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46 emner vises.
Infection, 20.06.2023
Tilføjet 20.06.2023
Abstract Purpose Antimicrobial resistance is a pressing issue in Ukraine, with healthcare-associated infections caused by multidrug-resistant organisms being a major concern. A recent prospective multicenter study revealed a staggering rate of 48.4% antimicrobial resistance to carbapenems among Enterobacterales causing a healthcare-associated infection. We conducted a systematic survey to investigate the incidence rate and incidence density of carbapenemase-producing Gram-negative bacteria (CPGN) among refugees and war-wounded Ukrainians in connection with the German health system. Methods From the onset of the war until November 2022, seven Ukrainian patients were admitted to our hospital. Upon admission, screening samples and samples from the focus of suspected infection were taken from all seven patients. The incidence rate and the incidence density of CPGN were calculated as a result of the microbiological findings. We sequenced all CPGN using Illumina technology. Results The incidence rate of CPGN at our hospital was 0.06 for 2021 and 0.18 for 2022. All seven Ukrainian patients were infected or colonized with at least one CPGN, including K. pneumoniae (14/25), P. aeruginosa (6/25), A. baumannii (1/25), Providencia stutartii (1/25), C. freundii (1/25), and E. coli (2/25). Genomic surveillance revealed that (i) most frequently detected carbapenemases among all sequenced isolates were blaNDM (17/25) and blaOXA-48 (6/25), (ii) most commonly observed plasmid replicons among the K. pneumoniae isolates recovered from Ukrainian patients were Col(pHAD28) (12/14), IncHI1B(pNDM-MAR) (9/14), IncFIB(pNDM-Mar) (12/14), and (iii) clonal relation between the pathogens of the Ukrainian isolates, but not for the isolates from our hospital surveillance system. Conclusion The rising prevalence of community-acquired colonization and infection with CPGN is having a direct effect on the infection prevention measures, such as higher number of isolations, reprocessing of patient rooms, additional microbiological testing and overall organization within hospitals.
Læs mere Tjek på PubMedMercedes, Rebecca A.; Kasbaum, Marie A.; George, Paul E.; Tumweheire, Enid G.; Scheurer, Michael E.; Nabukeera-Barungi, Nicolette
Journal of Acquired Immune Deficiency Syndromes, 20.06.2023
Tilføjet 20.06.2023
Background: Despite significant morbidity and mortality from human immunodeficiency virus (HIV) and severe acute malnutrition (SAM) among children in sub-Saharan Africa, research is lacking in these children. We describe the proportion of children living with HIV with SAM achieving recovery, the factors associated with recovery, and time to recovery in an outpatient therapeutic care (OTC) program. Setting and Methods: This is a retrospective observational study of children with SAM and HIV on antiretroviral therapy (6 months-15 years), enrolled in OTC from 2015-2017 at a pediatric HIV clinic in Kampala, Uganda. SAM diagnosis and recovery by 120 days after enrollment were determined per World Health Organization guidelines. Cox-proportional hazards models were used to determine predictors of recovery. Results: Data from 166 patients were analyzed (mean age 5.4 years, SD 4.7). Outcomes showed 36.1% recovered, 15.6% were lost to follow up, 2.4% died, and 45.8% failed. Average time to recovery was 59.9 days (SD 27.8). Patients 5 years or older were less likely to recover (CHR=0.33, 95% CI: 0.18-0.58). In multivariate analysis, febrile patients were less likely to recover (AHR=0.53, 95% CI: 0.12-0.65). Patients with CD4 count of 200 or less at enrollment were less likely to recover (CHR=0.46, 95% CI: 0.22-0.96). Conclusion: Despite treatment with antiretroviral therapy for children living with HIV, we observed poor rates of recovery from SAM, below the international target of >75%. Moreover, patients 5 years and older, fever, or low CD4 at diagnosis of SAM may require more intense therapy or closer monitoring than their counterparts. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYue Ding, Cheng Bei, Qinghua Xue, Liangfei Niu, Jingfeng Tong, Yiwang Chen, Howard E. Takiff, Qian Gao, Bo YanaKey Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity and Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of ChinabCenter for Tuberculosis Research, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of ChinacLaboratorio de Genética Molecular, CMBC, IVIC, Caracas, Venezuela, Sabine Ehrt
Infection and Immunity, 20.06.2023
Tilføjet 20.06.2023
Hayley M. Theriot, Priyangi A. Malaviarachchi, Madeleine G. Scott, Kenneth T. Appell, Srijon K. Banerjee, Roger D. PechousaDepartment of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USAbDepartment of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA, Igor E. Brodsky
Infection and Immunity, 20.06.2023
Tilføjet 20.06.2023
Sherry L. Kurtz, Lara R. Mittereder, Chelsea C. Lehman, Hamda Khan, Victoria A. Gould, Karen L. ElkinsaCenter for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA, Sabine Ehrt
Infection and Immunity, 20.06.2023
Tilføjet 20.06.2023
Tuyetnhu Pham, Yeqi Li, Wendy Watford, Xiaorong LinaDepartment of Plant Biology, University of Georgia, Athens, Georgia, USAbDepartment of Microbiology, University of Georgia, Athens, Georgia, USAcDepartment of Infectious Diseases, University of Georgia, Athens, Georgia, USA, Mairi C. Noverr
Infection and Immunity, 20.06.2023
Tilføjet 20.06.2023
Mackenzie E. Ryan, Prashant P. Damke, Carrie L. ShafferaDepartment of Microbiology, Immunology, and Molecular Genetics, University of Kentucky College of Medicine, Lexington, Kentucky, USAbDepartment of Veterinary Sciences, University of Kentucky College of Agriculture, Lexington, Kentucky, USAcDepartment of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky, USAdMarkey Cancer Center, University of Kentucky College of Medicine, Lexington, Kentucky, USA, Anthony R. Richardson
Infection and Immunity, 20.06.2023
Tilføjet 20.06.2023
Journal of the American Medical Association, 20.06.2023
Tilføjet 20.06.2023
An animated discussion on a vaccination bill in the English Commons on April 19. brought out a speech by Sir William Priestley, an eminent London practitioner, who was formerly a professor in King’s College medical school; it contained a sharp arraignment of the enemies of vaccination. Among other points he stated that it is computed that at present about a third of all the children born in England and Wales were escaping vaccination, i. e., about 300,000 children, and in this connection they could not but recollect the serious object lesson recently presented by Gloucester. The discovery of glycerinated lymph was made in 1891, and yet it had never been adopted systematically in this country. It was most likely, if once adopted, to remove many of the objections and apprehensions of parents, which he had no doubt were very conscientious. It had been adopted in other countries where they had ministers of public health, and where a great deal more attention was paid to the question of public health than was the case in this country. The system had been carried out at Berlin, Paris, Geneva and other centers, and as yet there had been no misadventures. Admitting that harm was done by the practice of vaccination, it was not easy at any time to do a vast amount of good without some modicum of harm. All medical efforts were relative; if they were absolute no one would die. If they were to look into the history of many remedies they would find that misadventures came by their use. It was well known for instance, that no one could avail himself of the administration of chloroform to relieve pain without fear of misadventure. In regard to those domestic remedies, Epsom salts and castor oil, the effects had gone in some cases much farther than had been intended or expected. The great thing in the use of all remedies was to do the greatest amount of good with the least possible harm. It was entirely a question of proportion.…A distinguished scientific friend of his once said he always tried to teach his pupils to think to scale as well as work to scale; but these people who were always dwelling on the harm did not think to scale. They concentrated all their attention upon the mischief and they came signally to grief in their reasoning. Sir William Priestley then went on to express approval of the proposed domiciliary vaccination, although at the same time he hoped that stations would not be abolished altogether.
Læs mere Tjek på PubMedJournal of the American Medical Association, 20.06.2023
Tilføjet 20.06.2023
This Viewpoint discusses the proliferation of decentralized clinical trials during the COVID-19 pandemic and the need for rigorous studies to inform whether decentralized approaches promote or prevent access to clinical trials for people facing health disparities.
Læs mere Tjek på PubMedJournal of the American Medical Association, 20.06.2023
Tilføjet 20.06.2023
For patients with recurrent tonsillitis, tonsillectomies resulted in almost 50% fewer days of sore throats over 2 years compared with standard nonsurgical care, which included painkillers and antibiotics as needed, according to results from a randomized clinical trial that enrolled 453 adults across 27 UK hospitals.
Læs mere Tjek på PubMedJournal of the American Medical Association, 20.06.2023
Tilføjet 20.06.2023
This study used a population-based individual patient data set that included diagnoses of COVID-19 to determine whether there was a temporal association between COVID-19 and type 1 diabetes in children.
Læs mere Tjek på PubMedJournal of the American Medical Association, 20.06.2023
Tilføjet 20.06.2023
This study uses data collected by Australia’s vaccine safety surveillance system to examine the adverse event profile of the modified vaccinia Ankara–Bavarian Nordic vaccine.
Læs mere Tjek på PubMedAbi Manesh, Emily Devasagayam, Kundakarla Bhanuprasad, Lalee Varghese, Regi Kurien, Lisa M. Cherian, Divya Dayanand, Mithun M. George, Selwyn S. Kumar, Rajiv Karthik, Harshad Vanjare, Jayanthi Peter, Joy S. Michael, Meera Thomas, Binu S. Mathew, Prasanna Samuel, Pimnara Peerawaranun, Mavuto Mukaka, Vedantam Rupa, George M. Varghese
Clinical Microbiology and Infection, 20.06.2023
Tilføjet 20.06.2023
To evaluate the efficacy and safety of short-course intravenous amphotericin B followed by sustained release posaconazole tablets for diabetes or COVID-19 associated rhino-orbito-cerebral mucormycosis (ROCM).
Læs mere Tjek på PubMedJulie Boisard, Isabelle Florent
Trends in Parasitology, 20.06.2023
Tilføjet 20.06.2023
The apicomplexan parasite Porospora gigantea (Van Beneden, 1869) Schneider, 1875, is a marine septate intestinal eugregarine of Homarus gammarus, with a poorly known pathogenicity. Previously named Gregarina gigantea, it presents three outstanding characteristics according to the literature: (i) a gigantic size of its trophozoite stages with (ii) a remarkable gliding speed, which are the largest and the fastest recorded to date for any Apicomplexa, and (iii) an ability to accumulate as very specific cyst forms in the chitinous folds of the lobster rectum.
Læs mere Tjek på PubMedIvan T Lee, Catherine A Cosgrove, Patrick Moore, Claire Bethune, Rhiannon Nally, Marcin Bula, Philip A Kalra, Rebecca Clark, Paul I Dargan, Marta Boffito, Ray Sheridan, Ed Moran, Thomas C Darton, Fiona Burns, Dinesh Saralaya, Christopher J A Duncan, Patrick J Lillie, Alberto San Francisco Ramos, Eva P Galiza, Paul T Heath, Bethany Girard, Christy Parker, Dondi Rust, Shraddha Mehta, Elizabeth de Windt, Andrea Sutherland, Joanne E Tomassini, Frank J Dutko, Spyros Chalkias, Weiping Deng, Xing Chen, Jing Feng, LaRee Tracy, Honghong Zhou, Jacqueline M Miller, Rituparna Das, Study Investigators
Lancet Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
Omicron-containing booster vaccines generated superior immunogenicity against omicron BA.1 and comparable immunogenicity against the original strain with no new safety concerns. It remains important to continuously monitor the immune responses and real-world vaccine effectiveness as divergent SARS-CoV-2 variants emerge.
Læs mere Tjek på PubMedClinical Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
AbstractBackgroundThere is growing consensus that COVID-19 booster vaccines may be coadministered with other age-appropriate vaccines. Adding to the limited available data supporting coadministration, especially with adjuvanted vaccines, could enhance vaccine coverage in adults.MethodsIn this phase 3, randomized, open-label study, eligible adults aged ≥50 years were randomly assigned (1:1) to receive mRNA-1273 (50µg) booster vaccination and a first dose of recombinant zoster vaccine (RZV1) 2 weeks apart (Seq group) or concomitantly (Coad group). The second RZV dose (RZV2) was administered 2 months post- RZV1 in both groups. Primary objectives were noninferiority of anti-glycoprotein E and anti-Spike protein antibody responses in the Coad group compared to the Seq group. Safety and further immunogenicity assessments were secondary objectives.Results273 participants were randomized to the Seq group, 272 to the Coad group. Protocol-specified non-inferiority criteria were met. The adjusted geometric mean concentration ratio (Seq/Coad) was 1.01 (95% confidence interval [CI], 0.89–1.13) for anti-gE antibodies 1-month post-RZV2, and 1.09 (95% CI 0.90–1.32) for anti-Spike antibodies 1-month post-mRNA-1273 booster. No clinically relevant differences were observed in overall frequency, intensity, or duration of adverse events between the 2 study groups. Most solicited adverse events were mild/moderate in intensity, each with median duration ≤2.5 days. Administration site pain and myalgia were the most frequently reported in both groups.ConclusionsCoadministration of mRNA-1273 booster vaccine with RZV in adults aged ≥50 years was immunologically noninferior to sequential administration and had a safety and reactogenicity profile consistent with both vaccines administered sequentially (clinicaltrials.gov NCT05047770).
Læs mere Tjek på PubMedClinical Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
AbstractBackgroundDespite being the leading cause of mortality from bloodstream infections worldwide, little is known about regional variation in treatment practices for Staphylococcus aureus bacteremia (SAB). The aim of this study was to identify global variation in management, diagnostics, and definitions of SAB.MethodsDuring a 20-day period in 2022, physicians throughout the world were surveyed on SAB treatment practices. The survey was distributed through listservs, e-mails, and social media.ResultsIn total 2,031 physicians from 71 different countries on 6 continents (North America [701, 35%], Europe [573, 28%], Asia [409, 20%], Oceania [182, 9%], South America [124, 6%], and Africa [42, 2%]) completed the survey. Management-based responses differed significantly by continent for preferred treatment of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) bacteremia, use of adjunctive rifampin for prosthetic material infection, and use of oral antibiotics (p
Læs mere Tjek på PubMedClinical Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
AbstractBackgroundAntimicrobial stewardship is an important topic in infectious diseases (ID) training, yet many ID fellowships lack formal training and little is known about fellows’ learning preferences.MethodsWe conducted 24 in-depth interviews with ID fellows across the United States during 2018 and 2019 to explore their experiences with and preferences for antimicrobial stewardship education during fellowship. Interviews were transcribed, de-identified, and analyzed to identify themes.ResultsFellows had variable exposure to antimicrobial stewardship before and during fellowship, which impacted their knowledge about and attitude toward stewardship as a career; however, all fellows expressed the importance of learning general stewardship principles during fellowship. Some fellows’ training included mandatory stewardship lectures and/or rotations, but most fellows felt their primary stewardship learning occurred through informal experiences in the clinical setting, such as holding the antimicrobial approval pager. Fellows expressed a preference for a standardized, structured curriculum that included in-person practical, interactive discussions with multidisciplinary faculty along with the opportunity to practice and apply their skills; however, they emphasized that time needed to be set aside for those educational activities. Although they wanted to learn the evidence and rationale for stewardship recommendations, they especially wanted training in and feedback on how to communicate stewardship recommendations to other health professionals, particularly in the setting of conflict.ConclusionsID fellows believe that standardized antimicrobial stewardship curricula should be included in their fellowship training, and they prefer structured, practical, and interactive learning experiences.
Læs mere Tjek på PubMedClinical Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
AbstractAntimicrobials are commonly prescribed and often misunderstood. With over 50% of hospitalized patients receiving an antimicrobial agent at any point in time, judicious and optimal use of these drugs is paramount to advancing patient care. This narrative will focus on myths relevant to nuanced consultation from infectious diseases specialists, particularly surrounding specific considerations for a variety of antibiotics.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
AbstractStaphylococcus aureus (S. aureus) is a major human pathogen associated with high mortality rates. The extensive use of antibiotics is associated with the rise of drug resistance, and exotoxins are not targeted by antibiotics. Therefore, monoclonal antibody (mAb) therapy has emerged as a promising solution to solve the clinical problems caused by refractory S. aureus. Recent research suggests that the synergistic effects of several cytotoxins, including bi-component toxins, are critical to the pathogenesis of S. aureus. By comparing the amino acid sequences, researchers found that α-toxin and bi-component toxins were found to have high homology. Therefore, we aimed to screen an antibody, designated as “all-in-one” mAb, that could neutralize both α-toxin and bi-component toxins through hybridoma fusion. We found that this mAb has a significant pharmacodynamic effect in vivo mouse models and in vitro experiments.
Læs mere Tjek på PubMedFEMS Microbiology Reviews, 20.06.2023
Tilføjet 20.06.2023
AbstractIn living cells the biochemical processes such as energy provision, molecule synthesis, gene expression and cell division take place in a confined space where the internal chemical and physical conditions are different from those in dilute solutions. The concentrations of specific molecules and the specific reactions and interactions vary for different types of cells, but a number of factors are universal and kept within limits, which we refer to as physicochemical homeostasis. For instance, the internal pH of many cell types is kept within the range of 7.0 to 7.5, the fraction of macromolecules occupies 15-20% of the cell volume (also know as macromolecular crowding) and the ionic strength is kept within limits to prevent salting-in or salting-out effects. In this article we summarize the generic physicochemical properties of the cytoplasm of bacteria, how they are connected to the energy status of the cell, and how they affect biological processes (Figure 1). We describe how the internal pH and proton motive force are regulated, how the internal ionic strength is kept within limits, what the impact of macromolecular crowding is on the function of enzymes and the interaction between molecules, how cells regulate their volume (and turgor), and how the cytoplasm is structured. Physicochemical homeostasis is best understood in Escherichia coli, but pioneering studies have also been performed in lactic acid bacteria.
Læs mere Tjek på PubMedGuillaume Favre, Emeline Maisonneuve, Léo Pomar, Charlotte Daire, Cécile Monod, Begoña Martinez de Tejada, Thibaud Quibel, Monya Todesco Bernasconi, Loïc Sentilhes, Caroline Blume, Andrea Papadia, Stephanie Sturm, Dirk Bassler, Claudia Grawe, Anda Petronela Radan, Marie-Claude Rossier, Jérôme Mathis, Romina Capoccia Brugger, Karine Lepigeon, Eva Gerbier, Marie Claude Addor, Ursula Winterfeld, David Baud, Alice Panchaud, COVI-PREG group
Clinical Microbiology and Infection, 20.06.2023
Tilføjet 20.06.2023
This study aimed to evaluate the risk of congenital malformation among pregnant women exposed to the mRNA COVID-19 vaccines during the first trimester of pregnancy, which is a developmental period where the fetus is at risk of teratogenicity.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
Abstract Background A key factor driving the development and maintenance of antibacterial resistance (ABR) is individuals’ use of antibiotics (ABs) to treat illness. To better understand motivations and context for antibiotic use we use the concept of a patient treatment-seeking pathway: a treatment journey encompassing where patients go when they are unwell, what motivates their choices, and how they obtain antibiotics. This paper investigates patterns and determinants of patient treatment-seeking pathways, and how they intersect with AB use in East Africa, a region where ABR-attributable deaths are exceptionally high. Methods The Holistic Approach to Unravelling Antibacterial Resistance (HATUA) Consortium collected quantitative data from 6,827 adult outpatients presenting with urinary tract infection (UTI) symptoms in Kenya, Tanzania, and Uganda between February 2019- September 2020, and conducted qualitative in-depth patient interviews with a subset (n = 116). We described patterns of treatment-seeking visually using Sankey plots and explored explanations and motivations using mixed-methods. Using Bayesian hierarchical regression modelling, we investigated the associations between socio-demographic, economic, healthcare, and attitudinal factors and three factors related to ABR: self-treatment as a first step, having a multi-step treatment pathway, and consuming ABs. Results Although most patients (86%) sought help from medical facilities in the first instance, many (56%) described multi-step, repetitive treatment-seeking pathways, which further increased the likelihood of consuming ABs. Higher socio-economic status patients were more likely to consume ABs and have multi-step pathways. Reasons for choosing providers (e.g., cost, location, time) were conditioned by wider structural factors such as hybrid healthcare systems and AB availability. Conclusion There is likely to be a reinforcing cycle between complex, repetitive treatment pathways, AB consumption and ABR. A focus on individual antibiotic use as the key intervention point in this cycle ignores the contextual challenges patients face when treatment seeking, which include inadequate access to diagnostics, perceived inefficient public healthcare and ease of purchasing antibiotics without prescription. Pluralistic healthcare landscapes may promote more complex treatment seeking and therefore inappropriate AB use. We recommend further attention to healthcare system factors, focussing on medical facilities (e.g., accessible diagnostics, patient-doctor interactions, information flows), and community AB access points (e.g., drug sellers).
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
Abstract Background Rapid and accurate identification of carbapenemase-producing organism (CPO) intestinal carriers is essential for infection prevention and control. Molecular diagnostic methods can produce results in as little as 1 h, but require special instrumentation and are expensive. Therefore, it is urgent to find an alternative method. The broth enrichment-multiplex lateral flow immunochromatographic assay was recently reported, but using it to directly detect CPO intestinal carriers in rectal swabs still requires the evaluation of many samples. The aim of this study was to compare the performance of these two methods, and to explore the control measures of CPO infection. Methods Through CPO selective culture, PCR and DNA sequencing, 100 rectal swabs confirmed to be CPO-positive and 100 rectal swabs with negative results were collected continuously. After eluting the rectal swabs with saline, three aliquots were used: one for counting, one for detection by Xpert Carba-R, and one for culture in broth for 0 h, 1 h, 2 h, 3 h and 4 h, followed by NG-Test CARBA 5 assessment. The sensitivity and specificity of the NG-Test CARBA 5 method after different incubation times were calculated. The limit of detection (LoD) of this assay after 4 h broth incubation was estimated by examining the bacterial suspensions and simulated faecal suspensions prepared with CPOs producing different types of carbapenemases. Results Xpert Carba-R demonstrated a combined sensitivity of 99.0% and specificity of 98.0%. The sensitivity and specificity were higher than 90.0% for the different enzyme types. The specificities of five common carbapenemases detected by the broth enrichment NG-Test CARBA 5 combined method after different incubation times were 100%. The sensitivities increased with increasing incubation time. At 4 h, the Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-beta-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-beta-lactamase (VIM), and oxacillinase (OXA) -48 detection sensitivities were 93.0%, 96.3%, 100%, 100% and 85.7%, respectively. The LoDs were between 102 and 104 CFU/mL for all five enzymes after 4 h of incubation. Conclusions This investigation highlighted that the broth enrichment-multiplex lateral flow immunochromatographic assay can be used as a new method for screening CPOs in rectal swabs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.06.2023
Tilføjet 20.06.2023
Abstract Background Awake prone positioning has been widely used in non-intubated patients with acute hypoxic respiratory failure (AHRF) due to COVID-19, but the evidence is mostly from observational studies and low-quality randomized controlled trials (RCTs), with conflicting results from published studies. A systematic review of published high-quality RCTs to resolve the controversy over the efficacy and safety of awake prone positioning in non-intubated patients with AHRF due to COVID-19. Methods Candidate studies were identified through searches of PubMed, Web of Science, Cochrane, Embase, Scopus databases from December 1, 2019 to November 1, 2022. Literature screening, data extraction and risk of bias assessment were independently conducted by two researchers. Results Eight RCTs involving 2657 patients were included. Meta-analysis of fixed effects models showed that awake prone positioning did not increase mortality(OR = 0.88, 95%CI [0.72, 1.08]), length of stay in ICU (WMD = 1.14, 95%CI [-0.45, 2.72]), total length of stay (WMD = 0.11, 95%CI [-1.02, 1.23]), or incidence of adverse events (OR = 1.02, 95%CI [0.79, 1.31]) compared with usual care, but significantly reduced the intubation rate (OR = 0.72, 95%CI [0.60, 0.86]). Similar results were found in a subgroup analysis of patients who received only high flow nasal cannula (Mortality: OR = 0.86, 95%CI [0.70, 1.05]; Intubation rate: OR = 0.69, 95%CI [0.58, 0.83]). All eight RCTs had high quality of evidence, which ensured the reliability of the meta-analysis results. Conclusions Awake prone positioning is safe and feasible in non-intubated patients with AHRF caused by COVID-19, and can significantly reduce the intubation rate. More studies are needed to explore standardized implementation strategies for the awake prone positioning. Trial registration CRD42023394113.
Læs mere Tjek på PubMedMalaria Journal, 19.06.2023
Tilføjet 19.06.2023
Abstract Background Anopheles stephensi is an efficient vector of both Plasmodium falciparum and Plasmodium vivax in South Asia and the Middle East. The spread of An. stephensi to countries within the Horn of Africa threatens progress in malaria control in this region as well as the rest of sub-Saharan Africa. Methods The available malaria data and the timeline for the detection of An. stephensi was reviewed to analyse the role of An. stephensi in malaria transmission in Horn of Africa of the Eastern Mediterranean Region (EMR) in Djibouti, Somalia, Sudan and Yemen. Results Malaria incidence in Horn of Africa of EMR and Yemen, increased from 41.6 in 2015 to 61.5 cases per 1000 in 2020. The four countries from this region, Djibouti, Somalia, Sudan and Yemen had reported the detection of An. stephensi as of 2021. In Djibouti City, following its detection in 2012, the estimated incidence increased from 2.5 cases per 1000 in 2013 to 97.6 cases per 1000 in 2020. However, its contribution to malaria transmission in other major cities and in other countries, is unclear because of other factors, quality of the urban malaria data, human mobility, uncertainty about the actual arrival time of An. stephensi and poor entomological surveillance. Conclusions While An. stephensi may explain a resurgence of malaria in Djibouti, further investigations are needed to understand its interpretation trends in urban malaria across the greater region. More investment for multisectoral approach and integrated surveillance and control should target all vectors particularly malaria and dengue vectors to guide interventions in urban areas.
Læs mere Tjek på PubMedLargent, J., Xie, Y., Knuth, K. B., Toovey, S., Reynolds, M. W., Brinkley, E., Mack, C. D., Dreyer, N. A.
BMJ Open, 19.06.2023
Tilføjet 19.06.2023
ObjectiveTo describe cognitive symptoms in people not hospitalised at study enrolment for SARS-CoV-2 infection and associated demographics, medical history, other neuropsychiatric symptoms and SARS-CoV-2 vaccination. DesignLongitudinal observational study. SettingDirect-to-participant registry with community-based recruitment via email and social media including Google, Facebook and Reddit, targeting adult US residents. Demographics, medical history, COVID-19-like symptoms, tests and vaccinations were collected through enrolment and follow-up surveys. ParticipantsParticipants who reported positive COVID-19 test results between 15 December 2020 and 13 December 2021. Those with cognitive symptoms were compared with those not reporting such symptoms. Main outcome measureSelf-reported cognitive symptoms (defined as ‘feeling disoriented or having trouble thinking’ from listed options or related written-in symptoms) ResultsOf 3908 participants with a positive COVID-19 test result, 1014 (25.9%) reported cognitive symptoms at any time point during enrolment or follow-up, with approximately half reporting moderate/severe symptoms. Cognitive symptoms were associated with other neuropsychiatric symptoms, including dysgeusia, anosmia, trouble waking up, insomnia, headache, anxiety and depression. In multivariate analyses, female sex (OR, 95% CI): 1.7 (1.3 to 2.2), age (40–49 years (OR: 1.5 (1.2–1.9) compared with 18–29 years), history of autoimmune disease (OR: 1.5 (1.2–2.1)), lung disease (OR: 1.7 (1.3–2.2)) and depression (OR: 1.4 (1.1–1.7)) were associated with cognitive symptoms. Conversely, black race (OR: 0.6 (0.5–0.9)) and COVID-19 vaccination before infection (OR: 0.6 (0.4–0.7)) were associated with reduced occurrence of cognitive symptoms. ConclusionsIn this study, cognitive symptoms among COVID-19-positive participants were associated with female gender, age, autoimmune disorders, lung disease and depression. Vaccination and black race were associated with lower occurrence of cognitive symptoms. A constellation of neuropsychiatric and psychological symptoms occurred with cognitive symptoms. Our findings suggest COVID-19’s full health and economic burden may be underestimated. Trial registration numberNCT04368065.
Læs mere Tjek på PubMedAiroldi, C., Pagnoni, F., Cena, T., Ceriotti, D., De Ambrosi, D., De Vito, M., Faggiano, F.
BMJ Open, 19.06.2023
Tilføjet 19.06.2023
ObjectiveTo find a definition of chronic disease based on literature review and to estimate the population-based prevalence rate of chronicity in a province in Northern Italy. DesignRetrospective observational study based on administrative databases. Data sources/settingArchives of the National Health Service that contain demographic and administrative information linked with the archives of ticket exemptions (2000–2019), the hospital discharge and drug prescriptions (2016–2019). ParticipantsSubjects who lived in Vercelli Local Health Authority, a Northern Italian province (Piedmont region), and were alive in December 2019. Main outcome measuresPrevalence of subjects with at least one chronic disease identified by administrative sources and stratification of population according to the number of comorbidities. The pathologies considered were: chronic ischaemic heart disease, congestive heart failure, cardiac arrhythmias, hypertension, stroke, neoplasm, asthma, chronic obstructive pulmonary disease, diabetes, thyroid disorders, osteoporosis, rheumatoid arthritis, chronic kidney disease, dementia, autism spectrum disorder, depression, schizophrenia, hepatitis, HIV and substance use disorders. ResultsOur target population was about 164 344 subjects. The overall prevalence of subjects with at least one chronic condition was 21.43% (n=35 212): 19 541 were female and 15 671 were male with a raw prevalence of 22.96% and 19.77%, respectively. The overall prevalence increases with age until 85 years old, then a decrease is observed. Moreover, 16.39% had only one pathology, 4.30% two diseases and 0.74% had a more complex clinical condition (more than three diseases). ConclusionsDespite the difficulty of having a unique definition of chronic disease, the prevalence obtained was coherent with the estimates reported by other national surveillance systems such as Passi and Passi d’Argento. Underestimates were observed when international comparisons were done; however, when we used less stringent definitions of chronic diseases, similar results were obtained.
Læs mere Tjek på PubMedHasen, A. A., Seid, A. A., Mohammed, A. A.
BMJ Open, 19.06.2023
Tilføjet 19.06.2023
IntroductionCOVID-19 pandemic is a global health problem. In Africa, healthcare professionals face mental health problems due to COVID-19. But little was done on the prevalence of mental disorders among healthcare professionals during COVID-19 in Africa. This umbrella review of meta-analysis aimed to provide the pooled prevalence of anxiety, depression, stress, suicide, demoralisation and insomnia during COVID-19 pandemic in Africa. Methods and analysisWe will search the African Journals Online, MedRxiv, PubMed and Google Scholar to identify studies published from the occurrence of the pandemic to March 2023. Systematic review and meta-analysis studies assessing mental health problems among healthcare professionals in Africa will be considered. The outcomes of interest include prevalence of mental health problems on healthcare professionals following COVID-19. Two researchers will extract data and execute quality assessment independently. The Joanna Briggs Institute critical appraisal checklist will be used to assess the quality of studies. Stata V.16.0 software will be used for statistical analysis. The I² and Cochran’s Q-statistics will be used for analysis of heterogeneity. Publication bias will be examined by DOI plot and Luis Furuya Kanamori (LFK) index. Ethics and disseminationEthical approval and informed consent are not required as this is a literature review. The final results will be published in a peer-reviewed journal and presented at relevant conferences. PROSPERO registration numberCRD42022383939.
Læs mere Tjek på PubMedJian-Ping Ren, Hao-Long Cong, Li-Jie Gao, Dong-Fang Jiang, Xin-Tong Li, Yun Wang, Jiu-Qiang Wang, Tie-Shan Tang
Virulence, 19.06.2023
Tilføjet 19.06.2023
Steven L Taylor, Lito E Papanicolas, Erin Flynn, Mark A Boyd, Steve L Wesselingh, Geraint B Rogers
International Journal of Infectious Diseases, 19.06.2023
Tilføjet 19.06.2023
Decline in the effectiveness of antibiotics due to the spread of acquired antibiotic resistance (AMR) threatens our ability to treat common infections and to undertake essential surgical procedures safely [1]. Multidrug resistant organisms (MDROs) that emerge where antibiotic stewardship is ineffective can move rapidly across international borders [2], with major consequences for global population health [3]. The increasing mobility of populations makes responding effectively to a constantly shifting AMR landscape a considerable challenge for health systems around the world.
Læs mere Tjek på PubMedAlessandra Vergori, Giulia Matusali, Alessandro Cozzi Lepri, Eleonora Cimini, Marisa Fusto, Francesca Colavita, Roberta Gagliardini, Stefania Notari, Valentina Mazzotta, Davide Mariotti, Stefania Cicalini, Enrico Girardi, Francesco Vaia, Fabrizio Maggi, Andrea Antinori, HIV-VAC Study group
International Journal of Infectious Diseases, 19.06.2023
Tilføjet 19.06.2023
It is well known that the SARS-CoV-2 omicron and its sub-lineages contain additional spike mutations that may allow virus to evade neutralizing antibody response and consequently affect mRNA vaccine effectiveness [1,2]. Immune evasiveness and waning immunity could be considered the main factors behind breakthrough infections [3], particularly for immunocompromised populations, including persons living with HIV (PLWH).
Læs mere Tjek på PubMedOriol Manuel, Lorena van den Bogaart, Nicolas J. Mueller, Dionysios Neofytos
Clinical Microbiology and Infection, 19.06.2023
Tilføjet 19.06.2023
We read with interest the comments from Lombardi et al. (1) regarding our proposal for conducting a clinical trial to assess the best strategy for culturing preservation fluid in abdominal organ transplantation (2). While our focus was on the culture of preservation fluid, Lombardi et al. correctly pointed out that there is a larger research gap regarding perfusion fluid. Perfusion fluid refers to the fluid used during normothermic or hypothermic machine perfusion to preserve and/or improve organ function before transplantation (3).
Læs mere Tjek på PubMedMalaria Journal, 18.06.2023
Tilføjet 18.06.2023
Abstract Background Early case detection and prompt treatment are important malaria control and elimination strategies. However, the emergence and rapid spread of drug-resistant strains present a major challenge. This study reports the first therapeutic efficacy profile of pyronaridine-artesunate against uncomplicated Plasmodium falciparum in Northwest Ethiopia. Methods This single-arm prospective study with 42-day follow-up period was conducted from March to May 2021 at Hamusit Health Centre using the World Health Organization (WHO) therapeutic efficacy study protocol. A total of 90 adults ages 18 and older with uncomplicated falciparum malaria consented and were enrolled in the study. A standard single-dose regimen of pyronaridine-artesunate was administered daily for 3 days, and clinical and parasitological outcomes were assessed over 42 days of follow-up. Thick and thin blood films were prepared from capillary blood and examined using light microscopy. Haemoglobin was measured and dried blood spots were collected on day 0 and on the day of failure. Results Out of 90 patients, 86/90 (95.6%) completed the 42-day follow-up study period. The overall PCR-corrected cure rate (adequate clinical and parasitological response) was very high at 86/87 (98.9%) (95% CI: 92.2–99.8%) with no serious adverse events. The parasite clearance rate was high with fast resolution of clinical symptoms; 86/90 (95.6%) and 100% of the study participants cleared parasitaemia and fever on day 3, respectively. Conclusion Pyronaridine-artesunate was highly efficacious and safe against uncomplicated P. falciparum in this study population.
Læs mere Tjek på PubMedStine Grønseth, Tormod Rogne, Lars Heggelund, Bjørn Olav Åsvold, Jan Egil Afset, Jan Kristian Damås
International Journal of Infectious Diseases, 18.06.2023
Tilføjet 18.06.2023
The epidemiology of Pneumocystis jirovecii is evolving. In countries without universal health access and coverage, this opportunistic fungus contributes significantly to the disease burden of the human immunodeficiency virus (HIV)/Acquired Immunodeficiency Deficiency Syndrome (AIDS)-epidemic [1]. Contrarily, we see an increasing incidence of non-HIV Pneumocystis pneumonia (PCP) resulting from iatrogenic immunosuppression in high-income countries [2,3]. Increased administration of chemotherapy and immunomodulatory drugs has led to improved survival in patients suffering from cancers and immunological disorders, and those undergoing transplantations but at the cost of a larger population at risk of opportunistic infections [4].
Læs mere Tjek på PubMedJournal of Infectious Diseases, 18.06.2023
Tilføjet 18.06.2023
AbstractLike Plasmodium vivax, both Plasmodium ovale curtisi and Plasmodium ovale wallikeri have the ability to cause relapse in humans, defined as recurring asexual parasitaemia originating from liver dormant forms subsequent to a primary infection. Here, we investigated relapse patterns in P. ovale wallikeri infections from a cohort of travelers who were exposed to the parasite in Sub-Saharan Africa and then experienced relapses after their return to France. Using a novel set of eight highly polymorphic microsatellite markers, we genotyped 15 P. ovale wallikeri relapses. For most relapses, the paired primary and relapse infections were highly genetically related (with 12 being homologous), an observation that was confirmed by whole-genome sequencing for the four relapses we further studied. This is, to our knowledge, the first genetic evidence of relapses in P. ovale spp.
Læs mere Tjek på PubMedMegan A. Greischar, Lauren M. Childs
Trends in Parasitology, 18.06.2023
Tilføjet 18.06.2023
The rate at which pathogenic organisms multiply determines their capacity to harm their hosts [1,2] and to evolve traits of concern like drug resistance [3]. Accordingly, substantial effort has gone into characterizing multiplication rates in pathogenic organisms that impose major health burdens, such as malaria parasites (e.g., [4–17]). Despite considerable effort and the comparative ease of sampling blood-borne parasites, it has proven difficult to link faster multiplication rates with disease severity in human malaria infections (reviewed in [18]).
Læs mere Tjek på PubMedMalaria Journal, 18.06.2023
Tilføjet 18.06.2023
Abstract Background Recent reports of artemisinin partial resistance from Rwanda and Uganda are worrisome and suggest a future policy change to adopt new anti-malarials. This is a case study on the evolution, adoption, and implementation of new anti-malarial treatment policies in Nigeria. The main objective is to provide perspectives to enhance the future uptake of new anti-malarials, with an emphasis on stakeholder engagement strategies. Methods This case study is based on an analysis of policy documents and stakeholders’ perspectives drawn from an empirical study conducted in Nigeria, 2019–2020. A mixed methods approach was adopted, including historical accounts, review of programme and policy documents, and 33 qualitative in-depth interviews and 6 focus group discussions. Results Based on policy documents reviewed, the adoption of artemisinin-based combination therapy (ACT) in Nigeria was swift due to political will, funding and support from global developmental partners. However, the implementation of ACT was met with resistance from suppliers, distributors, prescribers, and end-users, attributed to market dynamics, costs and inadequate stakeholder engagement. Deployment of ACT in Nigeria witnessed increased developmental partner support, robust data generation, ACT case-management strengthening and evidence on anti-malarial use in severe malaria and antenatal care management. A framework for effective stakeholder engagement for the future adoption of new anti-malarial treatment strategies was proposed. The framework covers the pathway from generating evidence on drug efficacy, safety and uptake; to making treatment accessible and affordable to end-users. It addresses which stakeholders to engage with and the content of engagement strategies with key stakeholders at different levels of the transition process. Conclusion Early and staged engagement of stakeholders from global bodies to community level end-users is critical to the successful adoption and uptake of new anti-malarial treatment policies. A framework for these engagements was proposed as a contribution to enhancing the uptake of future anti-malarial strategies.
Læs mere Tjek på PubMedImmunity, 17.06.2023
Tilføjet 17.06.2023
Publication date: Available online 16 June 2023 Source: Immunity Author(s): Mihael Vucur, Ahmed Ghallab, Anne T. Schneider, Arlind Adili, Mingbo Cheng, Mirco Castoldi, Michael T. Singer, Veronika Büttner, Leonie S. Keysberg, Lena Küsgens, Marlene Kohlhepp, Boris Görg, Suchira Gallage, Jose Efren Barragan Avila, Kristian Unger, Claus Kordes, Anne-Laure Leblond, Wiebke Albrecht, Sven H. Loosen, Carolin Lohr
Læs mere Tjek på PubMedSreelekshmy Mohandas, Anita Shete, Prasad Sarkale, Abhinendra Kumar, Chandrasekhar Mote, Pragya Yadav
Virulence, 17.06.2023
Tilføjet 17.06.2023
Pasathorn Yodtaweepornanan, Wanjak Pongsittisak, Panchalee Satpanich
Tropical Medicine & International Health, 17.06.2023
Tilføjet 17.06.2023
Anna Papach, Aura Palonen, Peter Neumann
Trends in Parasitology, 17.06.2023
Tilføjet 17.06.2023
Social insect colonies live in nests and are superorganisms consisting of individuals analogous to cells in metazoans. Small hive beetles, Aethina tumida, are free-flying parasites of social bee colonies, where they feed and reproduce. The kleptoparasitic adults exploit social feeding between hosts. Adults and larvae feed on honey, pollen, and host brood, which can damage colonies. Damage rarely occurs in the endemic range of A. tumida in sub-Saharan Africa. They have become a widespread invasive species and can cause severe damage to managed colonies in the new ranges, raising concern about the possible impact on wild bees.
Læs mere Tjek på PubMedIlinca I. Ciubotariu, April Monroe, Nana Aba Williams, Sheila B. Ogoma, Fredros Okumu
Trends in Parasitology, 17.06.2023
Tilføjet 17.06.2023
Bringing together the global community is vital for continued progress in the fight against malaria. The Ifakara MasterClasses consist of discussions with experts that allow for applied understanding of specific subjects related to malaria control. They enable researchers, postgraduate students, National Malaria Program officials, and malaria advocates to engage in the same virtual room to share best practices in malaria control. In this TrendsTalk, the organizers, hosts, and some participant researchers present a synthesis of five key MasterClasses held to emphasize their mission of promoting essential scientific discourse on malaria and its control by bringing together world-leading experts to discuss technical knowledge and experiences with a wide audience.
Læs mere Tjek på PubMedJoshua I. Brian
Trends in Parasitology, 17.06.2023
Tilføjet 17.06.2023
Parasites stabilise food webs and facilitate species coexistence but can also lead to population- or species-level extinctions. So, in biodiversity conservation, are parasites friends or foes? This question is misleading: it implies that parasites are not part of biodiversity. Greater integration of parasites into global biodiversity and ecosystem conservation efforts is required.
Læs mere Tjek på PubMedDan-Yu Lin, Yangjianchen Xu, Yu Gu, Donglin Zeng, Bradford Wheeler, Hayley Young, Zack Moore, Shadia K Sunny
Lancet Infectious Diseases, 17.06.2023
Tilføjet 17.06.2023
The BNT162b2 and mRNA-1273 vaccines were effective against omicron infection and severe outcomes in children younger than 12 years, although the effectiveness decreased over time. Bivalent boosters were more effective than monovalent boosters. Immunity acquired via omicron infection was high and waned gradually over time. These findings can be used to develop effective prevention strategies against COVID-19 in children younger than 12 years.
Læs mere Tjek på PubMedShamez N Ladhani, Alexander C Dowell, Scott Jones, Bethany Hicks, Cathy Rowe, Jusnara Begum, Dagmar Wailblinger, John Wright, Stephen Owens, Ailsa Pickering, Benjamin Shilltoe, Paddy McMaster, Elizabeth Whittaker, Jianmin Zuo, Annabel Powell, Gayatri Amirthalingam, Sema Mandal, Jamie Lopez-Bernal, Mary E Ramsay, Neave Kissane, Michael Bell, Heather Watson, David Ho, Bassam Hallis, Ashley Otter, Paul Moss, Jonathan Cohen
Lancet Infectious Diseases, 17.06.2023
Tilføjet 17.06.2023
A single dose of MVA–BN for post-exposure prophylaxis was well-tolerated in children and induced robust antibody and cellular immune responses up to 15 weeks after vaccination. Larger studies are needed to fully assess the safety, immunogenicity, and effectiveness of MVA–BN in children. Our findings, however, support its on-going use to prevent mpox in children as part of an emergency public health response.
Læs mere Tjek på PubMed