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1
Recurrent Valvular Vegetation: Fooled Me Once, But Won’t Fool Me Twice
Fritzlen J, Tichenor J, Moore C, et al.
Clinical Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
A 61-year-old female presented to the cardiology clinic for evaluation of dyspnea on exertion, dry cough, palpitations, and chest tightness that had been progressing over the past month. She had recently been seen by her rural primary care physician and was prescribed antibiotics and steroids for possible pneumonia, which did not alleviate her symptoms. She denied any fevers, chills, sweats, arthralgia, diarrhea, weight changes, or neurological complaints at the time of presentation. She denied any recent injuries or procedures. She had remained relatively healthy over the past few years, but remembered feeling similar 4 years earlier when she was found to have degenerative mitral valve disease requiring repair. At that time, a partially calcified vegetative lesion reminiscent of healed endocarditis was found on gross examination during surgical repair (Figure 1). Histological examination of the tissue showed calcification, fibrosis, and very focal myxoid change with mild acute and chronic inflammation. Gram stain showed rare neutrophils and no organisms. Tissue cultures did not grow bacteria, fungi, or mycobacteria. The patient was not evaluated by an infectious diseases physician at the time, possibly because of low suspicion of active infection. No additional serological evaluation was performed and the etiology of her endocarditis remained unknown.
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2
Diagnostic Value of 16S Ribosomal RNA Gene Polymerase Chain Reaction/Sanger Sequencing in Clinical Practice
Fida M, Khalil S, Abu Saleh O, et al.
Clinical Infectious Diseases, 18.08.2021
Tilføjet 15.09.2021
AbstractBackgroundAccurate microbiologic diagnosis is important for appropriate management of infectious diseases. Sequencing-based molecular diagnostics are increasingly used for precision diagnosis of infections. However, their clinical utility is unclear.MethodsWe conducted a retrospective analysis of specimens that underwent 16S ribosomal RNA (rRNA) gene polymerase chain reaction (PCR) followed by Sanger sequencing at our institution from April 2017 through March 2019.ResultsA total of 566 specimens obtained from 460 patients were studied. Patients were considered clinically infected or noninfected based on final diagnosis and management. In 17% of patients, 16S rRNA PCR/sequencing was positive and in 5% of patients, this test led to an impact on clinical care. In comparison, bacterial cultures were positive in 21% of patients. Specimens with a positive Gram stain had 12 times greater odds of having a positive molecular result than those with a negative Gram stain (95% confidence interval for odds ratio, 5.2–31.4). Overall, PCR positivity was higher in cardiovascular specimens (37%) obtained from clinically infected patients, with bacterial cultures being more likely to be positive for musculoskeletal specimens (P < .001). 16S rRNA PCR/sequencing identified a probable pathogen in 10% culture-negative specimens.Conclusion16S rRNA PCR/sequencing can play a role in the diagnostic evaluation of patients with culture-negative infections, especially those with cardiovascular infections.
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3
Epidemiology, Natural History, Diagnosis, and Treatment of Trichomonas vaginalis in Men
Van Gerwen O, Camino A, Sharma J, et al.
Clinical Infectious Diseases, 4.07.2021
Tilføjet 15.09.2021
AbstractTrichomonas vaginalis infections in men are traditionally considered to be benign and consequently have been overlooked. However, men with this common sexually transmitted infection can experience urethritis, prostatitis, reduced fertility, and amplified human immunodeficiency virus risk. In addition, men are often asymptomatic and can unknowingly spread the infection to their female sexual partners. With advances in T. vaginalis diagnostics, more men are being diagnosed, yet the optimal method of treatment in men remains unknown. The purpose of this review is to discuss the epidemiology, natural history, diagnosis, and treatment of T. vaginalis among men.
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4
Immunologic and Virologic Factors Associated With Hospitalization in Human Immunodeficiency Virus–Exposed, Uninfected Infants in the United States
Smith C, , Huo Y, et al.
Clinical Infectious Diseases, 22.06.2021
Tilføjet 15.09.2021
AbstractBackgroundHuman immunodeficiency virus (HIV)–exposed, uninfected (HEU) infants experience higher rates of morbidity and mortality than HIV-unexposed, uninfected (HUU) infants. Few studies have examined whether particular infections and/or immune responses are associated with hospitalization among HEU infants born in the United States.MethodsWe evaluated a subset of HEU infants enrolled in the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1025 and/or Pediatric HIV/AIDS Cohort Study Surveillance Monitoring for ART Toxicities studies. We determined seroconversion to 6 respiratory viruses and measured antibody concentrations to 9 vaccine antigens using quantitative ELISA or electrochemiluminescence. Multivariable modified Poisson regression models were fit to evaluate associations of seroconversion to each respiratory virus/family and antibody concentrations to vaccine antigens with risk of hospitalization in the first year of life. Antibody concentrations to vaccine antigens were compared between HEU infants and HUU infants from a single site using multivariable linear regression models.ResultsAmong 556 HEU infants, seroconversion to respiratory syncytial virus (RSV) and parainfluenza was associated with hospitalization (adjusted risk ratio, 1.95 [95% CI, 1.21–3.15] and 2.30 [1.42–3.73], respectively). Antibody concentrations to tetanus toxoid, pertussis, and pneumococcal vaccine antigens were higher among 525 HEU compared with 100 HUU infants. No associations were observed between antibody concentrations with any vaccine and hospitalization among HEU infants.ConclusionsRSV and parainfluenza contribute to hospitalization among HEU infants in the first year of life. HEU infants demonstrate robust antibody responses to vaccine antigens; therefore, humoral immune defects likely do not explain the increased susceptibility to infection observed in this population.
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5
Children and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission: A Step Closer to Better Understanding and Evidence-Based Interventions?
Buonsenso D, Valentini P.
Clinical Infectious Diseases, 18.06.2021
Tilføjet 15.09.2021
6
Improving the Outcomes of Immunocompromised Patients With Coronavirus Disease 2019
Haidar G, Mellors J.
Clinical Infectious Diseases, 5.05.2021
Tilføjet 15.09.2021
AbstractRecent case studies have highlighted the fact that certain immunocompromised individuals are at risk for prolonged SARS-CoV-2 replication, intrahost viral evolution of multiply-mutated variants, and poor clinical outcomes. The immunologic determinants of this risk, the duration of infectiousness, and optimal treatment and prevention strategies in immunocompromised hosts are ill defined. Of additional concern is the widespread use of immunosuppressive medications to treat COVID-19, which may enhance and prolong viral replication in the context of immunodeficiency. We outline the rationale for 4 interrelated approaches to usher in an era of evidence-based medicine for optimal management of immunocompromised patients with COVID-19: multicenter pathogenesis and outcomes studies to relate the risk of severe disease to the type and degree of immunodeficiency, studies to evaluate immunologic responses to SARS-CoV-2 vaccines, studies to evaluate the efficacy of monoclonal antibodies for primary prophylaxis, and clinical trials of novel antiviral agents for the treatment of COVID-19.
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7
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Viral Load Kinetics in Symptomatic Children, Adolescents, and Adults
Bellon M, Baggio S, Jacquerioz Bausch F, et al.
Clinical Infectious Diseases, 4.05.2021
Tilføjet 15.09.2021
AbstractSARS-CoV-2 viral load (VL) can serve as a correlate for infectious virus presence and transmission. Viral shedding kinetics over the first week of illness for symptomatic children (n = 279), adolescents (n = 639), and adults (n = 7109) show VLs compatible with infectious virus presence, with slightly lower VL in children than adults.
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8
Megasphaera in the Stool Microbiota Is Negatively Associated With Diarrheal Cryptosporidiosis
Carey M, Medlock G, Alam M, et al.
Clinical Infectious Diseases, 4.05.2021
Tilføjet 15.09.2021
AbstractBackgroundThe protozoan parasites in the Cryptosporidium genus cause both acute diarrheal disease and subclinical (ie, nondiarrheal) disease. It is unclear if the microbiota can influence the manifestation of diarrhea during a Cryptosporidium infection.MethodsTo characterize the role of the gut microbiota in diarrheal cryptosporidiosis, the microbiome composition of both diarrheal and surveillance Cryptosporidium-positive fecal samples from 72 infants was evaluated using 16S ribosomal RNA gene sequencing. Additionally, the microbiome composition prior to infection was examined to test whether a preexisting microbiome profile could influence the Cryptosporidium infection phenotype.ResultsFecal microbiome composition was associated with diarrheal symptoms at 2 timepoints. Megasphaera was significantly less abundant in diarrheal samples compared with subclinical samples at the time of Cryptosporidium detection (log2 [fold change] = –4.3; P = 10–10) and prior to infection (log2 [fold change] = –2.0; P = 10–4); this assigned sequence variant was detected in 8 children who had diarrhea and 30 children without diarrhea. Random forest classification also identified Megasphaera abundance in the pre- and postexposure microbiota as predictive of a subclinical infection.ConclusionsMicrobiome composition broadly, and specifically low Megasphaera abundance, was associated with diarrheal symptoms prior to and at the time of Cryptosporidium detection. This observation suggests that the gut microenvironment may play a role in determining the severity of a Cryptosporidium infection.Clinical Trials Registration. NCT02764918.
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9
Isavuconazole Treatment of Invasive Fungal Sinusitis: A Post Hoc Analysis of the SECURE and VITAL Trials
Durand M, Kitt T, Song Y, et al.
Clinical Infectious Diseases, 29.04.2021
Tilføjet 15.09.2021
AbstractThis post hoc analysis of international phase III isavuconazole trials identified 50 patients (90% immunocompromised or diabetic) with invasive fungal sinusitis (88% mucormycetes, Aspergillus) who received isavuconazole as primary (n = 33) or salvage (n = 17) therapy for a median of 82 days (range, 2–882). Overall survival was 82% at day 42 and 70% at day 84.
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10
Disease Severity and Durability of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Response: A View Through the Lens of the Second Year of the Pandemic
Pirofski L.
Clinical Infectious Diseases, 27.04.2021
Tilføjet 15.09.2021
National Institutes of Health10.13039/100000002R01AI123654R01AI143453National Center for Advancing Translational Sciences10.13039/1000061083UL1TR002556-04S1
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11
Moving on From HAND: Why We Need New Criteria for Cognitive Impairment in Persons Living With Human Immunodeficiency Virus and a Proposed Way Forward
Nightingale S, Dreyer A, Saylor D, et al.
Clinical Infectious Diseases, 27.04.2021
Tilføjet 15.09.2021
AbstractHuman immunodeficiency virus (HIV)–associated neurocognitive disorders (HAND) criteria are frequently used to describe cognitive impairment in persons living with HIV (PLWH) across diverse populations globally. These criteria typically find 20–60% of PLWH meet criteria for HAND, which does not tally with clinical observations in the modern era that cognitive disorders present relatively infrequently. Most with HAND have asymptomatic neurocognitive impairment; however, the significance of low cognitive test performance without symptoms is uncertain. Methods underlying HAND criteria carry a false-positive rate that can exceed 20%. Comorbidities, education, and complex socioeconomic factors can influence cognitive test performance, further increasing the potential for misclassification. We propose a new framework to characterize cognitive impairment in PLWH that requires a clinical history and acknowledges the multifactorial nature of low cognitive test performance. This framework is intended to be applicable across diverse populations globally, be more aligned with clinical observations, and more closely represent HIV brain pathology.
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12
Effectiveness of Messenger RNA Coronavirus Disease 2019 (COVID-19) Vaccines Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in a Cohort of Healthcare Personnel
Swift M, Breeher L, Tande A, et al.
Clinical Infectious Diseases, 26.04.2021
Tilføjet 15.09.2021
AbstractIn a large cohort of United States healthcare personnel without prior coronavirus disease 2019 (COVID-19) infection, 94 382 doses of messenger RNA (mRNA) COVID-19 vaccine were administered to 49 220 individuals. The adjusted vaccine effectiveness following 2 doses of each of the 2 available brands of mRNA vaccine exceeded 96%.
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13
Assess Ventilation When Determining Safe Distancing in Schools to Control Coronavirus Disease 2019 (COVID-19) Transmission
Lynch R, Favata E, Gochfeld M.
Clinical Infectious Diseases, 25.04.2021
Tilføjet 15.09.2021
14
Supporting Drug Development for Neglected Tropical Diseases Using Mathematical Modeling
Walker M, Hamley J, Milton P, et al.
Clinical Infectious Diseases, 23.04.2021
Tilføjet 15.09.2021
AbstractDrug-based interventions are at the heart of global efforts to reach elimination as a public health problem (trachoma, soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis) or elimination of transmission (onchocerciasis) for 5 of the most prevalent neglected tropical diseases tackled via the World Health Organization preventive chemotherapy strategy. While for some of these diseases there is optimism that currently available drugs will be sufficient to achieve the proposed elimination goals, for others—particularly onchocerciasis—there is a growing consensus that novel therapeutic options will be needed. Since in this area no high return of investment is possible, minimizing wasted money and resources is essential. Here, we use illustrative results to show how mathematical modeling can guide the drug development pathway, yielding resource-saving and efficiency payoffs, from the refinement of target product profiles and intended context of use to the design of clinical trials.
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15
Severe Emerging Infections, Survivorship, and the Need for Systematic Approaches that Incorporate Clinical Syndromes
Brett-Major D.
Clinical Infectious Diseases, 17.04.2021
Tilføjet 15.09.2021
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Viral Sequencing to Investigate Sources of SARS-CoV-2 Infection in US Healthcare Personnel
Braun K, Moreno G, Buys A, et al.
Clinical Infectious Diseases, 15.04.2021
Tilføjet 15.09.2021
AbstractBackgroundHealthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We posit that current infection control guidelines generally protect HCP from SARS-CoV-2 infection in a healthcare setting.MethodsIn this retrospective case series, we used viral genomics to investigate the likely source of SARS-CoV-2 infection in HCP at a major academic medical institution in the Upper Midwest of the United States between 25 March and 27 December 2020. We obtained limited epidemiological data through informal interviews and review of the electronic health record and combined this information with healthcare-associated viral sequences and viral sequences collected in the broader community to infer the most likely source of infection in HCP.ResultsWe investigated SARS-CoV-2 infection clusters involving 95 HCP and 137 possible patient contact sequences. The majority of HCP infections could not be linked to a patient or coworker (55 of 95 [57.9%]) and were genetically similar to viruses circulating concurrently in the community. We found that 10.5% of HCP infections (10 of 95) could be traced to a coworker. Strikingly, only 4.2% (4 of 95) could be traced to a patient source.ConclusionsInfections among HCP add further strain to the healthcare system and put patients, HCP, and communities at risk. We found no evidence for healthcare-associated transmission in the majority of HCP infections evaluated. Although we cannot rule out the possibility of cryptic healthcare-associated transmission, it appears that HCP most commonly become infected with SARS-CoV-2 via community exposure. This emphasizes the ongoing importance of mask wearing, physical distancing, robust testing programs, and rapid distribution of vaccines.
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17
What Fraction of Adult Community-Acquired Pneumonia Is Caused by the Pneumococcus? New Insights from Spain
Grijalva C.
Clinical Infectious Diseases, 14.04.2021
Tilføjet 15.09.2021
National Institute of Allergy and Infectious Diseases10.13039/100000060National Institutes of Health10.13039/100000002K24 AI148459
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18
Nosocomial Outbreak of Coronavirus Disease 2019 by Possible Airborne Transmission Leading to a Superspreading Event
Cheng V, Fung K, Siu G, et al.
Clinical Infectious Diseases, 14.04.2021
Tilføjet 15.09.2021
AbstractBackgroundNosocomial outbreaks with superspreading of coronavirus disease 2019 due to a possible airborne transmission have not been reported.MethodsEpidemiological analysis, environmental samplings, and whole-genome sequencing (WGS) were performed for a hospital outbreak.ResultsA superspreading event that involved 12 patients and 9 healthcare workers (HCWs) occurred within 9 days in 3 of 6 cubicles at an old-fashioned general ward with no air exhaust built within the cubicles. The environmental contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was significantly higher in air grilles (>2 m from patients’ heads and not within reach) than on high-touch clinical surfaces (36.4%, 8 of 22 vs 3.4%, 1 of 29, P = .003). Six (66.7%) of 9 contaminated air exhaust grilles were located outside patient cubicles. The clinical attack rate of patients was significantly higher than of HCWs (15.4%, 12 of 78 exposed patients vs 4.6%, 9 of 195 exposed HCWs, P = .005). Moreover, the clinical attack rate of ward-based HCWs was significantly higher than of nonward-based HCWs (8.1%, 7 of 68 vs 1.8%, 2 of 109, P = .045). The episodes (mean ± standard deviation) of patient-care duty assignment in the cubicles was significantly higher among infected ward-based HCWs than among noninfected ward-based HCWs (6.0 ± 2.4 vs 3.0 ± 2.9, P = .012) during the outbreak period. The outbreak strains belong to SARS-CoV-2 lineage B.1.36.27 (GISAID clade GH) with the unique S-T470N mutation on WGS.ConclusionsThis nosocomial point source superspreading event due to possible airborne transmission demonstrates the need for stringent SARS-CoV-2 screening at admission to healthcare facilities and better architectural design of ventilation systems to prevent such outbreaks. Portable high-efficiency particulate filters were installed in each cubicle to improve ventilation before resumption of clinical service.
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19
Sera Neutralizing Activities Against Severe Acute Respiratory Syndrome Coronavirus 2 and Multiple Variants 6 Months After Hospitalization for Coronavirus Disease 2019
Betton M, Livrozet M, Planas D, et al.
Clinical Infectious Diseases, 14.04.2021
Tilføjet 15.09.2021
AbstractBackgroundHumoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs within the first weeks after coronavirus disease 2019 (COVID-19). Those antibodies exert a neutralizing activity against SARS-CoV-2, whose evolution over time after COVID-19 as well as efficiency against novel variants are poorly characterized.MethodsIn this prospective study, sera of 107 patients hospitalized with COVID-19 were collected at 3 and 6 months postinfection. We performed quantitative neutralization experiments on top of high-throughput serological assays evaluating anti-spike (S) and anti-nucleocapsid (NP) immunoglobulin G (IgG).ResultsLevels of seroneutralization and IgG rates against the ancestral strain decreased significantly over time. After 6 months, 2.8% of the patients had a negative serological status for both anti-S and anti-NP IgG. However, all sera had a persistent and effective neutralizing effect against SARS-CoV-2. IgG levels correlated with seroneutralization, and this correlation was stronger for anti-S than for anti-NP antibodies. The level of seroneutralization quantified at 6 months correlated with markers of initial severity, notably admission to intensive care units and the need for mechanical invasive ventilation. In addition, sera collected at 6 months were tested against multiple SARS-CoV-2 variants and showed efficient neutralizing effects against the D614G, B.1.1.7, and P.1 variants but significantly weaker activity against the B.1.351 variant.ConclusionsDecrease in IgG rates and serological assays becoming negative did not imply loss of neutralizing capacity. Our results indicate a sustained humoral response against the ancestral strain and the D614G, B.1.1.7, and P.1 variants for at least 6 months in patients previously hospitalized for COVID-19. A weaker protection was, however, observed for the B.1.351 variant.
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20
The Evolution and Distribution of Pneumococcal Serotypes in Adults Hospitalized With Community-Acquired Pneumonia in Spain Using a Serotype-Specific Urinary Antigen Detection Test: The CAPA Study, 2011–2018
Torres A, Menéndez R, España P, et al.
Clinical Infectious Diseases, 14.04.2021
Tilføjet 15.09.2021
AbstractBackgroundSpain introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in the childhood National Immunization Program in 2015–2016 with coverage of 3 doses of 94.8% in 2018. We assessed the evolution of all pneumococcal, PCV13 vaccine type (VT), and experimental PCV20-VT (PCV13 + serotypes 8, 10A, 11A, 12F, 15B, 22F, 33F) hospitalized community-acquired pneumonia (CAP) in adults in Spain from 2011–2018.MethodsA prospective observational study of immunocompetent adults (≥18 years) admitted to 4 Spanish hospitals with chest X-ray–confirmed CAP between November 2011 and November 2018. Microbiological confirmation was obtained using the Pfizer serotype-specific urinary antigen detection tests (UAD1/UAD2), BinaxNow test for urine, and conventional cultures of blood, pleural fluid, and high-quality sputum.ResultsOf 3107 adults hospitalized with CAP, 1943 were ≥65 years. Underlying conditions were present in 87% (n = 2704) of the participants. Among all patients, 895 (28.8%) had pneumococcal CAP and 439 (14.1%) had PCV13-VT CAP, decreasing from 17.9% (n = 77) to 13.2% (n = 68) from 2011–2012 to 2017–2018 (P = .049). PCV20-VT CAP occurred in 243 (23.8%) of those included in 2016–2018. The most identified serotypes were 3 and 8. Serotype 3 accounted for 6.9% (n = 215) of CAP cases, remaining stable during the study period, and was associated with disease severity.ConclusionsPCV13-VT caused a substantial proportion of CAP in Spanish immunocompetent adults 8 years after introduction of childhood PCV13 immunization. Improving direct PCV13 coverage of targeted adult populations could further reduce PCV13-VT burden, a benefit that could be increased further if PCV20 is licensed and implemented.
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21
Epidemiologic Characteristics Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antigen-Based Test Results, Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) Cycle Threshold Values, Subgenomic RNA, and Viral Culture Results From University Testing
Ford L, Lee C, Pray I, et al.
Clinical Infectious Diseases, 12.04.2021
Tilføjet 15.09.2021
AbstractBackgroundReal-time reverse transcription polymerase chain reaction (rRT-PCR) and antigen tests are important diagnostics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sensitivity of antigen tests has been shown to be lower than that of rRT-PCR; however, data to evaluate epidemiologic characteristics that affect test performance are limited.MethodsPaired mid-turbinate nasal swabs were collected from university students and staff and tested for SARS-CoV-2 using both Quidel Sofia SARS Antigen Fluorescent Immunoassay (FIA) and rRT-PCR assay. Specimens positive by either rRT-PCR or antigen FIA were placed in viral culture and tested for subgenomic RNA (sgRNA). Logistic regression models were used to evaluate characteristics associated with antigen results, rRT-PCR cycle threshold (Ct) values, sgRNA, and viral culture.ResultsAntigen FIA sensitivity was 78.9% and 43.8% among symptomatic and asymptomatic participants, respectively. Among rRT-PCR positive participants, negative antigen results were more likely among asymptomatic participants (odds ratio [OR] 4.6, 95% confidence interval [CI]: 1.3–15.4) and less likely among participants reporting nasal congestion (OR 0.1, 95% CI: .03–.8). rRT-PCR-positive specimens with higher Ct values (OR 0.5, 95% CI: .4–.8) were less likely, and specimens positive for sgRNA (OR 10.2, 95% CI: 1.6–65.0) more likely, to yield positive virus isolation. Antigen testing was >90% positive in specimens with Ct values < 29. Positive predictive value of antigen test for positive viral culture (57.7%) was similar to that of rRT-PCR (59.3%).ConclusionsSARS-CoV-2 antigen test advantages include low cost, wide availability and rapid turnaround time, making them important screening tests. The performance of antigen tests may vary with patient characteristics, so performance characteristics should be accounted for when designing testing strategies and interpreting results.
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22
Reactivation of Resolved Hepatitis B After Daratumumab for Multiple Myeloma
Lee S, Sung P, Park S, et al.
Clinical Infectious Diseases, 12.04.2021
Tilføjet 15.09.2021
AbstractThe risk of reactivation of resolved hepatitis B virus (HBV) in hepatitis B surface antigen (HBsAg)-negative multiple myeloma patients after daratumumab has not been reported. Among 93 patients with daratumumab treatment, reactivation occurred in 6 patients (6.5%) with one hepatic failure. This is the first report demonstrating a considerable risk of reactivation of resolved HBV after daratumumab.
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23
Effect of high and low risk susceptibles in the transmission dynamics of COVID-19 and control strategies
Adnan Khan, Mohsin Ali, Wizda Iqbal, Mudassar Imran
PLoS One Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
by Adnan Khan, Mohsin Ali, Wizda Iqbal, Mudassar Imran
In this study, we formulate and analyze a deterministic model for the transmission of COVID-19 and evaluate control strategies for the epidemic. It has been well documented that the severity of the disease and disease related mortality is strongly correlated with age and the presence of co-morbidities. We incorporate this in our model by considering two susceptible classes, a high risk, and a low risk group. Disease transmission within each group is modelled by an extension of the SEIR model, considering additional compartments for quarantined and treated population groups first and vaccinated and treated population groups next. Cross Infection across the high and low risk groups is also incorporated in the model. We calculate the basic reproduction number R0 and show that for R01 the disease is endemic. We note that varying the relative proportion of high and low risk susceptibles has a strong effect on the disease burden and mortality. We devise optimal medication and vaccination strategies for effective control of the disease. Our analysis shows that vaccinating and medicating both groups is needed for effective disease control and the controls are not very sensitive to the proportion of the high and low risk populations.
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24
Acceptance of COVID-19 vaccine in Pakistan among health care workers
Asmara Malik, Jahanzeb Malik, Uzma Ishaq
PLoS One Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
by Asmara Malik, Jahanzeb Malik, Uzma Ishaq
Objective Acceptance of the COVID-19 vaccine will impart a pivotal role in eradicating the virus. In Pakistan, health care workers (HCWs) are the first group to receive vaccination. This survey aimed at the level of acceptance to the COVID-19 vaccine and predictors of non-acceptance in HCWs.
Method This was a cross-sectional study design and data were collected through 3rd December 2020 and February 14th, 2021. An English questionnaire was distributed through social media platforms and administration of affiliate hospitals along with snowball sampling for private hospitals.
Results Out of 5,237 responses, 3,679 (70.2%) accepted COVID-19 vaccination and 1,284 (24.5%) wanted to delay until more data was available. Only 5.2% of HCWs rejected being vaccinated. Vaccine acceptance was more in young (76%) and female gender (63.3%) who worked in a tertiary care hospital (51.2%) and were direct patient care providers (61.3%). The reason for rejection in females was doubtful vaccine effectiveness (31.48%) while males rejected due to prior COVID-19 exposure (42.19%) and side effect profile of the vaccine (33.17%). Logistic regression analysis demonstrated age between 51–60 years, female gender, Pashtuns, those working in the specialty of medicine and allied, taking direct care of COVID-19 patients, higher education, and prior COVID-19 infection as the predictors for acceptance or rejection of COVID-19 vaccine.
Conclusion In conclusion, this survey suggests that early on in a vaccination drive, majority of the HCWs in Pakistan are willing to be vaccinated and only a small number of participants would actually reject being vaccinated.
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25
Comparison of machine learning methods for estimating case fatality ratios: An Ebola outbreak simulation study
Alpha Forna, Ilaria Dorigatti, Pierre Nouvellet, Christl A. Donnelly
PLoS One Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
by Alpha Forna, Ilaria Dorigatti, Pierre Nouvellet, Christl A. Donnelly
Background Machine learning (ML) algorithms are now increasingly used in infectious disease epidemiology. Epidemiologists should understand how ML algorithms behave within the context of outbreak data where missingness of data is almost ubiquitous.
Methods Using simulated data, we use a ML algorithmic framework to evaluate data imputation performance and the resulting case fatality ratio (CFR) estimates, focusing on the scale and type of data missingness (i.e., missing completely at random—MCAR, missing at random—MAR, or missing not at random—MNAR).
Results Across ML methods, dataset sizes and proportions of training data used, the area under the receiver operating characteristic curve decreased by 7% (median, range: 1%–16%) when missingness was increased from 10% to 40%. Overall reduction in CFR bias for MAR across methods, proportion of missingness, outbreak size and proportion of training data was 0.5% (median, range: 0%–11%).
Conclusion ML methods could reduce bias and increase the precision in CFR estimates at low levels of missingness. However, no method is robust to high percentages of missingness. Thus, a datacentric approach is recommended in outbreak settings—patient survival outcome data should be prioritised for collection and random-sample follow-ups should be implemented to ascertain missing outcomes.
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26
How did Covid-19 impact US household foods? an analysis six months in
Kuan-Ming Huang, Ana Claudia Sant’Anna, Xiaoli Etienne
PLoS One Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
by Kuan-Ming Huang, Ana Claudia Sant’Anna, Xiaoli Etienne
Using a nationwide survey of primary grocery shoppers conducted in August 2020, we examine household food spending when the economy had partially reopened and consumers had different spending opportunities in comparison to when the Covid-19 lockdown began. We estimate the impact of Covid-19 on household spending using interval and Order Probit regressions. Income levels, age, access to grocery stores and farmers markets, household demographic information, along with other independent variables are controlled in the model. Findings show that middle-class households (with income below $50,000, or with income between $50,000 and $99,999) are less likely to increase their grocery expenditures during the pandemic. Households with children or elderlies that usually require higher food quality and nutrition intakes had a higher probability of increasing their spending during Covid-19 than before. Furthermore, consumers’ spending behaviors were also significantly affected by their safe handing levels and the Covid-19 severity and food accessibility in their residences.
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27
Seroprevalence of SARS-CoV-2 antibodies among homeless people living rough, in shelters and squats: A large population-based study in France
Sandrine Loubiere, Elisabetta Monfardini, Camille Allaria, Marine Mosnier, Agathe Allibert, Laetitia Ninove, Thomas Bosetti, Cyril Farnarier, Ilyes Hamouda, Pascal Auquier, Emilie Mosnier, Aurélie Tinland
PLoS One Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
by Sandrine Loubiere, Elisabetta Monfardini, Camille Allaria, Marine Mosnier, Agathe Allibert, Laetitia Ninove, Thomas Bosetti, Cyril Farnarier, Ilyes Hamouda, Pascal Auquier, Emilie Mosnier, Aurélie Tinland
Background Overcrowded housing, as well as inadequate sanitary conditions, contribute to making homeless people particularly vulnerable to the SARS-CoV-2 infection. We aimed to assess the seroprevalence of the SARS-CoV-2 infection among people experiencing homelessness on a large city-wide scale in Marseille, France, taking into account different types of accommodation.
Methods A consortium of outreach teams in 48 different locations including streets, slums, squats, emergency or transitional shelters and drop-in centres participated in the inclusion process. All participants consented to have a validated rapid antibody assay for immunoglobulins M (IgM) and G (IgG) and to answer a questionnaire on medical health conditions, comorbidities, and previous COVID-19 symptoms. Information on their housing conditions since the COVID-19 crisis was also collected from the participants.
Results From June 01 to August 05, 2020, 1,156 homeless participants were enrolled in the study and tested. The overall seroprevalence of SARS-CoV-2 IgG/IgM antibodies was 5.6% (95%CI 2.3–7.0), ranging from 2.2% in people living on the streets to 8.1% in people living in emergency shelters (P = 0.009). Around one third of the seropositive participants reported COVID-19 symptoms. Compared to the general population in Marseille (3.6%), the homeless population living in the same urban area experienced a significantly increased risk of SARS-CoV-2 infection (|z| = 3.65 > 1.96).
Conclusion These findings highlight the need for regular screening among the homeless to prevent clustering in overcrowded or inadequate accommodations. It is also necessary to provide essential resources to keep homeless people healthy, the vast majority of whom have cumulative risk factors for SARS-CoV-2 infection.
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28
Changes in values and well-being amidst the COVID-19 pandemic in Poland
Agnieszka Bojanowska, Łukasz D. Kaczmarek, Maciej Koscielniak, Beata Urbańska
PLoS One Infectious Diseases, 15.09.2021
Tilføjet 15.09.2021
by Agnieszka Bojanowska, Łukasz D. Kaczmarek, Maciej Koscielniak, Beata Urbańska
COVID-19 caused a global change in the lifestyles of people around the world. It provided a unique opportunity to examine how external circumstances impact two crucial aspects of functioning relating to "who I am" (values) and "how I feel" (well-being). Participants (N = 215) reported their values and subjective and eudaimonic well-being, nine months before the first lockdown in Poland and two weeks and four weeks into the first lockdown. We observed increased valuing of self-direction, security, conformity, humility, caring, and universalism and a decrease in valuing hedonism. Individuals experienced decreased subjective and eudaimonic well-being, with women responding with stronger negative affect intensity relative to men. Finally, we identified that individuals who were more open to change before the COVID-19 pandemic responded with higher eudaimonic well-being two weeks into lockdown relative to their less open to change peers. This study is unique in that it shows that well-being and individually held values are flexible and adaptive systems that react to external circumstances such as global critical events.
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29
Lung Ultrasound Findings of Patients with Dengue Infection: A Prospective Observational Study
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 766-770
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30
Performance of a New Microfluidic Dengue NS1 Immuno-magnetic Agglutination Assay for the Rapid Diagnosis of Dengue Infection in Adults
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 771-776
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31
Probable Nipa Palm Wine-Associated Hepatitis A Outbreak after Attending a Funeral Ceremony in Sabah
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 777-782
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32
Incidence of Laboratory-Confirmed Influenza among HIV-Infected versus HIV-Uninfected Individuals in Two Districts of Ghana, 2014 to 2016
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 783-787
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33
Risk Factors and Protective Immunity Against Rabies in Unvaccinated Butchers Working at Dog Slaughterhouses in Northern Vietnam
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 788-793
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34
Characteristics of Three Person-to-Person Transmission Clusters of Severe Fever with Thrombocytopenia Syndrome in Southeastern China
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 794-800
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35
Acute Appendicitis Associated with Hantaan Virus Infection
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 801-806
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36
La Crosse Virus Disease in the United States, 2003–2019
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 807-812
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37
Identification and Isolation of Japanese Encephalitis Virus Genotype IV from Culex vishnui Collected in Bali, Indonesia in 2019
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 813-817
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38
Nosocomial Respiratory Infections in a Rural Zambian Hospital
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 818-821
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39
Precision of Serologic Testing from Dried Blood Spots Using a Multiplex Bead Assay
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 822-827
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40
The Burden of Snakebite in Rural Communities in Kenya: A Household Survey
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 828-836
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41
Disparities in Physical Accessibility among Rural Thais Under Universal Health Coverage
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 837-845
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42
The Association of Low Blood Glucose and Low Serum Cortisol Levels in Severely Ill Children Admitted to Tertiary Referral Hospitals in Malawi: A Case-Control Study
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 846-851
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43
Stability of Zika Virus Antibodies in Specimens from a Retrospective Serological Study
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 852-852
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44
Another View of American Descendants of Slavery Representation in the American Global Health Community
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 854-854
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45
Re-Expanding Opportunities for American Descendants of Slavery to Build a More Inclusive and Diverse Global Health Workforce
American Journal of Tropical Medicine and Hygiene, 15.09.2021
Tilføjet 15.09.2021
Journal Name: The American Journal of Tropical Medicine and HygieneVolume: 105Issue: 3Pages: 855-855
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