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Robin N Thompson, Edward M Hill, Julia R Gog
Lancet Infectious Diseases, 14.04.2021
Tilføjet 14.04.2021
An Editorial1 earlier this year described the potential for the evolution of SARS-CoV-2 variants that render vaccines less effective (vaccine escape), assisted by waning immunity following vaccination. This raises a crucial question: how can COVID-19 exit strategies be planned while limiting the vaccine escape risk?
Læs mere Tjek på PubMedEmerging Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
Emerging Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
Emerging Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
Emerging Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
Hitomi Hoshi, Po-sung Chu, Aya Yoshida, Nobuhito Taniki, Rei Morikawa, Karin Yamataka, Fumie Noguchi, Ryosuke Kasuga, Takaya Tabuchi, Hirotoshi Ebinuma, Hidetsugu Saito, Takanori Kanai, Nobuhiro Nakamoto
PLoS One Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
by Hitomi Hoshi, Po-sung Chu, Aya Yoshida, Nobuhito Taniki, Rei Morikawa, Karin Yamataka, Fumie Noguchi, Ryosuke Kasuga, Takaya Tabuchi, Hirotoshi Ebinuma, Hidetsugu Saito, Takanori Kanai, Nobuhiro Nakamoto
Background Acute decompensation (AD) of liver cirrhosis (LC) and subsequent acute-on-chronic liver failure (ACLF) are fatal and impair quality of life. Insufficient knowledge of the highly heterogeneous natural history of LC, including decompensation, re-compensation, and possible recurrent decompensation, hinders the development and application of novel therapeutics. Approximately 10%-50% of AD/ACLF is reported to be precipitated by any indeterminate (unidentifiable, cryptogenic, or unknown) acute insults; however, its clinical characteristics are unclear.
Methods We conducted a single-center observational study of 2165 consecutively admitted patients with LC from January 2012 to December 2019. A total of 466 episodes of AD/ACLF in 285 patients, including their 285 first indexed AD/ACLF, were extracted for analysis. Stratified analyses of different acute precipitants, classified as indeterminate (AD/ACLFIND), bacterial infection (AD/ACLFBAC), gastrointestinal bleeding, active alcoholism, and miscellaneous, were performed.
Results AD/ACLFIND was the leading acute precipitant (28%), followed by AD/ACLFBAC (23%). AD/ACLFIND showed better survival outcomes than AD/ACLFBAC (P = 0.03); however, hyperbilirubinemia, hyponatremia, or leukocytosis significantly and uniquely characterized subgroups of AD/ACLFIND with comparable or even worse survival outcomes than those of AD/ACLFBAC. Patients with subsequent AD/ACLF significantly tended to suffer from AD/ACLF with any organ failure in AD/ACLFIND but not in AD/ACLFBAC (P = 0.004, for trend). In competing risk analysis, patients with AD/ACLFIND were significantly more vulnerable to suffer from recurrent episodes of AD/ACLF within 180 days, compared to those triggered by other precipitants (P = 0.04).
Conclusions AD/ACLFIND, the leading acute precipitant, also plays a role in subsequent AD/ACLF. An abruptly exacerbating, remitting, and relapsing nature of systemic inflammation underlying AD/ACLF may also be useful for risk estimation.
Læs mere Tjek på PubMedTakashi Aoyama, Tomoko Kudo
PLoS One Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
by Takashi Aoyama, Tomoko Kudo
The Japanese Ministry of Health requires large-scale cooking facilities to use sodium hypochlorite aqueous solution (HYP) on food preparation tools, equipment, and facilities to prevent secondary contamination. This study aimed to compare the disinfecting effect of HYP and surfactant using adenosine triphosphate (ATP) swab testing on large-scale equipment and facilities that could not be disassembled and disinfected in hospital kitchen. From May 2018 to July 2018, ATP swab tests were performed on the following six locations in the Shizuoka Cancer Centre Dietary Department Kitchen: cooking counter, mobile cooking counter, refrigerator handle, conveyor belt, tap handle, and sink. Six relative light unit (RLU) measurements were taken from each location. The log10 values of the RLU measurements were evaluated by dividing the samples into two groups: the control group (surfactant followed by HYP swabbing) and the HYP group (HYP swabbing only). The results showed that the RLUs (log10 values) in both the groups improved after disinfection (p
Læs mere Tjek på PubMedMichael Eder, Haris Omic, Jana Gorges, Florian Badt, Zeljko Kikic, Marcus D. Saemann, Allison Tong, David Bauer, Georg Semmler, Thomas Reiberger, Heimo Lagler, Bernhard Scheiner
PLoS One Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
by Michael Eder, Haris Omic, Jana Gorges, Florian Badt, Zeljko Kikic, Marcus D. Saemann, Allison Tong, David Bauer, Georg Semmler, Thomas Reiberger, Heimo Lagler, Bernhard Scheiner
Introduction Seasonal influenza is a major global health problem causing substantial morbidity and health care costs. Yet, in many countries, the rates of influenza vaccination remain low. Chronic kidney or liver diseases (CKLD) predispose patients to severe influenza infections, but data on vaccination acceptance and status is limited in this risk population. We investigated the influenza vaccination awareness considering sociodemographic factors in CKLD patients.
Patients and methods This cross-sectional, questionnaire-based study recruited CKLD patients managed at three Viennese tertiary care centers between July and October 2020. CKLD was defined as chronic kidney- (all stages) or compensated/decompensated liver disease, including kidney/liver transplant recipients. Questionnaires assessed sociodemographic and transplant- associated parameters, patients vaccination status and the individuals self-perceived risks of infection and associated complications.
Results In total 516 patients (38.1% female, mean age 56.4 years) were included. 43.9% of patients declared their willingness to be vaccinated in the winter season 2020/2021, compared to 25.4% in 2019/2020 and 27.3% in 2016-2018. Vaccination uptake was associated with the self-perceived risks of infection (OR: 2.8 (95%CI: 1.8-4.5), p<0.001) and associated complications (OR: 3.8 (95%CI: 2.3-6.3), p<0.001) as well as with previously received influenza vaccination (2019/2020: OR 17.1 (95%CI: 9.5-30.7), p<0.001; season 2016-2018: OR 8.9 (95%CI: 5.5-14.5), p<0.001). Most frequent reasons for not planning vaccination were fear of a) graft injury (33.3%), b) complications after vaccination (32.4%) and c) vaccine inefficiency (15.0%).
Conclusion While influenza vaccination willingness in patients with CKLD is increasing in the 2020/2021 season, vaccination rates may still remain
Læs mere Tjek på PubMedMichael Owusu, Augustina Angelina Sylverken, Philip El-Duah, Nana Kwame Ayisi-Boateng, Richmond Yeboah, Eric Adu, Jesse Asamoah, Michael Frimpong, Japhet Senyo, Godfred Acheampong, Mohamed Mutocheluh, John Amuasi, Ellis Owusu-Dabo, Yaw Adu-Sarkodie, Richard Odame Phillips
PLoS One Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
by Michael Owusu, Augustina Angelina Sylverken, Philip El-Duah, Nana Kwame Ayisi-Boateng, Richmond Yeboah, Eric Adu, Jesse Asamoah, Michael Frimpong, Japhet Senyo, Godfred Acheampong, Mohamed Mutocheluh, John Amuasi, Ellis Owusu-Dabo, Yaw Adu-Sarkodie, Richard Odame Phillips
Background The novel coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), continues to remain a global challenge. There is emerging evidence of SARS-CoV-2 virus found in the blood of patients from China and some developed countries. However, there is inadequate data reported in Ghana and other parts of Africa, where blood transfusion service heavily relies on voluntary and replacement blood donors. This study aimed to investigate whether plasma of infected individuals could pose significant transfusion transmitted risk of COVID-19 in Ghanaian populations.
Methods This cross-sectional retrospective study was conducted at the Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), KNUST, Ghana. Study subjects comprised contacts of COVID-19 individuals, those with classical symptoms of COVID-19 and individuals who had recovered based on the new Ghana discharge criteria. Whole blood, sputum or deep coughed saliva samples were collected and transported to KCCR for SARS-CoV-2 testing. Viral nucleic acid was extracted from sputum/nasopharyngeal samples using Da An Gene column based kit and from plasma using LBP nucleic acid extraction kit. Real-Time PCR was performed specifically targeting the ORF1ab and Nucleocapsid (N) genomic regions of the virus.
Results A total of 97 individuals were recruited into the study, with more than half being males (58; 59.7%). The mean age of all subjects was 33 years (SD = 7.7) with minimum being 22 years and maximum 56 years. Majority (76; 78.4%) of all the subjects were asymptomatic, and among the few symptomatic subjects, cough (10; 10.3%) was the most predominant symptom. Of the 97 sputum samples tested, 79 (81.4%) were positive for SARS-CoV-2. We identified SARS-CoV-2 viral RNA in the plasma of 1 (1.03%) subject who had clinically recovered.
Conclusion This study reports the identification of SARS-CoV-2 viral RNA in a convalescent individual in Ghana. Due to the low prevalence observed and the marginal cycling thresholds associated, the risk of transfusion transmission of SARS-CoV-2 is negligible. Well-powered studies and advanced diagnostics to determine infectious viremia is recommended to further evaluate the potential risk of hematogenous transmission among recovered patients.
Læs mere Tjek på PubMedLyanne McCallan, Cathy Brooks, Claire Barry, Catherine Couzens, Fiona J. Young, Jim McNair, Andrew W. Byrne
PLoS One Infectious Diseases, 13.04.2021
Tilføjet 13.04.2021
by Lyanne McCallan, Cathy Brooks, Claire Barry, Catherine Couzens, Fiona J. Young, Jim McNair, Andrew W. Byrne
The ability to accurately identify infected hosts is the cornerstone of effective disease control and eradication programs. In the case of bovine tuberculosis, accurately identifying infected individual animals has been challenging as all available tests exhibit limited discriminatory ability. Here we assess the utility of two serological tests (IDEXX Mycobacterium bovis Ab test and Enfer multiplex antibody assay) and assess their performance relative to skin test (Single Intradermal Comparative Cervical Tuberculin; SICCT), gamma-interferon (IFNγ) and post-mortem results in a Northern Ireland setting. Furthermore, we describe a case-study where one test was used in conjunction with statutory testing. Serological tests using samples taken prior to SICCT disclosed low proportions of animals as test positive (mean 3% positive), despite the cohort having high proportions with positive SICCT test under standard interpretation (121/921; 13%) or IFNγ (365/922; 40%) results. Furthermore, for animals with a post-mortem record (n = 286), there was a high proportion with TB visible lesions (27%) or with laboratory confirmed infection (25%). As a result, apparent sensitivities within this cohort was very low (≤15%), however the tests succeeded in achieving very high specificities (96-100%). During the case-study, 7/670 (1.04%) samples from SICCT negative animals from a large chronically infected herd were serology positive, with a further 17 animals being borderline positive (17/670; 2.54%). Nine of the borderline animals were voluntarily removed, none of which were found to be infected post-mortem (no lesions/bacteriology negative). One serology test negative animal was subsequently found to have lesions at slaughter with M. bovis confirmed in the laboratory.
Læs mere Tjek på PubMedInfection, 13.04.2021
Tilføjet 13.04.2021
Abstract
Purpose
The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study™s aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD.
Methods
We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified.
Results
Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (>‰85 years compared to 15-65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27-33.20, p‰=‰0.025). We further identified markedly elevated lactate dehydrogenase (>‰2‰Ã—‰upper limit of normal, aOR 23.21, 95% CI 3.66-147.11, p‰<‰0.001), thrombocytopenia (<‰120,000/µl, aOR 11.66, 95% CI 2.49-54.70, p‰=‰0.002), anemia (Hb‰<‰10 g/dl, aOR 3.21, 95% CI 1.17-8.82, p‰=‰0.024), and C-reactive protein (≥‰30 mg/l, aOR 3.44, 95% CI 1.13-10.45, p‰=‰0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68-1.93, p‰=‰0.611).
Conclusion
The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.
Læs mere Tjek på PubMed