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Infection, 9.09.2022
Tilføjet 9.09.2022
Abstract
Purpose
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is currently the major threat for immunocompromised individuals. The course of COVID-19 in lung transplant recipients in the Omicron era remains unknown. The aim of the study was to assess outcome and associated factors in lung transplant recipients in a German-wide multicenter approach.
Methods
All affected individuals from January 1st to March 20th, 2022 from 8 German centers during the Omicron wave were collected. Baseline characteristics and antiviral measures were associated with outcome.
Results
Of 218 patients with PCR-proven SARS-CoV-2 infection 166 patients (76%) received any early (< 7 days) antiviral therapy median 2 (interquartile range 1–4) days after symptom onset. Most patients received sotrovimab (57%), followed by remdesivir (21%) and molnupiravir (21%). An early combination therapy was applied in 45 patients (21%). Thirty-four patients (16%) developed a severe or critical disease severity according to the WHO scale. In total, 14 patients (6.4%) died subsequently associated with COVID-19. Neither vaccination and antibody status, nor applied treatments were associated with outcome. Only age and glomerular filtration rate < 30 ml/min/1.73m2 were independent risk factors for a severe or critical COVID-19.
Conclusion
COVID-19 due to Omicron remains an important threat for lung transplant recipients. In particular, elderly patients and patients with impaired kidney function are at risk for worse outcome. Prophylaxis and therapy in highly immunocompromised individuals need further improvement.
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BMC Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
BMC Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
Abstract
Background
This study compared clinical features of the Delta variant of coronavirus disease 2019 (COVID-19) in children and adults.
Methods
Clinical data included 80 children and 132 adults with the Delta variant of COVID-19, hospitalized in the Affiliated Hospital of Putian College between September and October 2021. The data was analyzed retrospectively.
Results
The proportion of mild patients in the children group (50%) was higher than that in the adults group (17.9%). Cough (25%, 20/80) and diarrhea (1.3%, 1/80) symptoms in children group were significantly less frequent. Compared with adults, there was no significant difference in the viral load of SARS-CoV-2 in samples collected by nasopharyngeal swabs. In children, lymphocyte count was higher [1.98 (0.25–4.25) vs 1.20 (0.29–4.27) ×109/L], whereas the interleukin-6 level was lower [5.87 (1.50–61.40) vs 15.15 (1.79–166.30) pg/mL] than that in adults group. Additionally, the incidence of liver injury in children group was lower than that in adults group. There was no significant difference in the incidence of proteinuria (22/75 vs 45/112) between the two groups, but the serum creatinine level in children was lower [42.0 (28.0–73.0) vs 57.0 (32.0–94.0) µmol/L].
Conclusion
Compared with adults, children with the Delta variant of COVID-19 have differences in symptoms, clinical classification, inflammatory indices, and liver/kidney function injury. Children’s illness is relatively mild. Clinicians should pay attention to their differences and use drugs accurately.
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BMC Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
Abstract
Background
In December 2019, in Wuhan, China, coronavirus disease 2019 (COVID-19) was emerged due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It seems that children and neonates, similar to adult and elderly individuals, are at risk of SARS-CoV-2 infection. However, adequate data are not available about neonates infected with SARS-CoV-2.
Methods
This study evaluated the presence of SARS-CoV-2 infection in neonates born to mothers or relatives with COVID-19. This cross-sectional study was performed on 25,044 consecutive Iranian participants in Tehran, Iran, from January 2020 to August 2020. Viral ribonucleic acid (RNA) was extracted from 500 µl of the oropharyngeal and nasopharyngeal specimens of the participants. The genomic RNA of SARS-CoV-2 was detected by real-time polymerase chain reaction (PCR) assay.
Results
Out of all participants, 98 (0.40%) cases were neonates born to mothers or relatives with SARS-CoV-2 infection. Therefore, the current study was performed on these neonates. Out of 98 studied neonates, 6 (6.1%) cases had positive PCR results for SARS-CoV-2 infection. Moreover, among 98 studied neonates’ mothers, 25 (25.5%) cases had positive PCR results for SARS-CoV-2 infection.
Conclusion
The findings of this study demonstrated that the rate of COVID-19 in neonates born to mothers or relatives with SARS-CoV-2 infection in the Iranian population is about 6.1%.
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Ahmed, S. I., Khowaja, B. M. H., Barolia, R., Sikandar, R., Rind, G. K., Khan, S., Rani, R., Cheshire, J., Dunlop, C. L., Coomarasamy, A., Sheikh, L., Lissauer, D.
BMJ Open, 9.09.2022
Tilføjet 9.09.2022
Objective
A maternal sepsis management bundle for resource-limited settings was developed through a synthesis of evidence and international consensus. This bundle, called ‘FAST-M’ consists of: Fluids, Antibiotics, Source control, assessment of the need to Transport/Transfer to a higher level of care and ongoing Monitoring (of the mother and neonate). The study aimed to adapt the FAST-M intervention including the bundle care tools for early identification and management of maternal sepsis in a low-resource setting of Pakistan and identify potential facilitators and barriers to its implementation.
Setting
The study was conducted at the Liaquat University of Medical and Health Sciences, which is a tertiary referral public sector hospital in Hyderabad.
Design and participants
A qualitative exploratory study comprising key informant interviews and a focus group discussion was conducted with healthcare providers (HCPs) working in the study setting between November 2020 and January 2021, to ascertain the potential facilitators and barriers to the implementation of the FAST-M intervention. Interview guides were developed using the five domains of the Consolidated Framework for Implementation Research: intervention characteristics, outer setting, inner setting, characteristics of the individuals and process of implementation.
Results
Four overarching themes were identified, the hindering factors for implementation of the FAST-M intervention were: (1) Challenges in existing system such as a shortage of resources and lack of quality assurance; and (2) Clinical practice variation that includes lack of sepsis guidelines and documentation; the facilitating factors identified were: (3) HCPs’ perceptions about the FAST-M intervention and their positive views about its execution and (4) Development of HCPs readiness for FAST-M implementation that aided in identifying solutions to potential hindering factors at their clinical setting.
Conclusion
The study has identified potential gaps and probable solutions to the implementation of the FAST-M intervention, with modifications for adaptation in the local context
Trial registration number
ISRCTN17105658.
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Hutfless, S., Shiratori, Y., Chu, D., Liu, S., Kalloo, A.
BMJ Open, 9.09.2022
Tilføjet 9.09.2022
Objective
Contaminated reprocessed duodenoscopes pose a serious threat to patients in the endoscopy unit. Despite manufacturer changes to reprocessing guidelines, 20% of reprocessed duodenoscopes meet criteria for quarantine-level contamination based on microbiological or ATP testing. We aimed to examine risk factors for postendoscopic retrograde cholangiopancreatography (ERCP) infection.
Design
Retrospective cohort analysis.
Setting
US Medicare Fee-For-Service claims (2015–2021) and all-payer data (2017).
Participants
In the Medicare data, 823 575 ERCP procedures were included. The all-payer five-state data, 16 609 procedures were included.
Interventions
ERCP was identified by Current Procedural Terminology and International Classification of Disease (ICD) procedure codes. We identified inpatient infections using ICD diagnosis codes.
Outcome measures
A logistic regression model predicted risk factors for infections occurring within 7-day and 30-day periods following ERCP. 7-day and 30-day all-cause hospitalisations and post-ERCP pancreatitis were also examined.
Results
Post-ERCP infection occurred within 3.5% of 7-day and 7.7% of 30-day periods in Medicare. Disposable duodenoscopes were billed in 711 procedures, with 1.4% (n=10, 7-day) and 3.5% (n=25, 30-day) post-ERCP infections. Urgent ERCPs were the strongest risk factor for infections in the 7-day period (OR 3.3, 95% CI 3.2 to 3.4). Chronic conditions, sex (male), age (older) and race (non-white) were also risk factors. In the all-payer five-state data, fewer infections (2.4%, 7 days) were observed. No difference arose between Medicare and other payers for 7-day period infections (OR 1.0, 95% CI 0.7 to 1.3).
Conclusions
Urgent ERCPs, patient chronic conditions and patient demographics are post-ERCP infection risk factors. Patients with infection risk factors should be targeted for specialised infection control prevention measures, including disposable duodenoscopes.
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Malaria Journal, 9.09.2022
Tilføjet 9.09.2022
Abstract
Background
Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity after successful malaria treatment. HRP2 tests are also threatened by the emergence of Plasmodium that do not carry pfhrp2 or pfhrp 3 genes. Plasmodium lactate dehydrogenase (pLDH)-based tests are promising alternatives, but less available. This study assessed the performances of HRP2 and pLDH(pan) tests under field conditions.
Methods
The study performed a prospective facility-based diagnostic evaluation of two malaria RDTs in Aweil, South Sudan, during the high transmission season. Capillary blood by fingerprick was collected from 800 children under 15 years of age with fever and no signs of severity. SD Bioline HRP2 and CareStart pLDH(pan) RDTs were performed in parallel, thick and thin smears for microscopy were examined, and dried blood was used for PCR testing.
Results
Using microscopy as the gold standard, the sensitivity of both tests was estimated at > 99%, but the specificity of each was lower: 55.0% for the pLDH test and 61.7% for the HRP2 test. When using PCR as the gold standard, the sensitivity of both tests was lower than the values assessed using microscopy (97.0% for pLDH and 96.5% for HRP2), but the specificity increased (65.1% for pLDH and 72.9% for HRP2). Performance was similar across different production lots, sex, and age. Specificity of both the pLDH and HRP2 tests was significantly lower in children who reported taking a therapeutic course of anti-malarials in the 2 months prior to enrollment. The prevalence of pfhrp2/3 deletions in the study population was 0.6%.
Conclusions
The low specificity of the pLDH RDT in this setting confirms previous results and suggests a problem with this specific test. The prevalence of pfhrp2/3 deletions in the study area warrants continued monitoring and underscores the relevance of assessing deletion prevalence nationally. Improved malaria RDTs for high-transmission environments are needed.
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Malaria Journal, 8.09.2022
Tilføjet 9.09.2022
Abstract
Background
Glucose-6-phosphate dehydrogenase (G6PD) is cytosolic enzyme, which has a vital role for the integrity and functioning of red blood cells. Lower activity of this enzyme leads to the occurrence of acute haemolytic anaemia after exposure to oxidative stressors like primaquine. Primaquine is an important drug for the radical cure of Plasmodium vivax and blocking transmission of Plasmodium falciparum, and thereby enhancing malaria elimination. However, there is a need to identify G6PD deficient individuals and administer the drug with caution due to its haemolytic side effects. The main objective of this study is to determine the prevalence of G6PD deficiency among malaria-suspected individuals.
Methods
A facility-based cross-sectional study was conducted from September 2020 to September 2021 in Metehara Health Centre, Eastern Ethiopia. A structured questionnaire was used to collect the socio-demographic and clinical information of the study participants. Capillary and venous blood samples were collected based on standard procedures for onsite screening, dried blood spot preparation, and malaria microscopy. The G6PD enzyme activity was measured by careSTART™ G6PD biosensor analyzer. Data was entered and analysed by SPSS.
Results
A total of 498 study participants were included in the study, of which 62% (309) were males. The overall prevalence of G6PD deficiency based on the biosensor screening was 3.6% (18/498), of which 2.9% and 4.8% were males and females, respectively. Eleven of the G6PD deficient samples had mutations confirmed by G6PD gene sequencing analysis. Mutations were detected in G267 + 119C/T, A376T, and ChrX:154535443. A significant association was found in sex and history of previous malaria infection with G6PD deficiency.
Conclusions
The study showed that the G6PD deficient phenotype exists in Metehara even if the prevalence is not very high. G267 + 119C/T mutation is the predominant G6PD variant in this area. Therefore, malaria patient treatment using primaquine should be monitored closely for any adverse effects.
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Parikshit S. Prayag, Shweta P. Panchakshari, Namita P. Mahalle, Surabhi Dhupad, Sampada A. Patwardhan, Sadanand S. Naik, Sharwari Narawade, Sameer Melinkeri, Amrita P. Prayag
International Journal of Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
Posaconazole is a broad spectrum triazole antifungal with activity against various clinically important fungi. The delayed release (DR) tablet of posaconazole has been shown to have a superior pharmacokinetic profile in comparison with the oral suspension.
Læs mere Tjek på PubMedSazaly AbuBakar, Sharifa Ezat Wan Puteh, Randee Kastner, Louisa Oliver, Shi Hao Lim, Riona Hanley, Elaine Gallagher
International Journal of Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
Dengue is a mosquito-borne viral disease caused by four distinct, but closely related dengue virus (DENV) serotypes (WHO, 2020). Dengue is endemic in Malaysia and continues to be a serious public health threat since its first reported major outbreak in 1902 (Abubakar and Shafee, 2002).
Læs mere Tjek på PubMedIppazio Cosimo Antonazzo, Carla Fornari, Davide Rozza, Sara Conti, Raffaella di Pasquale, Paolo Cortesi, Shaniko Kaleci, Pietro Ferrara, Alberto Zucchi, Giovanni Maifredi, Andrea Silenzi, Giancarlo Cesana, Lorenzo Giovanni Mantovani, Giampiero Mazzaglia
International Journal of Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
: Previous studies ruled out the benefits of azithromycin for COVID-19 treatment in hospitalized patients. However, the effects of azithromycin for treatment of SARS-CoV-2 positive patients in the community is still a matter of debate. This study aimed at assessing whether azithromycin is associated with a reduced risk of hospitalization, in-hospital COVID-19 outcomes, and death when used in subjects after positive testing for SARS-CoV-2.
Læs mere Tjek på PubMedZoe Marjenberg, Ciara Wright, Nick Pooley, Ka Wang Cheung, Yusuke Shimakawa, Juan C. Vargas-Zambrano, Emmanuel Vidor
International Journal of Infectious Diseases, 8.09.2022
Tilføjet 9.09.2022
Hepatitis B virus (HBV) infection incurs a substantial burden worldwide due to the associated cost of prevention, diagnosis, and treatment (Zampino et al., 2015). Global HBV seroprevalence in 2016 was estimated to be 3.9%, with approximately 296 million people living with chronic HBV infection in 2019 and 1.5 million new infections annually (CDA Foundation Polaris Observatory, 2020; World Health Organization, 2021, 2017). In highly endemic countries, mother-to-child transmission (MTCT) accounts for most new cases (Gentile and Borgia, 2014).
Læs mere Tjek på PubMedMaartje R. Inklaar, Carolina Barillas-Mury, Matthijs M. Jore
Trends in Parasitology, 8.09.2022
Tilføjet 9.09.2022
During its life cycle, Plasmodium, the malaria parasite, is exposed to the human and mosquito complement systems. Early experiments demonstrated that activation of complement can pose a serious threat to parasites, but recent studies revealed complement-evasion mechanisms important for parasite survival. Blood-stage parasites and gametes recruit regulators to neutralize human complement activation, while ookinetes inhibit mosquito complement by disrupting epithelial nitration in response to midgut invasion.
Læs mere Tjek på PubMedFilipe Dantas-Torres, Domenico Otranto
Trends in Parasitology, 8.09.2022
Tilføjet 9.09.2022
Rhipicephalus sanguineus sensu stricto (part of the R. sanguineus group) is a tick found mainly on dogs and occasionally on other hosts; for example, wild carnivores and hedgehogs are speculated to be the hosts for one or several stages of this tick. Previously thought to be distributed worldwide, current available evidence indicates that R. sanguineus s.s. is found predominantly in cold and temperate areas of the Americas (e.g., Argentina, southern Brazil, Chile, Uruguay, and the USA) and Europe (e.g., France, Italy, Spain, Portugal, and Switzerland).
Læs mere Tjek på PubMedThe Lancet
Lancet, 10.09.2022
Tilføjet 9.09.2022
From Sept 19 to 22, the Global Fund to Fight AIDS, Tuberculosis and Malaria will gather international donors to replenish funding for its vital core mission towards Sustainable Development Goal (SDG) 3: ending AIDS, tuberculosis, and malaria and building resilient and sustainable health systems. But the global context of this replenishment is unlike any other. The COVID-19 pandemic has rendered vulnerable health systems even more fragile and derailed crucial programmes across the Global Fund's disease portfolio.
Læs mere Tjek på PubMedNicholas J White, James A Watson, Sophie Uyoga, Thomas N Williams, Kathryn M Maitland
Lancet, 10.09.2022
Tilføjet 9.09.2022
WHO has estimated that nearly 2000 African children die each day as a result of severe falciparum malaria,1 a depressing figure that has changed little since 2015. This terrible death toll is a major justification for the substantial global investments in malaria control. Yet there is little research on severe malaria in humans. The pathobiology and clinical management of the lethal infection are seldom discussed in the interminable international meetings on malaria. The only substantial change in policies in recent years has been WHO's ill-advised and unwarranted moratorium on pre-referral rectal artesunate.
Læs mere Tjek på PubMedChristina Yek, Sarah Warner, Alex Mancera, Sameer S Kadri
Lancet, 10.09.2022
Tilføjet 9.09.2022
Tommy Nyberg and colleagues1 use an unvaccinated cohort to show differences between the intrinsic severity of the omicron (B.1.1.529) and delta (B.1.617.2) variants of SARS-CoV-2 without confounding by pre-existing immunity. They report an 80% reduction in the severity of the omicron compared with the delta variant, suggesting the possibility of living through the COVID-19 pandemic without social and economic disruptions. However, reliance on SARS-CoV-2 test positivity to identify cases of COVID-19 and on all-cause hospitalisations and deaths as outcomes could have introduced misclassification bias and residual confounding.
Læs mere Tjek på PubMedTommy Nyberg, Neil M Ferguson, Joshua Blake, Wes Hinsley, Samir Bhatt, Daniela De Angelis, Simon Thelwall, Anne M Presanis
Lancet, 10.09.2022
Tilføjet 9.09.2022
We thank Christina Yek and colleagues for their Correspondence regarding our Article.1 They note that people who test positive for SARS-CoV-2 generally have more severe disease than those who are infected but not tested. This finding could lead to the overestimation of absolute risks, but relative risks are not necessarily biased unless the proportion of detected severe cases differs systematically between variants. Citing modelling results that indicated a declining infection detection rate in the USA during the transition period between the dominance of the delta (B.1.617.2) and omicron (B.1.1.529) variants, possibly driven by increasing proportions of undetected infections in people with non-severe disease, Yek and colleagues hypothesise a mechanism for differential detection rates: the omicron cases for which a positive test result was recorded might have included a relatively higher proportion of infected people who were prone to severe disease than the analogous delta cases—for example, because a higher proportion of people infected with the omicron variant who sought testing had comorbidity.
Læs mere Tjek på PubMedLoren E Hernandez, Arvin Jadoo, Robert S Kirsner
Lancet, 10.09.2022
Tilføjet 9.09.2022
A 37-year-old man attended our hospital with a 1-week history of fever, chills, headaches, sore throat, generalised malaise, and a rash on his arms, legs, trunk, and in his groin. The patient also reported significant pain and discomfort in his rectum when defecating. He had a history of HIV and metastatic Kaposi sarcoma; secondary syphilis, which had been treated; and hypertension. He was prescribed the following medications: emtricitabine-tenofovir, doravarine, darunavir-cobicistat, and hydrochlorothiazide.
Læs mere Tjek på PubMedChristopher M. Richards , Sabrina Jabs , Wenjie Qiao , Lauren D. Varanese , Michaela Schweizer , Peter R. Mosen , Nicholas M. Riley , Malte Klüssendorf , James R. Zengel , Ryan A. Flynn , Arjun Rustagi , John C. Widen , Christine E. Peters , Yaw Shin Ooi , Xuping Xie , Pei-Yong Shi , Ralf Bartenschlager , Andreas S. Puschnik , Matthew Bogyo , Carolyn R. Bertozzi , Catherine A. Blish , Dominic Winter , Claude M. Nagamine , Thomas Braulke , Jan E. Carette
Science, 8.09.2022
Tilføjet 9.09.2022
Morgan M. Severn, Alexander R. Horswill
Nat Rev Microbiol, 30.08.2022
Tilføjet 8.09.2022
Nature Reviews Microbiology, Published online: 30 August 2022; doi:10.1038/s41579-022-00780-3In this Review, Severn and Horswill highlight new developments in our understanding of Staphylococcus epidermidis strain diversity, skin colonization dynamics and its multifaceted positive and negative interactions with the host and other members of the skin microbiota during skin colonization or infection.
Læs mere Tjek på PubMedAshlan J. Kunz Coyne, Mohammad Alshaer, Anthony M. Casapao, Veena Venugopalan, Carmen Isache, Jason Ferreira, Christopher A. Jankowski aUF Health Jacksonville, Department of Medicine, Jacksonville, Florida, USA bInfectious Diseases Pharmacokinetics Laboratory, Emerging Pathogens Institute and College of Pharmacy, University of Floridagrid.15276.37, Gainesville, Florida, USA cUF College of Pharmacy, Jacksonville, Florida, USA dUF College of Pharmacy, Gainesville, Florida, USA
Antimicrobial Agents And Chemotherapy, 8.09.2022
Tilføjet 8.09.2022
Madison R. Stock, Liwei Fang, Kaelie R. Johnson, Chance Cosgriff, Wei Ping Teoh, Francis Alonzo aDepartment of Microbiology and Immunology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA bDepartment of Microbiology and Immunology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA, Victor J. Torres
Infection and Immunity, 8.09.2022
Tilføjet 8.09.2022
Jackson A. Campbell, Nicholas P. Cianciotto aDepartment of Microbiology and Immunology, Northwestern University Medical School, Chicago, Illinois, USA, Andreas J. Bäumler
Infection and Immunity, 8.09.2022
Tilføjet 8.09.2022
Ivan Radević, Nikša Alfirević, Anđelko Lojpur
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Ivan Radević, Nikša Alfirević, Anđelko Lojpur
In this paper, we analyze the influence of corruption perception, experiences of corruptive behavior, and healthcare autonomy on the public trust in Montenegrin healthcare, by surveying the general population before and after the global COVID-19 pandemic. By providing a quasi-replication of a previous empirical study of corruption and trust in the Croatian public healthcare sector, we introduce the COVID-19 pandemic as a new research context. Before the pandemic, we found a consistent and significant negative influence of the corruptive practices and the generally perceived level of corruption (corruption salience) on the trust in public healthcare. The emergence of COVID-19 had mixed effects: while there is a slightly higher effect of corruption salience to the preference of public healthcare, corruptive experiences still matter but are tolerated much higher than before the pandemic. Public assessment of the autonomy of the health system increases preference for public healthcare, both before and after the pandemic, although the emergence of COVID-19 somewhat lowers this effect. The obtained results point to the most significant challenges of the ‘post-COVID-19’ social context to public health policymaking and management of public healthcare institutions. These include focusing the public healthcare reforms on corruption, reducing waiting times for different diagnostics and medical procedures in the public healthcare system, and regulating the ‘dual practice’ (simultaneous work in public and private healthcare institutions).
Læs mere Tjek på PubMedAlireza Badirzadeh, Mehdi Najm, Andrew Hemphill, Maryam Alipour, Hamid Hasanpour, Leila Masoori, Poorya Karimi
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Alireza Badirzadeh, Mehdi Najm, Andrew Hemphill, Maryam Alipour, Hamid Hasanpour, Leila Masoori, Poorya Karimi
Background Cutaneous leishmaniasis (CL) is a Neglected Tropical Disease (NTD) that causes high morbidity in the tropics and sub-tropics. Despite the remarkable advancements in the treatment of CL, the available therapeutics are far from ideal and also cause serious adverse side effects. Negative air ions (NAIs) generators are widely available for domestic and industrial uses. Several studies have reported on positive effects of NAIs therapy on human health as a non-pharmaceutical treatment for respiratory disease, allergy, or stress-related health conditions, including infectious diseases. To our knowledge, no studies have examined the effectiveness of the NAIs therapy against Leishmania parasites. The aims of this study were to investigate the effect of NAIs therapy on Leishmania major (L. major) the causative agent of CL in in vitro and in a murine model. Methodology/Principal findings In vitro anti-leishmanial effects of NAIs therapy were measured by parasitological methods. NAIs therapy was assessed in vivo in L. major infected BALB/c mice by measuring the footpad (FP) lesion size and parasite load using metric caliper tool and qPCR, respectively. Immune responses in treated and non-treated mice were assessed by measuring the levels of IFN-γ, IL-4, NO and arginase activity. In vitro NAIs therapy significantly decreased the viability of Leishmania promastigotes and of amastigotes cultured in macrophages, but did not affect the host cells. NAIs therapy of L. major infected BALB/c mice resulted in reduced FP lesion size, diminished parasite burden, and importantly decreased induction of IL-4 and arginase activity in the presence of NAIs. In contrast IFN-γ and NO levels were significantly enhanced. NAIs therapy significantly diminished the progression of disease compared to the control group, but was less effective than amphotericin B treatment. Conclusions Our study shows that NAIs treatment was effective in vitro and in Leishmania-infected mice, elicited a T-helper 1 (Th1) response and increased efficient cellular immunity, resulting in a diminished parasite load. Therefore, NAIs therapy can be considered as a useful and safe tool that can contribute to clearing L. major infections without inducing toxicity in host cells. The applications and mechanisms of NAIs therapy warrant further investigation especially in humans suffering from CL.
Læs mere Tjek på PubMedYoung Joon Moon, Kang Su Cho, Jae Yong Jeong, Doo Yong Chung, Dong Hyuk Kang, Hae Do Jung, Joo Yong Lee
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Young Joon Moon, Kang Su Cho, Jae Yong Jeong, Doo Yong Chung, Dong Hyuk Kang, Hae Do Jung, Joo Yong Lee
Purpose During the coronavirus disease 2019 (COVID-19) pandemic, the European Association of Urology (EAU) recommended that courses of intravesical bacillus Calmette-Guérin (BCG) therapy lasting more than 1 year could be safely terminated for patients with high-risk non-muscle-invasive bladder cancer (NMIBC). Thus, we conducted a systematic review and network meta-analysis according to EAU’s COVID-19 recommendations. Materials and methods A systematic review was performed following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We conducted a network meta-analysis of recurrence rate in patients with NMIBC receiving induction therapy (M0) and those receiving maintenance therapy lasting 1 year (M1) and more than 1 year (M2). Results Nineteen studies of 3,957 patients were included for the network meta-analysis. In a node-split forest plot using Bayesian Markov Chain Monte Carlo (MCMC) modeling, there were no differences between the M1 and M2 groups in recurrence rate [odds ratio (OR) 0.95 (0.73–1.2)]. However, recurrence rate in the M0 group was higher than that in the M1 [OR 1.9 (1.5–2.5)] and M2 [OR 2.0 (1.7–2.4)] groups. P-score tests using frequentist inference to rank the treatments in the network demonstrated that the therapy used in the M2 group (P-score 0.8701) was superior to that used in the M1 (P-score 0.6299) and M0 groups (P-score 0). In rank-probability tests using MCMC modeling, the M2 group showed the highest rank, followed by the M1 and M0 groups. Conclusion In the network meta-analysis, there were no differences between those receiving BCG maintenance therapies in terms of recurrence rate. In the rank tests, therapy lasting more than 1-year appears to be most effective. During the COVID-19 pandemic, 1-year maintenance therapy can be used, but after the COVID-19 pandemic, therapy lasting more than 1-year could be beneficial.
Læs mere Tjek på PubMedBojan Rakonjac, Zorica Lepšanović, Vesna Šuljagić, Branko Jovčić, Milan Kojić, Anders Rhod Larsen, Momčilo Đurić, Ivana Ćirković
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Bojan Rakonjac, Zorica Lepšanović, Vesna Šuljagić, Branko Jovčić, Milan Kojić, Anders Rhod Larsen, Momčilo Đurić, Ivana Ćirković
Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is continually changing. Frequency of genotypes typical for community-associated MRSA (CA-MRSA) is increasing in hospitals, as well as resistance to antimicrobial agents. Moreover, different clones predominate in different geographic regions, and temporal shifts occur in the predominant clonal type. The aim of this study was to estimate the prevalence of MRSA, CA-MRSA and PVL-positive MRSA isolates from patients hospitalised in the Military Medical Academy (MMA) and from outpatients, and to perform genotyping of PVL-positive MRSA isolates. MRSA isolates were obtained by standard microbiological techniques. PVL-positive MRSA were detected by single PCR. Determination of SCCmec types in MRSA isolates was done using multiplex PCR and genotyping of PVL-positive MRSA by PFGE, MLST and spa typing. The prevalence of MRSA among S. aureus isolates from different clinical specimens was 43.4%. In outpatients the prevalence of MRSA was 3.2%. SCCmec types specific for CA-MRSA were found in 26% of MRSA isolates from hospitalised patients. In groups, hospitalised patients and outpatients, the prevalence of PVL-positive MRSA isolates was 4%, and all of them harboured SCCmec type V genetic element. PFGE revealed minor differences between four groups of PVL-positive MRSA isolates, but all of them belonged to ST152, and all except one were of the t355 spa type. High prevalence of MRSA and CA-MRSA in MMA, especially the presence of PVL-positive CA-MRSA, represent a serious health threat for patients. Genotype t355/ST152/SCCmec V is the dominant MRSA clone among PVL-positive CA-MRSA.
Læs mere Tjek på PubMedPratiwi Soedarmono, Aly Diana, Patricia Tauran, Dewi Lokida, Abu Tholib Aman, Bachti Alisjahbana, Dona Arlinda, Emiliana Tjitra, Herman Kosasih, Ketut Tuti Parwati Merati, Mansyur Arif, Muhammad Hussein Gasem, Nugroho Harry Susanto, Nurhayati Lukman, Retna Indah Sugiyono, Usman Hadi, Vivi Lisdawati, Karine G. Fouth Tchos, Aaron Neal, Muhammad Karyana
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Pratiwi Soedarmono, Aly Diana, Patricia Tauran, Dewi Lokida, Abu Tholib Aman, Bachti Alisjahbana, Dona Arlinda, Emiliana Tjitra, Herman Kosasih, Ketut Tuti Parwati Merati, Mansyur Arif, Muhammad Hussein Gasem, Nugroho Harry Susanto, Nurhayati Lukman, Retna Indah Sugiyono, Usman Hadi, Vivi Lisdawati, Karine G. Fouth Tchos, Aaron Neal, Muhammad Karyana
Blood culturing remains the “gold standard” for bloodstream infection (BSI) diagnosis, but the method is inaccessible to many developing countries due to high costs and insufficient resources. To better understand the utility of blood cultures among patients in Indonesia, a country where blood cultures are not routinely performed, we evaluated data from a previous cohort study that included blood cultures for all participants. An acute febrile illness study was conducted from July 2013 to June 2016 at eight major hospitals in seven provincial capitals in Indonesia. All participants presented with a fever, and two-sided aerobic blood cultures were performed within 48 hours of hospital admission. Positive cultures were further assessed for antimicrobial resistance (AMR) patterns. Specimens from participants with negative culture results were screened by advanced molecular and serological methods for evidence of causal pathogens. Blood cultures were performed for 1,459 of 1,464 participants, and the 70.6% (1,030) participants that were negative by dengue NS1 antigen test were included in further analysis. Bacteremia was observed in 8.9% (92) participants, with the most frequent pathogens being Salmonella enterica serovar Typhi (41) and Paratyphi A (10), Escherichia coli (14), and Staphylococcus aureus (10). Two S. Paratyphi A cases had evidence of AMR, and several E. coli cases were multidrug resistant (42.9%, 6/14) or monoresistant (14.3%, 2/14). Culture contamination was observed in 3.6% (37) cases. Molecular and serological assays identified etiological agents in participants having negative cultures, with 23.1% to 90% of cases being missed by blood cultures. Blood cultures are a valuable diagnostic tool for hospitalized patients presenting with fever. In Indonesia, pre-screening patients for the most common viral infections, such as dengue, influenza, and chikungunya viruses, would maximize the benefit to the patient while also conserving resources. Blood cultures should also be supplemented with advanced laboratory tests when available.
Læs mere Tjek på PubMedLaura Lara, Mahia Saracostti, Ximena de-Toro
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Laura Lara, Mahia Saracostti, Ximena de-Toro
School engagement has been demonstrated to be a relevant aspect in promoting students’ successful trajectories, a commitment that in its turn is influenced by contextual factors (family, teachers, and peers). Having instruments to measure these constructs allows decisions to be made to improve student retention, especially relevant in the context of uncertainty caused by covid-19. The aim of the study was to adapt and analyze the psychometric properties of questionnaires used to measure school engagement and contextual factors in the context of the pandemic with elementary school students in Chile. After adaptation of the instruments, through expert evaluation and focus groups with students, they were administered to 579 students in seventh and eighth grade (mean age = 12.79, 52% were boys), and to 334 students in fifth and sixth grade (mean age = 11.35, 38% were boys) in Chile. Confirmatory factor analyses showed that the two versions of the school engagement measurement instrument had an adequate fit with the original model of three correlated factors, cognitive, affective, and behavioral commitment. Similarly, these two versions of the instrument measuring the contextual factors had a good fit with the original model of three correlated factors, family, teachers, and peers. In addition, both versions of both questionnaires presented appropriate levels of internal consistency.
Læs mere Tjek på PubMedKruger Kaswaswa, Peter MacPherson, Moses Kumwenda, James Mpunga, Deus Thindwa, Marriott Nliwasa, Mphatso Mwapasa, Jon Odland, Tamiwe Tomoka, Geoffrey Chipungu, Mavuto Mukaka, Elizabeth L. Corbett
PLoS One Infectious Diseases, 8.09.2022
Tilføjet 8.09.2022
by Kruger Kaswaswa, Peter MacPherson, Moses Kumwenda, James Mpunga, Deus Thindwa, Marriott Nliwasa, Mphatso Mwapasa, Jon Odland, Tamiwe Tomoka, Geoffrey Chipungu, Mavuto Mukaka, Elizabeth L. Corbett
Background Household contact tracing provides TB screening and TB preventive therapy (TPT) to contacts at high risk of TB disease. However, it is resource intensive, inconvenient, and often poorly implemented. We investigated a novel model aiming to improve uptake. Methods Between May and December 2014, we randomised patient with TB who consented to participate in the trial to either standard of care (SOC) or intervention (PACTS) arms. Participants randomised to PACTS received one screening/triage tool (adapted from WHO integrated management of adolescent and adult illnesses [IMAI] guidelines) and sputum pots for each reported household contact. The tool guided participants through symptom screening; TPT (6-months of isoniazid) eligibility; and sputum collection for contacts. Patients randomised to SOC were managed in accordance with national guidelines, that is, they received verbal instruction on who to bring to clinics for investigation using national guidelines. Main outcome and measures The primary outcome was the proportion of adult contacts receiving treatment for TB within 3 months of randomisation. Secondary outcomes were the proportions of child contacts under age 5 years (U5Y) who were commenced on, and completed, TPT. Data were analyzed by logistic regression with random effects to adjust for household clustering. Results Two hundred and fourteen index TB participants were block-randomized from two sites (107 PACTS, reporting 418 contacts; and 107 SOC, reporting 420 contacts). Overall, 62.8% of index TB participants were HIV-positive and 52.1% were TB culture-positive. 250 otherwise eligible TB patients declined participation and 6 households (10 PACTS, 6 SOC) were lost to follow-up and were not included in the analysis. By three months, nine contacts (PACTS: 6, [1.4%]; SOC: 3, [0.7%]) had TB diagnosed, with no difference between groups (adjusted odds ratio [aOR]: 2.18, 95% CI: 0.60–7.95). Eligible PACTS contacts (37/96, 38.5%) were more likely to initiate TPT by 3-months compared to SOC contacts (27/101, 26.7%; aOR 2.27, 95% CI: 1.04–4.98). U5Y children in the PACTS arm (47/81 58.0%) were more likely to have initiated TPT before the 3-month visit compared to SOC children (36/89, 41.4%; aOR: 2.31, 95% CI: 1.05–5.06). Conclusions and relevance A household-centred patient-delivered symptom screen and IPT eligibility assessment significantly increased timely TPT uptake among U5Y children, but did not significantly increase TB diagnosis. This model needs to be optimized for acceptability, given low participation, and investigated in other low resource settings. Clinical trial registration TRIAL REGISTRATION NUMBER: ISRCTN81659509 https://www.isrctn.com/ISRCTN81659509?q=&filters=conditionCategory:Respiratory,recruitmentCountry:Malawi,ageRange:Mixed&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search. 19 July 2012.
Læs mere Tjek på PubMedMegan B. Diamond, Aparna Keshaviah, Ana I. Bento, Otakuye Conroy-Ben, Erin M. Driver, Katherine B. Ensor, Rolf U. Halden, Loren P. Hopkins, Katrin G. Kuhn, Christine L. Moe, Eric C. Rouchka, Ted Smith, Bradley S. Stevenson, Zachary Susswein, Jason R. Vogel, Marlene K. Wolfe, Lauren B. Stadler, Samuel V. Scarpino
Nature, 8.09.2022
Tilføjet 8.09.2022
Nature Medicine, Published online: 08 September 2022; doi:10.1038/s41591-022-01940-xWastewater monitoring has been used to identify SARS-CoV-2 outbreaks and track new variants. This sentinel system should be expanded to monitor other pathogens and boost public health preparedness.
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