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Gavin Z. ChambersKathryn M. F. ChambersRichard T. Marconi1Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, Richmond, Virginia, USAAndreas J. Bäumler
Infection and Immunity, 23.10.2024
Tilføjet 23.10.2024
Louis-Philippe LerouxVisnu ChaparroAlexandra PlouffeBrent JohnstonMaritza Jaramillo1Institut National de la Recherche Scientifique (INRS)-Centre Armand-Frappier Santé Biotechnologie (CAFSB), Laval, Québec, Canada2Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, CanadaJeroen P. J. Saeij
Infection and Immunity, 23.10.2024
Tilføjet 23.10.2024
Infection, 23.10.2024
Tilføjet 23.10.2024
Infection, 23.10.2024
Tilføjet 23.10.2024
Abstract Purpose Antibiotics are often only available in predefined pack sizes, which may not align with guideline recommendations. This can result in leftover pills, leading to inappropriate self-medication or waste disposal, which can both foster the development of antibiotic resistance. The magnitude of inappropriate pack sizes is largely unknown. The objective of this study was to evaluate the potential non-conformity of prescribed antibiotic pack sizes. Methods This retrospective observational study was based on claims data from a large Swiss health insurance company. The study analysed the prescriptions of eleven different antibiotic substances recommended for the five most common indications for antibiotics in Switzerland. All prescriptions for adult outpatients issued by general practitioners in 2022 were included and extrapolated to the entire Swiss population. Potential non-conformity was defined as a mismatch between the total dosage in a pack and the total dosage recommended. Results A total of n = 947,439 extrapolated prescriptions were analysed. In 10 of 23 of all analysed substance/indication combinations none of the prescribed packs aligned with the respective guideline recommendation. Considering pack sizes in which the total prescribed dosage of a substance did not correspond to any of the total dosages recommended in at least one of the guidelines, 31.6% of prescriptions were potentially non-conform and an estimated number of 2.7 million tablets were overprescribed. Conclusions We found a large discrepancy between prescribed pack sizes and guideline recommendations. Since inadequately prepacked antibiotics may lead to antibiotic resistance and unnecessary waste, efforts are needed to implement alternatives like exact pill dispensing.
Læs mere Tjek på PubMedInfection, 23.10.2024
Tilføjet 23.10.2024
Abstract Purpose Although guidelines recommend adjunctive rifampin and gentamicin use for patients with staphylococcal prosthetic valve endocarditis (PVE), evidence behind the recommendation is limited and conflicting. Methods We performed a retrospective cohort study of all patients with staphylococcal PVE within the Veterans Health Administration during 2003–2021. Patients were identified with diagnostic codes for prosthetic valves and positive blood cultures for Staphylococcus species and confirmed via manual chart reviews. The primary outcome was the composite of all-cause mortality or recurrence of staphylococcal PVE within one year from diagnosis. Inverse probability of treatment weighting (IPTW) was used to estimate the probability of individuals receiving rifampin using propensity scores. IPTW-adjusted multivariable Cox regression analysis was used to compare outcomes between patients who received rifampin and gentamicin, and those did not. Results Among 373 patients with staphylococcal PVE, 275 (73.7%) and 225 (60.3%) received at least one dose of rifampin and gentamicin, respectively. The incidence of staphylococcal PVE increased from 0.47 (2003-11) to 0.77 (2012-21) per 10,000 hospitalizations. Gentamicin use declined over time (70.1% in 2003–2011 to 54.8% in 2012–2021, p = 0.04) while rifampin use did not change significantly (76.1% in 2003–2011 to 72.4% in 2012–2021, p = 0.43). The composite outcome was observed in 209 (56.0%). Neither rifampin use (adjusted hazard ratio [HR] 0.77, 95% CI 0.48–1.24) and gentamicin use (adjusted HR 1.11, 95% CI 0.71–1.74) was associated with the composite outcome. Conclusion No significant association was observed between adjunctive rifampin or gentamicin use and improved outcomes.
Læs mere Tjek på PubMedInfection, 23.10.2024
Tilføjet 23.10.2024
Abstract Purpose The worldwide prevalence of Chagas Cardiomyopathy (CCM) as well as the trends in the prevalence of CCM over time have not been well characterized. Methods An analysis of the Global Burden of Disease (GBD) data from 1990 to 2019 was conducted to assess the burden of CCM. This study focused on determining the prevalence of CCM, along with its age-standardized prevalence rate (ASR) per 1,00,000 people, considering various patient demographics and geographical regions as defined in the GBD. Additionally, the study examined the temporal trends over this 30-year period by calculating the estimated annual percentage change (EAPC) in CCM prevalence for the global population and specific subgroups. Results Worldwide, the GBD reported 220,166 individuals with CCM in 1990 and 2,83,236 individuals in 2019, with a decline in the ASR from 5.23 (3.34–7.47) to 3.42 (2.2–4.91) per 1,00,000 individuals during that period. In 2019, the prevalence was highest in individuals over age 70 and in males compared to females. Among available geographic classifications in 2019, Latin American regions had the highest rates (ASR of 39.49–61.15/1,00,000), while high income North American and Western European regions had the lowest rates (ASRs of 0.67 and 0.34/1,00,000, respectively). Between 1990 and 2019, the worldwide prevalence of CCM per 1,00,000 decreased (EAPC of −0.35, −0.37 to −0.32), with similar trends among most regions and subgroups. Conclusion This analysis of the GBD data reveals both global and country-specific patterns in the prevalence and trends of CCM. Notably, CCM shows the highest prevalence in Latin American countries, although it’s also significantly present in regions beyond Latin America. Notably, the global age-standardized rate of CCM is on the decline, suggesting improvements in healthcare strategies or lifestyle changes across the world.
Læs mere Tjek på PubMedLaila Sara Arroyo Mühr, Carina Eklund, Camilla Lagheden, Emel Yilmaz, Ola Forslund, Marina Lilja, Joakim Dillner
Journal of Medical Virology, 23.10.2024
Tilføjet 23.10.2024
Anders Boyd, Pauline Mathieu, Ugo Françoise, Hayette Rougier, Thibault Chiarabini, Nadia Valin, Karine Lacombe, Paul-Louis Woerther, Laure Surgers
International Journal of Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Enterobacterales is a large order of Gram-negative bacillus, found as commensal organisms in the digestive tract; and can lead to urinary, gastroenterological, and pulmonary infections. Of the Enterobacterales, the production of extended-spectrum β-lactamase (ESBL) is the principal mechanism of resistance to 3rd generation cephalosporin antibiotics. The therapeutic options for individuals infected with these microorganisms are limited and almost always require the use of carbapenems. Escherichia coli is the most common ESBL-producing Enterbacterales (ESBL-E) in community [1].
Læs mere Tjek på PubMedJournal of Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract Background Development of a screening assay for the clinical use of broadly neutralizing antibodies (bnAbs) is a priority for HIV therapy and cure initiatives.Methods We assessed the PhenoSense Monoclonal Antibody (mAb) Assay (Labcorp-Monogram Biosciences) which is CLIA-validated and has been used prospectively and retrospectively in multiple recent bnAb clinical trials.Results When performed on pre-ART plasma and on-ART longitudinal PBMC samples sourced from a recent clinical trial, the PhenoSense mAb Assay produced robust reproducibility, concordance across sample types, and expected ranges in the susceptibility measures of bnAbs in clinical development. PhenoSense mAb applied retrospectively to baseline samples from three recent studies correlated with published laboratory-based study evaluations, but baseline bnAb susceptibility was not consistently predictive of durable virus suppression. Assessment of the feasibility of the assay in four recent clinical studies provides estimates of assay success rate and processing time.Conclusions The PhenoSense mAb Assay provides reproducible bnAb susceptibility measurements across relevant sample types yet was not consistently predictive of virus suppression. Logistical and operational assay requirements can impact timely clinical trial conduct. These results inform bnAb studies in development.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract We assessed neutralizing antibody responses in a well-characterized cohort of 60 women with different Chlamydia trachomatis infection outcomes noted at a treatment visit and 3-month follow-up. We found varying rates of neutralization (inhibition of C. trachomatis) in sera at different dilution levels and varying neutralizing antibody titers across outcomes. Median neutralization rates were significantly higher in sera at high dilutions (1:320-1:1280) from women with spontaneous resolution versus persisting infection before treatment (all P< .05). These findings suggest that neutralizing antibody responses may contribute to protective immunity against chlamydia.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract HIV exposed but uninfected infants (iHEU) display altered immunity and are at increased risk of infection. We previously reported that iHEU have decreased maternal microchimerism (MMc)—maternal cells transferred to the offspring in utero/during breastfeeding. We quantified MMc in T cell subpopulations in iHEU and unexposed infants (iHU) to determine whether a selective deficiency in MMc contributes to altered cellular immunity. Across all infants, MMc levels were highest in CD8+ T cells; however, the level of CD8+ T cell MMc was lower in iHEU versus iHU. In limited functional studies, we did not identify CMV-specific MMc during infant primary infection.
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.10.2024
Tilføjet 23.10.2024
A healthy 9-year-old had 10 days of nonproductive cough without fever, wheeze, chest pain, or abdominal pain but with diminished breath sounds in the right lower lung field. Results of laboratory testing were unremarkable; computed tomography revealed a fat-density mass in the right anterior mediastinum. What is the diagnosis and what would you do next?
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.10.2024
Tilføjet 23.10.2024
In early September, the first human case of highly pathogenic avian influenza A(H5), or H5 bird flu, “without a known occupational exposure to sick or infected animals,” occurred in Missouri, the US Centers for Disease Control and Prevention (CDC) announced. The patient, who had underlying medical conditions, was hospitalized, treated with antiviral medication, and discharged. There were no reports of transmission among the patient’s close contacts.
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.10.2024
Tilføjet 23.10.2024
Several new tick-borne viruses have been discovered in various parts of the world in the past 10 years. The latest may be a previously unknown orthonairovirus known as Wetland virus (WELV).
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.10.2024
Tilføjet 23.10.2024
Approximately 22% of deaths in 2021 from COVID-19 in US hospitals could be attributed to the imbalance between the number of patients being treated by the hospital and the resources to care for them, according to a cohort study published in the Annals of Internal Medicine.
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.10.2024
Tilføjet 23.10.2024
This cohort study examines cardiovascular complications of postvaccine and other types of myocarditis (ie, post–COVID-19 and conventional myocarditis) during 18-month follow-up.
Læs mere Tjek på PubMedGuangting Zeng
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
Swank et al.collected plasma and serum samples to determine the proportion of individuals with detectable antigen after SARS-CoV-2 infection[1].Importantly, their study suggested that detection of viral RNA were significantly associated with with postacute sequelae of COVID-19(PASC) symptoms. This study further reinforce and expand previous findings that long COVID is associated with persistence of SARS-CoV-2 RNA and proteins.
Læs mere Tjek på PubMedPaola Cantero, Laurence Ehret-Sabatier, Cédric Lenormand, Yves Hansmann, Erik Sauleau, Laurence Zilliox, Benoit Westermann, Benoit Jaulhac, Didier Mutter, Cathy Barthel, Pauline Perdu-Alloy, Martin Martinot, Dan Lipsker, Nathalie Boulanger
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
We have developed targeted proteomics in the context of Lyme borreliosis as a new direct diagnostic tool for detecting Borrelia proteins in the skin of patients with erythema migrans. If satisfactory, this proteomic technique could be used in addition to culture and/or PCR for disseminated infections, where Borrelia detection is essential to demonstrate active infection. In these infections, diagnosis is indirect and relies mainly on serology.
Læs mere Tjek på PubMedGuillaume Favre, Rebecca L. Bromley, Matthew Bluett-Duncan, Emeline Maisonneuve, Léo Pomar, Charlotte Daire, Anda-Petronela Radan, Luigi Raio, Daniel Surbek, Carolin Blume, Stylianos Kalimeris, Yoann Madec, Juliane Schneider, Myriam Bickle Graz, Ursula Winterfeld, Alice Panchaud, David Baud
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
Data are lacking regarding the long-term consequences of SARS-CoV-2 and COVID-19 mRNA vaccine on infants exposed in utero. We aimed to evaluate the neurodevelopment of infants exposed prenatally to SARS-CoV-2 or mRNA-COVID-19 vaccine during pregnancy at 12 months after birth.
Læs mere Tjek på PubMedJoseph Sassine, Chrysanthi Skevaki, Roy F. Chemaly, European Society for Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
The past decade has seen a significant rise in the prevalence of patients on immunosuppression, more than doubling compared to the prior decade [1], and the definition of immunocompromised hosts is ever expanding. With the advancements in molecular and genetic diagnoses, and improved clinician awareness, primary immunodeficiencies are increasingly identified [2]. On the other hand, cancer therapeutics have largely expanded over the past 10 to 15 years, with the emergence of targeted therapies, cellular therapies, immunotherapy, mono- and bispecific antibodies.
Læs mere Tjek på PubMedYijun He, Lingyu Shen, Jiang Du, Xuefang Cao, Bin Zhang, Dakuan Wang, Boxuan Feng, Zihan Li, Yuanzhi Di, Juanjuan Huang, Tonglei Guo, Jianguo Liang, Jiaoxia Yan, Zisen Liu, Qi Jin, Weitao Duan, Henan Xin, Lei Gao
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
To determine the agreement of Mycobacterium tuberculosis (MTB) antigen-based skin test (TBST) with interferon-gamma release assay (IGRA) in elderly individuals aged ≥ 65 years beyond instruction for use in China.
Læs mere Tjek på PubMedBrandon J. Webb, Mark A. Fisher, Nick Tinker
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
“HACEK” is a clinical mnemonic referring to a group of five genera of fastidious gram-negative bacteria that share a propensity to cause infective endocarditis (IE). These organisms, Haemophilus (parainfluenzae, haemolyticus, parahaemolyticus), Aggregatibacter (actinomycetemcomitans, aphrophilus, segnis), Cardiobacterium (hominis, valvarum), Eikenella corrodens, and Kingella (dentrificans, kingae), comprise up to 3% of IE.(1) Although not a taxonomic categorization, the HACEK organisms share common clinical and microbiological characteristics.
Læs mere Tjek på PubMedChristophe Le Terrier, Patrice Nordmann, Adam Delaval, NARA Network, Laurent Poirel
Clinical Microbiology and Infection, 23.10.2024
Tilføjet 23.10.2024
The global dissemination of NDM-producing Escherichia coli represents a significant challenge, as it leaves very few effective antimicrobial options available. The two current guidelines published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the Infectious Diseases Society of America (IDSA) suggest the combination of ceftazidime-avibactam with aztreonam or the use of cefiderocol as a first-line treatment for infections associated with NDM-producing E. coli [1,2].
Læs mere Tjek på PubMedBeaulieu, M., Viens, D., Gilbert-Ouimet, M., Rossignol, S., Gagnon, M.-P., Turmel, N., Racine, S., Cameron, M., Roy, N., Bernier, L., Gravel, C., Turcotte, S.
BMJ Open, 23.10.2024
Tilføjet 23.10.2024
IntroductionThe COVID-19 pandemic has had a major impact on nursing staff, resulting in alarming turnover rates. As part of the Quebec (Canada) government’s response to the pandemic, nurses have been offered exceptional financial incentives. Considering the cost of these measures, the current article presents the research protocol of a study aiming to explore the impact of financial incentives on full-time equivalent, and retention rates among the nursing staff in two healthcare settings in Quebec. Methods and analysisA sequential mixed design (QUANT->QUAL) will be used. The quantitative phase will involve a quantitative descriptive analysis and the qualitative phase will consist of a qualitative descriptive study. Administrative data (working hours, employment status and retention rate) will be analysed over a 4.5-year follow-up (from 1 January 2019 to 30 June 2023) to explore the impact of the financial incentives. Focus groups will explore nurses’ views on financial incentives. The results will inform the development of future interventions to mitigate attrition problems among nurses and ultimately improve access to and the continuity of public health services. Ethics and disseminationThe study has been approved by ethics committees of the participating healthcare settings (Comité d’éthique de la recherche sectorial en santé des populations et première ligne du CIUSSS de la Capitale-Nationale; Comité d’éthique de la recherche du CISSS de Chaudière-Appalaches). The results will be disseminated mainly in scientific publications and at academic conferences in addition to presentations tailored to various non-academic audiences.
Læs mere Tjek på PubMedO'Hara, D. V., Bassi, A., Wilcox, A., Jha, V., Rathore, V., D'Cruz, S., Snelling, T. L., Jones, M., Totterdell, J., Bangi, A., Jain, M. K., Pollock, C., Burrell, L., Fox, G., Jones, C., Kotwal, S., Faridah Syed Omar, S., Jardine, M., on behalf of the CLARITY 2.0 trial investigators, Bathla, Diamante, Mercade, Xie, Nair, Decaria, Abignano, Jindal, Siddiqui, Patel, Sahu, Shaikh, Jain, Soni, Kanje, Vimal, Kalyan Chakravarthy, Sathish Babu, Cheema, Moni, Nair, Haynes, Kang, Thwaites, Staplin, Heritier
BMJ Open, 23.10.2024
Tilføjet 23.10.2024
ObjectiveTo determine whether a chemokine receptor type 2 antagonist, DMX-200 (repagermanium), in combination with an angiotensin receptor blocker, candesartan, improves clinical outcomes in people with COVID-19. DesignProspective, multicentre, double-blind, placebo-controlled trial. SettingTen acute care hospitals in India. ParticipantsAdults
Læs mere Tjek på PubMedLi, L., Su, S., Yang, H., Xie, H.-B.
BMJ Open, 23.10.2024
Tilføjet 23.10.2024
ObjectiveThis study aimed to use systematic review and meta-analysis to establish the influence of antifungal therapy on pulmonary Candida colonisation of patients with mechanical ventilation (MV). DesignSystematic review and meta-analysis. Data sourcesAn extensive search was undertaken on publications from inception to 25 July 2023, through PubMed, Web of Science, Medline, Embase, China National Knowledge Infrastructure, Wanfang Data and VIP Databases. Eligibility criteria for selecting studiesRandomised trials, cohort studies and case-control studies comparing the efficacy of antifungal treatment in immunocompetent patients with pulmonary Candida colonisation after invasive ventilation. Data extraction and synthesisTwo reviewers independently extracted the data and assessed the quality of studies. Dichotomous outcomes were expressed as ORs with 95% CIs. Continuous outcomes were expressed as standardised mean differences (SMD) with 95% CIs. Primary and secondary outcome measuresThe primary outcomes included intensive care unit (ICU), hospital, 28-day, and 90-day mortality. The secondary outcomes included ICU length of stay, MV duration and ventilator-associated pneumonia (VAP). ResultsNine high-quality studies were included. According to the data collected from these nine studies, there is no significant evidence showing a difference between the therapy group treated with antifungal drugs and the control group without antifungal drugs in clinical outcomes, including ICU mortality (OR: 1.37; 95% CI 0.84 to 2.22), hospital mortality (OR: 1.17; 95% CI 0.57 to 2.38), 28-day mortality (OR: 0.71; 95% CI 0.45 to 1.14), 90-day mortality (OR: 0.76; 95% CI 0.35 to 1.63), ICU length of stay (SMD: –0.15; 95% CI –0.88 to 0.59), MV duration (SMD: 0.11; 95% CI –0.88 to 1.10) and VAP (OR: 1.54; 95% CI 0.56 to 4.20). Subgroup analysis of different treatment types indicates that the combined effect size is stable and unaffected by different treatment types including inhalation (OR: 2.32; 95% CI 0.30 to 18.09) and intravenous (OR: 0.65; 95% CI 0.13 to 3.34). ConclusionThe application of antifungal treatment did not improve clinical outcomes in patients with MV. We do not suggest initiating antifungal treatment in patients with Candida pulmonary colonisation after invasive ventilation. Trial registration numberInternational Prospective Register of Systematic Reviews, CRD42020161138.
Læs mere Tjek på PubMedGould, L. J., Angwin, E., Powell, R., Lawrance, E.
BMJ Open, 23.10.2024
Tilføjet 23.10.2024
BackgroundThe National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID-19 pandemic. An in-depth understanding of healthcare workers’ (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs’ concerns during the COVID-19 pandemic—expressed in real time during an active mental health crisis. DesignThis study involved analysis of data from ‘Shout’, a text message-based, UK-wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudorandom sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 to March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose-built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with subthemes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication. ResultsThree themes emerged from the data: (1) poor mental health, subthemes—(a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. (2) Negative work experiences, subthemes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and (d) abuse at work. (3) The impact of the COVID-19 pandemic, subthemes: (a) additional work pressure and (b) isolation and risk. ConclusionThis study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision.
Læs mere Tjek på PubMedBelachew, T. W., Mitiku, A. K., Tegegne, D. M., Yimer, T. S., Mekuriaw, B. Y., Mengistu, T. D., Aynekulu, G. T., Ferede, W. Y.
BMJ Open, 23.10.2024
Tilføjet 23.10.2024
BackgroundAdherence to option B+antiretroviral therapy medication is crucial for the effective implementation of the Prevention of Mother-to-Child Transmission (PMTCT) programme. Ethiopia has adopted the WHO’s target of achieving over 95% adherence. However, research conducted in southern Ethiopia found that only 81.4% of women adhered to option B+medication, which reflects a poor level of adherence and remains a concern. ObjectiveThe objective of the study was to assess the level of option B+PMTCT drug adherence and associated factors among women who were breast feeding for up to 18 months in government health facilities of North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022 DesignAn institution-based cross-sectional study was conducted. SettingThe study was carried out in hospitals located in the North Gojjam Zone of Northwest Ethiopia. ParticipantsThe study was conducted with 223 HIV-positive women who were breast feeding for up to 18 months, from 1 March 2022 to 30 April 2022. Primary and secondary outcomesThe primary outcome was to assess the level of option B+PMTCT drug adherence, while the secondary outcome was to identify factors associated with option B+PMTCT drug adherence among HIV-positive women who were breast feeding for up to 18 months. Associations between variables were analysed using both bivariate and multivariable logistic regression models, with a p
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract Background Neonatal Nosocomial infections (NNIs) are a significant cause of morbidity and mortality for neonates in an intensive care unit. Neonatal causes of death in healthcare facilities are attributed to different factors. We aimed to investigate factors associated with NNIs, estimate the burden of NNIs, and assess how the prediction effects help to save medical mortality and length of hospital stay. Method A prospective longitudinal study was conducted and data were collected from January 2022 to June 2022 from Jimma University Medical Center (JUMC). The data were gathered in a variety of ways, including an in-person interview with the patient’s caregiver, direct observations of neonatal patients, and a review of the study participants’ charts. This study includes patients aged 3 to 28 days who were admitted to the JUMC neonatal ward and stayed for at least 48 h. Multi-state model formulation and multivariate logistic regression were used for data analysis. Results A total of 545 neonates were included out of 688, and 30% (n = 164) of them acquired nosocomial infections (NIs); 98 (33%) of infected patients were born prematurely; and 71 (31.4%) were underweight at birth. NIs were higher in neonates with long hospital stay (AOR: 1.16, 95%CI: 1.13–1.20), use of urinary catheters (AOR: 3.09, 95%CI: 1.55–6.15), and undergoing surgical procedures (AOR: 2.42, 95%CI: 1.13–5.17). Patients who developed NIs had a higher risk of death (HR: 2, 95% CI: 1.31, 3.04). The burden of neonatal NIs was determined to have a risk of 0.3, a mortality rate of 9.6%, and an average duration of hospital stay of 14.6 days. Competing risk regression suggests that neonates with NIs have a significantly higher risk of death than those who are not infected (HR: 16.42, 95% CI: 8.70-30.98, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract Background Immunosuppressive therapies are associated with a risk of infections. Nevertheless, their incidence in this population remains unclear. This study aims to determine the incidence of serious respiratory tract infections (SRI) in a population exposed to immunosuppressive therapies. Methods Data from a representative sample of the French healthcare claims from 01/01/2014 to 12/31/2019 were analyzed. Exposure to immunosuppressive therapy was defined by the dispensation of drugs through community pharmacies or in hospitals. SRI diagnosis was based on ICD-10 codes from hospitalization records. A cohort analysis was performed to estimate standardized SRI incidence rates. A nested case-control analysis within this cohort was used to study the characteristics associated with SRI. Results We identified 24,122 individuals exposed to immunosuppressive therapies, among which 1,559 developed SRI, resulting in a standardized incidence rate of 1,398 per 100,000 person-years. In this population, the risk of SRI was associated with a history of cancer (OR 2.68, 95% Confidence Intervals (CI) 2.24–3.21; p
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract A paradoxical reaction (PR) during the treatment of tuberculosis was defined as the worsening of preexisting disease either clinically or radiologically or the appearance of a new tuberculous lesion. These reactions are frequently observed in patients coinfected with human immunodeficiency virus (HIV) upon the initiation of antiretroviral therapy (ART). Herein, we present a unique case of a paradoxical reaction in a previously healthy 19-year-old female who started anti-tuberculosis treatment for disseminated tuberculosis. Four weeks after treatment initiation, she developed two new swollen masses in her left dorsum of the hand, accompanied by fever and new right submandibular painful lymphadenopathy, with worsening of the preexisting left lower neck lymph node. The patient underwent needle aspiration from her new skin abscess on the dorsum of her left hand, which revealed positive polymerase chain reaction (PCR) for Mycobacterium tuberculosis. Anti-tuberculosis treatment was continued, and the patient fully recovered. We described an unusual presentation of paradoxical reaction manifested by a skin abscess at a site distant from her primary disease in an immunocompetent TB patient, which demonstrated the importance of considering paradoxical reactions in HIV-negative patients who present with worsening signs and symptoms after initial improvement following treatment initiation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract Objectives COVID-19 viral pneumonia can result in increased arterial stiffness, along with cardiac and systemic inflammatory responses. This study aimed to investigate the association between arterial stiffness, inflammation severity, and all-cause mortality in patients with COVID-19. Methods In this study, anthropometric data, pneumonia infection severity, and blood tests were analyzed. Arterial stiffness was assessed using the non-invasive assessment indices, including arterial velocity pulse index (AVI) and central arterial pulse pressure (CAPP). Infection volumes and percentages for the whole lungs, most lobes, and most segments were extracted from CT images using artificial intelligence-based quantitative analysis software. The relationship between arterial stiffness, central hemodynamics, and all-cause mortality was investigated. Results In multivariable Cox regression analysis, high CAPP was significantly associated with all-cause mortality (hazard ratio: 0.263, 95% CI, 0.073–0.945, p = 0.041). Whole lung infection percentages were independently associated with high CAPP, with an area under the curve (AUC) of 0.662 and a specificity of 89.09%. Conclusions High CAPP, but not high AVI, demonstrated independent prognostic value for all-cause mortality in patients due to COVID-19 pneumonia infection. Evaluating this parameter could help in risk assessment and improve diagnostic and therapeutic strategies in viral pneumonia infections.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.10.2024
Tilføjet 23.10.2024
Abstract Background Pneumococcal meningitis, a vaccine-preventable disease caused by Streptococcus pneumoniae (Spn) is the leading bacterial meningitis in under five children. In April 2014, Uganda introduced routine immunization with 10-valent Pneumococcal Conjugate Vaccine (PCV10) for infants. The target coverage for herd immunity is ≥ 90% with three doses (PCV10-dose 3). We assessed the effect of PCV10 introduction and coverage on the trends of pneumococcal meningitis in under five children. Methods We analyzed laboratory-confirmed pediatric bacterial meningitis (PBM) data at two high-volume WHO-accredited sentinel surveillance hospitals in Kampala City and Gulu District, from 2003 to 2022. We used confirmed cases to estimate the minimum incidence of pneumococcal meningitis in the host districts and calculated annual incidence of pneumococcal meningitis per one million populations, and the proportion of confirmed PBM attributable to Spn. We divided the study period into 2003–2013 (pre-PCV10) and 2014–2022 (post-PCV10), and conducted interrupted time series analysis using autoregressive integrated moving average models for the effect of PCV10 on trends of pneumococcal meningitis and PBM attributable to Spn. We analyzed reported PCV10 data in DHIS2 from 2014 to 2022 for annual PCV10-dose 3 coverage. Results Among the 534 confirmed PBM cases, 331(62%) were pneumococcal meningitis; 227(69%) from Gulu District and 104(31%) from Kampala City. The majority (95%) of the isolates were not serotyped. The majority (57%) were male and unimmunized (98%); median age = 14(IQR = 6–27) months with most (55%) aged ≥ 12 months. The case-fatality rate was 9%. During Pre-PCV10 period, the overall incidence of pneumococcal meningitis in the host districts increased; slope change = 1.0 (95%CI = 0.99999, 1.00001) but declined in post-PCV10 period (2014–2022) by 92% from 86 cases /1,000,000 in 2014 to 7/1,000,000 in 2022, slope change= -1.00006 (95%CI=-1.00033, -0.99979). Whereas there was an immediate decline in the proportion of confirmed PBM attributable to Spn in the host districts, level change=-1.84611(95%CI=-1.98365,-1.70856), an upward trend was recorded from 2016 to 2022, slope change = 1.0 (95%CI = 0.99997, 1.00003). During 2015–2022, PCV10-dose 3 coverage was largely > 90% for Gulu District and 52–72% for Kampala City. Conclusion The PCV10 routine immunization program reduced the incidence of pneumococcal meningitis in Kampala City and Gulu District. There was no effect on the confirmed PBM proportionately attributable to Spn. Kampala City persistently recorded PCV10-dose3 coverage
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