Overall, we conclude that data-driven modelling approaches of LoS using these methods is useful in epidemic planning and management, and should be considered for widespread adoption throughout healthcare systems internationally where similar data resources exist.
Læs mere Tjek på PubMedDidem Görgün Hattatoğlu, Birsen Pınar Yıldız
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Tarun Kumar Suvvari, LV Simhachalam Kutikuppala, Christos Tsagkaris, Anna Chiara Corriero, Venkataramana Kandi
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Silvia Carbonell‐Sahuquillo, María Isabel Lázaro‐Carreño, Jorge Camacho, Ana Barrés‐Fernández, Eliseo Albert, Ignacio Torres, José Rafael Bretón‐Martínez, Cecilia Martínez‐Costa, David Navarro
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Olivier UWISHEMA, Baha Aldeen Abdalaziz Alshareif, Mohamed Yousif Elamin Yousif, Mohammed Eltahier Abdalla Omer, Alfredo Lorenzo Recio Sablay, Rabeet Tariq, Amirsaman Zahabioun, Rehema Mkamburi Mwazighe, Helen Onyeaka
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Olivier Uwishema, Ekene Mary Nnagha, Elie Chalhoub, Goodluck Nchasi, Rehema Mkamburi Mwazighe, Burak Talha Akin, Irem Adanur, Helen Onyeaka
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Philipp Sprengholz, Cornelia Betsch
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Ahmad M. Saad, Ahmed ES. Abdel‐Megied, Rizk A. Elbaz, Sobhy E. Hassab El‐Nabi, Rami M. Elshazli
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Jordan Z. Neises, Md Saddam Hossain, Rifat Sultana, Kevin N. Wanniarachchi, Jared W. Wollman, Eric Nelson, Bonny L. Specker, Adam D. Hoppe, Steven R. Lawson, Natalie W. Thiex
Journal of Medical Virology, 21.07.2021
Tilføjet 22.07.2021
Nicholas I. Paton, Joseph Musaazi, Cissy Kityo, Stephen Walimbwa, Anne Hoppe, Apolo Balyegisawa, Arvind Kaimal, Grace Mirembe, Phionah Tukamushabe, Gilbert Ategeka, James Hakim, Henry Mugerwa, Abraham Siika, Jesca Asienzo, Barbara Castelnuovo, Agnes Kiragga, Andrew Kambugu
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
New England Journal of Medicine, Volume 385, Issue 4, Page 330-341, July 2021.
Læs mere Tjek på PubMedEric J. Rubin, Lindsey R. Baden, Katrina A. Armstrong, Stephen Morrissey
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
Victoria T. Chu, Anna R. Yousaf, Karen Chang, Noah G. Schwartz, Clinton J. McDaniel, Scott H. Lee, Christine M. Szablewski, Marie Brown, Cherie L. Drenzek, Emilio Dirlikov, Dale A. Rose, Julie Villanueva, Alicia M. Fry, Aron J. Hall, Hannah L. Kirking, Jacqueline E. Tate, Tatiana M. Lanzieri, Rebekah J. Stewart
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
Stephen J.W. Evans, Nicholas P. Jewell
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
Jamie Lopez Bernal, Nick Andrews, Charlotte Gower, Eileen Gallagher, Ruth Simmons, Simon Thelwall, Julia Stowe, Elise Tessier, Natalie Groves, Gavin Dabrera, Richard Myers, Colin N.J. Campbell, Gayatri Amirthalingam, Matt Edmunds, Maria Zambon, Kevin E. Brown, Susan Hopkins, Meera Chand, Mary Ramsay
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
Garth Rapeport, Emma Smith, Anthony Gilbert, Andrew Catchpole, Helen McShane, Christopher Chiu
New England Journal of Medicine, 21.07.2021
Tilføjet 22.07.2021
Benjamas Chuaychoo, Kanokwan Rattanasaengloet, Run Banlengchit, Navin Horthongkham, Niracha Athipanyasilp, Kanyarat Totanarungroj, Nisa Muangman
International Journal of Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
Influenza virus is an important cause of adult hospitalization while respiratory syncytial virus (RSV) infection is increasingly recognized, especially in older adults with co-morbidities (Falsey et al. 2014; Lee et al. 2013; Olsen et al. 2010; Walker and Ison 2014). In studies from America, Europe, and Asia, RSV infection represented 2.3% to 13.0% of adult hospitalizations (Falsey et al. 2005; Falsey et al. 2014; Lee et al. 2013; Loubet et al. 2017; Malosh et al. 2017; Naorat et al. 2013; Olsen et al.
Læs mere Tjek på PubMedLijun Xu, Yufan Xu, Yanghao Zheng, Xiuming Peng, Zongxing Yang, Qing Cao, Dairong Xiang, Handan Zhao
Clinical & Experimental Immunology, 21.07.2021
Tilføjet 22.07.2021
Eric P. Caragata, Heverton L.C. Dutra, Pedro H.F. Sucupira, Alvaro G.A. Ferreira, Luciano A. Moreira
Trends in Parasitology, 21.07.2021
Tilføjet 22.07.2021
In this review we examine how exploiting the Wolbachia–mosquito relationship has become an increasingly popular strategy for controlling arbovirus transmission. Field deployments of Wolbachia-infected mosquitoes have led to significant decreases in dengue virus incidence via high levels of mosquito population suppression and replacement, emphasizing the success of Wolbachia approaches. Here, we examine how improved knowledge of Wolbachia–host interactions has provided key insight into the mechanisms of the essential phenotypes of pathogen blocking and cytoplasmic incompatibility.
Læs mere Tjek på PubMedNathella Pavan Kumar, Chandrasekaran Padmapriyadarsini, Anuradha Rajamanickam, Perumal Kannabiran Bhavani, Arul Nancy, Bharathi Jayadeepa, Nandhini Selvaraj, Dinesh Ashokan, Rachel Mariam Renji, Vijayalakshmi Venkataramani, Srikanth Tripathy, Subash Babu
International Journal of Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
Bacillus Calmette–Guérin (BCG) is a live-attenuated vaccine largely established to protect against childhood meningitis and disseminated tuberculosis (TB) (Foster et al., 2021) Several epidemiological findings suggest that BCG may increase the capacity of the immune system to fight against pathogens other than TB (Leentjens et al., 2015) and such non-specific responses augment both T cell–mediated adaptive and innate immune memory in a process called trained immunity and this could have important implications for improving vaccination strategies.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
Ann M. Navar, Stacey N. Purinton, Qingjiang Hou, Robert J. Taylor, Eric D. Peterson
PLoS One Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
by Ann M. Navar, Stacey N. Purinton, Qingjiang Hou, Robert J. Taylor, Eric D. Peterson
Introduction At the population level, Black and Hispanic adults in the United States have increased risk of dying from COVID-19, yet whether race and ethnicity impact on risk of mortality among those hospitalized for COVID-19 is unclear.
Methods Retrospective cohort study using data on adults hospitalized with COVID-19 from the electronic health record from 52 health systems across the United States contributing data to Cerner Real World DataTM. In-hospital mortality was evaluated by race first in unadjusted analysis then sequentially adjusting for demographics and clinical characteristics using logistic regression.
Results Through August 2020, 19,584 patients with median age 52 years were hospitalized with COVID-19, including n = 4,215 (21.5%) Black and n = 5,761 (29.4%) Hispanic patients. Relative to white patients, crude mortality was slightly higher in Black adults [22.7% vs 20.8%, unadjusted OR 1.12 (95% CI 1.02–1.22)]. Mortality remained higher among Black adults after adjusting for demographic factors including age, sex, date, region, and insurance status (OR 1.13, 95% CI 1.01–1.27), but not after including comorbidities and body mass index (OR 1.07, 95% CI 0.93–1.23). Compared with non-Hispanic patients, Hispanic patients had lower mortality both in unadjusted and adjusted models [mortality 12.7 vs 25.0%, unadjusted OR 0.44(95% CI 0.40–0.48), fully adjusted OR 0.71 (95% CI 0.59–0.86)].
Discussion In this large, multicenter, EHR-based analysis, Black adults hospitalized with COVID-19 had higher observed mortality than white patients due to a higher burden of comorbidities in Black adults. In contrast, Hispanic ethnicity was associated with lower mortality, even in fully adjusted models.
Læs mere Tjek på PubMedSandip Das Sanyam, Sanjay Kumar Sah, Pankaj Chaudhary, Matthew J. Burton, Jeremy J. Hoffman
PLoS One Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
by Sandip Das Sanyam, Sanjay Kumar Sah, Pankaj Chaudhary, Matthew J. Burton, Jeremy J. Hoffman
Background Nepal was under a severe lockdown for several months in 2020 due to the COVID-19 pandemic. There were concerns regarding misinformation circulating on social media. This study aimed to analyse the knowledge and awareness of COVID-19 amongst eye care professionals in Nepal during the first wave of the pandemic.
Methodology We invited 600 participants from 12 ophthalmic centres across Nepal to complete a qualitative, anonymous online survey. Altogether, 25 questions (both open and closed-ended) were used. An overall performance score was calculated from the average of the 12 “Knowledge” questions for all the participants.
Results Of the 600 eye care professionals invited, 310 (51%) participated in the survey. The symptoms of COVID-19 were known to 94%, whilst only 49% of the participants were aware how the disease was transmitted, with 54% aware that anyone can be infected with SARS-CoV-2. Almost 98% of participants recognized the World Health Organization’s (WHO) awareness message, but surprisingly, 41% of participants felt that consumption of hot drinks helps to destroy the virus, in contradiction to WHO information. Importantly, 95% of the participants were aware of personal protective equipment (PPE) and what the acronym stands for. Social distancing was felt to be key to limiting the disease spread; whilst 41% disagreed that PPE should be mandatory for eye care practitioners. The mean overall “Knowledge” performance score was 69.65% (SD ± 22.81).
Conclusion There is still considerable scope to improve the knowledge of COVID-19 amongst ophthalmic professionals in Nepal. Opinion is also split on measures to prevent transmission, with misinformation potentially fuelling confusion. It is recommended to follow WHO and national guidelines, whilst seeking published scientific evidence behind any unofficial statements, to accurately inform one’s clinical practice.
Læs mere Tjek på PubMedFolake Temitope Fadare, Anthony Ifeanyi Okoh
PLoS One Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
by Folake Temitope Fadare, Anthony Ifeanyi Okoh
Globally, there is an increasing occurrence of multidrug-resistant (MDR) Enterobacteriaceae with extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases in clinical and environmental settings of significant concern. Therefore, we aimed to evaluate the occurrence of ESBL/pAmpC genetic determinants, and some essential non-β-lactam genetic determinants in the MDR phenotypic antimicrobial resistance in Enterobacteriaceae isolates recovered from hospital wastewater. We collected samples from two hospitals in Amathole and Chris Hani District Municipalities in the Eastern Cape Province, South Africa, within October and November 2017. Using the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF), we identified a total of 44 presumptive Enterobacteriaceae isolates. From this, 31 were identified as the targeted Enterobacteriaceae members. Thirty-six percent of these belonged to Klebsiella oxytoca, while 29% were Klebsiella pneumoniae. The other identified isolates included Citrobacter freundii and Escherichia coli (10%), Enterobacter asburiae (6%), Enterobacter amnigenus, Enterobacter hormaechei, and Enterobacter kobei (3%). We established the antibiotic susceptibility profiles of these identified bacterial isolates against a panel of 18 selected antibiotics belonging to 11 classes were established following established guidelines by the Clinical and Laboratory Standard Institute. All the bacterial species exhibited resistance phenotypically against at least four antibiotic classes and were classified as MDR. Notably, all the bacterial species displayed resistance against cefotaxime, ampicillin, nalidixic acid, and trimethoprim-sulfamethoxazole. The generated multiple antibiotic resistance indices ranged between 0.5 to 1.0, with the highest value seen in one K. oxytoca isolated. Molecular characterization via the Polymerase Chain Reaction uncovered various ESBLs, pAmpCs, and other non-β-lactam encoding genes. Of the phenotypically resistant isolates screened for each class of antibiotics, the ESBLs detected were blaCTX-M group (including groups 1, 2, and 9) [51.6% (16/31)], blaTEM [32.3% (10/31)], blaOXA-1-like [19.4% (6/31)], blaSHV [12.9% (4/31)], blaPER [6.5% (2/31)], blaVEB [3.2% (1/31)], blaOXA-48-like and blaVIM [15.4% (2/13)], and blaIMP [7.7% (1/13)]. The pAmpC resistance determinants detected were blaCIT [12.9% (4/31)], blaFOX [9.7% (3/31)], blaEBC [6.5% (2/31)], and blaDHA [3.2% (1/31)]. The frequencies of the non-β-lactam genes detected were catII [79.2% (19/24)], tetA [46.7% (14/30)], sulI and sulII [35.5% (11/31)], tetB [23.3% (7/30)], aadA [12.9% (4/31)], tetC [10% (3/30)], and tetD [3.3% (1/30)]. These results indicate that hospital wastewater is laden with potentially pathogenic MDR Enterobacteriaceae with various antibiotic resistance genes that can be spread to humans throughout the food chain, provided the wastewaters are not properly treated before eventual discharge into the environment.
Læs mere Tjek på PubMedMuhammad Adam Norrulashikin, Fadhilah Yusof, Nur Hanani Mohd Hanafiah, Siti Mariam Norrulashikin
PLoS One Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
by Muhammad Adam Norrulashikin, Fadhilah Yusof, Nur Hanani Mohd Hanafiah, Siti Mariam Norrulashikin
The increasing trend in the number new cases of influenza every year as reported by WHO is concerning, especially in Malaysia. To date, there is no local research under healthcare sector that implements the time series forecasting methods to predict future disease outbreak in Malaysia, specifically influenza. Addressing the problem could increase awareness of the disease and could help healthcare workers to be more prepared in preventing the widespread of the disease. This paper intends to perform a hybrid ARIMA-SVR approach in forecasting monthly influenza cases in Malaysia. Autoregressive Integrated Moving Average (ARIMA) model (using Box-Jenkins method) and Support Vector Regression (SVR) model were used to capture the linear and nonlinear components in the monthly influenza cases, respectively. It was forecasted that the performance of the hybrid model would improve. The data from World Health Organization (WHO) websites consisting of weekly Influenza Serology A cases in Malaysia from the year 2006 until 2019 have been used for this study. The data were recategorized into monthly data. The findings of the study showed that the monthly influenza cases could be efficiently forecasted using three comparator models as all models outperformed the benchmark model (Naïve model). However, SVR with linear kernel produced the lowest values of RMSE and MAE for the test dataset suggesting the best performance out of the other comparators. This suggested that SVR has the potential to produce more consistent results in forecasting future values when compared with ARIMA and the ARIMA-SVR hybrid model.
Læs mere Tjek på PubMedNick Scott, Allan Saul, Tim Spelman, Mark Stoove, Alisa Pedrana, Alexander Saeri, Emily Grundy, Liam Smith, Michael Toole, Chandini Raina McIntyre, Brendan S. Crabb, Margaret Hellard
PLoS One Infectious Diseases, 21.07.2021
Tilføjet 22.07.2021
by Nick Scott, Allan Saul, Tim Spelman, Mark Stoove, Alisa Pedrana, Alexander Saeri, Emily Grundy, Liam Smith, Michael Toole, Chandini Raina McIntyre, Brendan S. Crabb, Margaret Hellard
Background Whilst evidence of use of face masks in reducing COVID-19 cases is increasing, the impact of mandatory use across a large population has been difficult to assess. Introduction of mandatory mask use on July 22, 2020 during a resurgence of COVID-19 in Melbourne, Australia created a situation that facilitated an assessment of the impact of the policy on the epidemic growth rate as its introduction occurred in the absence of other changes to restrictions.
Methods and findings Exponential epidemic growth or decay rates in daily COVID-19 diagnoses were estimated using a non-weighted linear regression of the natural logarithm of the daily cases against time, using a linear spline model with one knot (lspline package in R v 3.6.3). The model’s two linear segments pivot around the hinge day, on which the mask policy began to take effect, 8 days following the introduction of the policy. We used two forms of data to assess change in mask usage: images of people wearing masks in public places obtained from a major media outlet and population-based survey data. Potential confounding factors (including daily COVID-19 tests, number of COVID-19 cases among population subsets affected differentially by the mask policy–e.g., healthcare workers) were examined for their impact on the results. Daily cases fitted an exponential growth in the first log-linear segment (k = +0.042, s.e. = 0.007), and fitted an exponential decay in the second (k = -0.023, s.e. = 0.017) log-linear segment. Over a range of reported serial intervals for SARS-CoV-2 infection, these growth rates correspond to a 22–33% reduction in an effective reproduction ratio before and after mandatory mask use. Analysis of images of people in public spaces showed mask usage rose from approximately 43% to 97%. Analysis of survey data found that on the third day before policy introduction, 44% of participants reported “often” or “always” wearing a mask; on the fourth day after, 100% reported “always” doing so. No potentially confounding factors were associated with the observed change in growth rates.
Conclusions The mandatory mask use policy substantially increased public use of masks and was associated with a significant decline in new COVID-19 cases after introduction of the policy. This study strongly supports the use of masks for controlling epidemics in the broader community.
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