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Journal of Infectious Diseases, 26.01.2023
Tilføjet 26.01.2023
AbstractBackgroundWe evaluated the associations between baseline influenza virus-specific hemagglutination inhibition (HAI) and microneutralization (MN) titers and subsequent symptomatic influenza virus infection in a controlled human infection study.MethodsWe inoculated unvaccinated healthy adults aged 18 through 49 years with an influenza A/California/04/2009/H1N1pdm-like virus (NCT04044352). We collected serial safety labs, serum for HAI and MN, and nasopharyngeal swabs for RT-PCR testing. Analyses used the putative seroprotective titer of ≥40 for HAI and MN. The primary clinical outcome was mild-to-moderate influenza disease (MMID), defined as ≥1 post-challenge positive qualitative RT-PCR test with a qualifying symptom/clinical finding.ResultsOf 76 participants given influenza virus challenge, 54 (71.1%) experienced MMID. Clinical illness was generally very mild. MMID attack rates among participants with baseline titers ≥40 by HAI and MN were 64.9% and 67.9%, respectively, while MMID attack rates among participants with baseline titers <40 by HAI and MN were 76.9% and 78.3%, respectively. The estimated odds of developing MMID decreased by 19% (odds ratio=0.81; 95% CI: 0.62, 1.06; p=0.126) for every two-fold increase in baseline HAI. There were no significant adverse events.ConclusionsWe achieved a 71.1% attack rate of MMID. High baseline HAI and MN were associated with protection from illness.
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.01.2023
Tilføjet 26.01.2023
AbstractBackgroundImmunoassays designed to detect SARS-CoV-2 protein antigens (Ag) are commonly used to diagnose COVID-19. The most widely used tests are lateral flow assays that generate results in approximately 15 minutes for diagnosis at the point-of-care. Higher throughput, laboratory-based SARS-CoV-2 Ag assays have also been developed. The number of commercially available SARS-CoV-2 Ag detection tests has increased rapidly, as has the COVID-19 diagnostic literature. The Infectious Diseases Society of America (IDSA) convened an expert panel to perform a systematic review of the literature and develop best practice guidance related to SARS-CoV-2 Ag testing. This guideline is an update to the third in a series of frequently updated COVID-19 diagnostic guidelines developed by the IDSA.ObjectiveThe IDSA’s goal was to develop evidence-based recommendations or suggestions that assist clinicians, clinical laboratories, patients, public health authorities, administrators and policymakers in decisions related to the optimal use of SARS-CoV-2 Ag tests in both medical and non-medical settings.MethodsA multidisciplinary panel of infectious diseases clinicians, clinical microbiologists and experts in systematic literature review identified and prioritized clinical questions related to the use of SARS-CoV-2 Ag tests. A review of relevant, peer-reviewed published literature was conducted through April 1, 2022. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations.ResultsThe panel made ten diagnostic recommendations. These recommendations address Ag testing in symptomatic and asymptomatic individuals and assess single versus repeat testing strategies.ConclusionsU.S. Food and Drug Administration (FDA) SARS-CoV-2 Ag tests with Emergency Use Authorization (EUA) have high specificity and low to moderate sensitivity compared to nucleic acid amplification testing (NAAT). Ag test sensitivity is dependent on the presence or absence of symptoms, and in symptomatic patients, on timing of testing after symptom onset. In contrast, Ag tests have high specificity, and, in most cases, positive Ag results can be acted upon without confirmation. Results of point-of-care testing are comparable to those of laboratory-based testing, and observed or unobserved self-collection of specimens for testing yields similar results. Modeling suggests that repeat Ag testing increases sensitivity compared to testing once, but no empirical data were available to inform this question. Based on these observations, rapid RT-PCR or laboratory-based NAAT remains the testing method of choice for diagnosing SARS-CoV-2 infection. However, when timely molecular testing is not readily available or is logistically infeasible, Ag testing helps identify individuals with SARS-CoV-2 infection. Data were insufficient to make a recommendation about the utility of Ag testing to guide release of patients with COVID-19 from isolation. The overall quality of available evidence supporting use of Ag testing was graded as very low to moderate.
Læs mere Tjek på PubMedAzhar S. Sindi, Ali S. Cheema, Michelle L. Trevenen, Donna T. Geddes, Matthew S. Payne, Lisa F. Stinson
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Azhar S. Sindi, Ali S. Cheema, Michelle L. Trevenen, Donna T. Geddes, Matthew S. Payne, Lisa F. StinsonHuman milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.
Læs mere Tjek på PubMedManjusha Vaidya, Jonhoi Smith, Melvin Field, Kiminobu Sugaya
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Manjusha Vaidya, Jonhoi Smith, Melvin Field, Kiminobu SugayaExosomes participate in intercellular communication by transporting functionally active molecules. Such cargo from the original cells comprising proteins, micro-RNA, mRNA, single-stranded (ssDNA) and double-stranded DNA (dsDNA) molecules pleiotropically transforms the target cells. Although cancer cells secrete exosomes carrying a significant level of DNA capable of modulating oncogene expression in a recipient cell, the regulatory mechanism is unknown. We have previously reported that cancer cells produce exosomes containing NANOGP8 DNA. NANOGP8 is an oncogenic paralog of embryonic stem cell transcription factor NANOG and does not express in cells since it is a pseudogene. However, in this study, we evaluated NANOGP8 expression in glioblastoma multiforme (GBM) tissue from a surgically removed brain tumor of a patient. Significantly higher NANOGP8 transcription was observed in GBM cancer stem cells (CSCs) than in GBM cancer cells or neural stem cells (NSCs), despite identical sequences of NANOGP8-upstream genomic region in all the cell lines. This finding suggests that upstream genomic sequences of NANOGP8 may have environment-dependent promoter activity. We also found that the regulatory sequences upstream of exosomal NANOGP8 GBM DNA contain multiple core promoter elements, transcription factor binding sites, and segments of human viruses known for their oncogenic role. The exosomal sequence of NANOGP8-upstream GBM DNA is different from corresponding genomic sequences in CSCs, cancer cells, and NSCs as well as from the sequences reported by NCBI. These sequence dissimilarities suggest that exosomal NANOGP8 GBM DNA may not be a part of the genomic DNA. Exosomes possibly acquire this DNA from other sources where it is synthesized by an unknown mechanism. The significance of exosome-bestowed regulatory elements in the transcription of promoter-less retrogene such as NANOGP8 remains to be determined.
Læs mere Tjek på PubMedGeorgina Drago, Francisco Javier Pérez-Sádaba, Susana Aceituno, Carla Gari, Juan Luis López-Belmonte
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Georgina Drago, Francisco Javier Pérez-Sádaba, Susana Aceituno, Carla Gari, Juan Luis López-BelmonteObjectives Describe healthcare resource use and costs per hospitalized coronavirus disease-2019 (COVID-19) patient during the three main outbreak waves. Methods A retrospective observational study. COVID-19 patient data were collected from a dataset from 17 hospitals in the HM Hospitals Group. Mean total costs per hospitalized patient and per day were estimated in each wave, as defined by the Spanish National Health System perspective. In addition, costs were estimated for both patients admitted and those not admitted to the intensive care unit (ICU) and were stratified by age groups. Results A total of 3756 COVID-19 patients were included: 2279 (60.7%) for the first, 740 (19.7%) for the second, and 737 (19.6%) for the and third wave. Most (around 90%) did not require ICU treatment. For those patients, mean ± SD cost per patient ranged from €10 196.1 ± €7237.2 (mean length of stay [LOS] ± SD: 9.7 ± 6.2 days) for the second wave to €9364.5 ± €6321.1 for the third wave (mean 9.0 ± 5.7 days). Mean costs were around €1000 per day for all the waves. For patients admitted to the ICU, cost per patient ranged from €81 332.5 ± €63 725.8 (mean 31.0 ± 26.3 days) for the second wave to €36 952.1 ± €24 809.2 (mean 15.7 ± 8.2 days) for the third wave. Mean costs per day were around €3000 for all the waves. When estimated by age, mean LOS and costs were greater in patients over 80 when not admitted to the ICU and for patients aged 60 to 79 when admitted to the ICU. Conclusions LOS was longer for patients admitted to the ICU (especially in the first two waves) and for older patients in our study cohort; these populations incurred the highest hospitalization costs.
Læs mere Tjek på PubMedAlexandros Chrysos, Iakovos Amygdalos, Priscila Nunes, Guenter Haselow, Konstantinos Lioupis, Raphael Rosch, Roman Marius Eickhoff, Georg Wiltberger, Ulf Peter Neumann, Andreas Lambertz
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Alexandros Chrysos, Iakovos Amygdalos, Priscila Nunes, Guenter Haselow, Konstantinos Lioupis, Raphael Rosch, Roman Marius Eickhoff, Georg Wiltberger, Ulf Peter Neumann, Andreas LambertzThis study aimed to observe the impact of the COVID-19 outbreak on acute general surgery in the first German “hotspot” regions of Heinsberg and Aachen, during the first months of the pandemic. The incidence and severity of acute appendicitis, acute cholecystitis and mechanical bowel obstruction, were compared between March and May 2020 and a control period (same months of the previous three years). Pre-, intra- and postoperative data was compared between three regional hospitals of Heinsberg and the closest maximum care, university hospital. A total of 592 operated patients were included, 141 belonging to the pandemic cohort and 451 to the historic cohort. The pandemic group showed higher rates of clinical peritonitis (38% vs. 27%, p = 0.015), higher rates of mean white blood cell count (13.2±4.4 /nl vs. 12.3±4.7 /nl, p = 0.044) and mean C-reactive protein (60.3±81.1 mg/l vs. 44.4±72.6 mg/l, p = 0.015) preoperatively. Specifically in patients with acute appendicitis, there were less patients with catarrhal appendicitis (23% vs. 35%, p = 0.021) and a tendency towards more advanced histological findings in the pandemic cohort. In the university hospital, a 42% reduction in acute operated cases was observed at the onset of the pandemic (n = 30 in 2020 vs. n = 52 in 2019), whereas in the peripheral hospitals of Heinsberg there was only a 10% reduction (n = 111 in 2020 vs. n = 123 in 2019). The onset of the COVID-19 pandemic in our region was accompanied by advanced preoperative and intraoperative findings in patients undergoing emergency general surgery. A greater reduction in acute operated surgical cases was observed at the university hospital, in contrast to the smaller hospitals of Heinsberg, suggesting a possible shift of emergency patients, requiring immediate operation, from maximum care hospital to the periphery.
Læs mere Tjek på PubMedJulia K. Prümmer, Veronika M. Stein, Eliane Marti, Andreas Lutterotti, Ilijas Jelcic, Gertraud Schüpbach-Regula, Thorsten Buch, Arianna Maiolini
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Julia K. Prümmer, Veronika M. Stein, Eliane Marti, Andreas Lutterotti, Ilijas Jelcic, Gertraud Schüpbach-Regula, Thorsten Buch, Arianna MaioliniBackground Meningoencephalitis of unknown origin (MUO) is an inflammatory disease of the canine central nervous system (CNS) that shares several features with multiple sclerosis (MS) in humans. In approximately 95% of MS patients, ≥ two immunoglobulin G (IgG) oligoclonal bands (OCBs) are detectable exclusively in the cerebrospinal fluid (CSF). Hypothesis/objectives To investigate OCBs in CSF and serum in dogs affected by MUO, intervertebral disc disease (IVDD), idiopathic epilepsy (IE), intracranial neoplasia (IN), steroid-responsive meningitis-arteritis (SRMA), and diseases outside the CNS. We hypothesize that the highest prevalence of CSF-specific OCBs (≥ two OCBs uniquely in the CSF) would be found in dogs affected by MUO. Animals Client-owned dogs (n = 121) presented to the neurology service due to neurological deficits. Methods Prospective study. Measurement of IgG concentration in CSF and serum via a canine IgG ELISA kit. OCB detection via isoelectric focusing (IEF) and immunoblot. Results Presence of CSF-specific OCBs was significantly higher in dogs with MUO (57%) compared to 22% in IN, 6% in IE, 15% in SRMA, 13% in IVDD, and 0% in the non-CNS group (p < .001). Dogs with MUO were 9.9 times more likely to show CSF-specific OCBs than all other diseases together (95% confidence interval, 3.7–26.4; p < .001). Conclusions and clinical importance MUO showed the highest prevalence of CSF-specific OCBs, indicating an inflammatory B cell response. Future studies are needed to evaluate the prevalence in the specific MUO subtypes and a possible similarity with human MS.
Læs mere Tjek på PubMedOluwapelumi Olufemi Adeyemi, Nnaemeka Darlington Ndodo, Mariam Kehinde Sulaiman, Oyeronke Temidayo Ayansola, Oluwabunmi Idera Nimat Buhari, Olusola Anuoluwapo Akanbi, Oladimeji Akeem Bolarinwa, Chimaobi Chukwu, Ireoluwa Yinka Joel, Adesuyi Ayodeji Omoare, Kolawole Wasiu Wahab, Celestina Obiekea, Mikhail Olayinka Buhari, Anthony Ahumibe, Caroline Folasade Kolawole, Catherine Okoi, Olumuyiwa Babagbemi Omotesho, Nwando Mba, Oluwafemi Adeniyi, Olajumoke Babatunde, Nathaniel Akintunde, Ganiu Ayinla, Oluwatosin Wuraola Akande, Rasheed Adekeye Odunola, Mohammed Jimoh Saka, Omotosho Ibrahim Musa, Idayat Adenike Durotoye, Chikwe Ihekweazu, Ifedayo Morayo Adetifa, Abayomi Fadeyi
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Oluwapelumi Olufemi Adeyemi, Nnaemeka Darlington Ndodo, Mariam Kehinde Sulaiman, Oyeronke Temidayo Ayansola, Oluwabunmi Idera Nimat Buhari, Olusola Anuoluwapo Akanbi, Oladimeji Akeem Bolarinwa, Chimaobi Chukwu, Ireoluwa Yinka Joel, Adesuyi Ayodeji Omoare, Kolawole Wasiu Wahab, Celestina Obiekea, Mikhail Olayinka Buhari, Anthony Ahumibe, Caroline Folasade Kolawole, Catherine Okoi, Olumuyiwa Babagbemi Omotesho, Nwando Mba, Oluwafemi Adeniyi, Olajumoke Babatunde, Nathaniel Akintunde, Ganiu Ayinla, Oluwatosin Wuraola Akande, Rasheed Adekeye Odunola, Mohammed Jimoh Saka, Omotosho Ibrahim Musa, Idayat Adenike Durotoye, Chikwe Ihekweazu, Ifedayo Morayo Adetifa, Abayomi FadeyiThe COVID-19 global pandemic is being driven by evolving SARS-CoV-2 variants with consequential implications on virus transmissibility, host immunity, and disease severity. Continuous molecular and genomic surveillance of the SARS-CoV-2 variants is therefore necessary for public health interventions toward the management of the pandemic. This study is a retrospective analysis of COVID-19 cases reported in a Nigerian tertiary institution from July to December 2021. In total, 705 suspected COVID-19 cases that comprised 547 students and 158 non-students were investigated by real time PCR (RT-PCR); of which 372 (~52.8%) tested positive for COVID-19. Using a set of selection criteria, 74 (~19.9%) COVID-19 positive samples were selected for next generation sequencing. Data showed that there were two outbreaks of COVID-19 within the university community over the study period, during which more females (56.8%) tested positive than males (47.8%) (p
Læs mere Tjek på PubMedAlima Qureshi, Elizabeth Keen, George Brown, Lauren Cator
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Alima Qureshi, Elizabeth Keen, George Brown, Lauren CatorMass-rearing of mosquitoes under laboratory conditions is an important part of several new control techniques that rely on the release of males to control mosquito populations. While previous work has investigated the effect of larval density and diet amount on colony productivity, the role of the size of the container in which larval development takes place has been relatively ignored. We investigated the role of container size in shaping life history and how this varied with density and food availability in Aedes aegypti, an important disease vector and target of mass-rearing operations. For each treatment combination, immature development time and survival and adult body size and fecundity were measured, and then combined into a measure of productivity. We additionally investigated how larval aggregation behaviour varied with container size. Container size had important effects on life history traits and overall productivity. In particular, increasing container size intensified density and diet effects on immature development time. Productivity was also impacted by container size when larvae were reared at high densities (1.4 larva/ml). In these treatments, the productivity metric of large containers was estimated to be significantly lower than medium or small containers. Regardless of container size, larvae were more likely to be observed at the outer edges of containers, even when this led to extremely high localized densities. We discuss how container size and larval aggregation responses may alter the balance of energy input and output to shape development and productivity.
Læs mere Tjek på PubMedNebiyu Mengistu, Endashaw Habtamu, Chalachaw Kassaw, Derebe Madoro, Wondwosen Molla, Aregahegn Wudneh, Lulu Abebe, Bereket Duko
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Nebiyu Mengistu, Endashaw Habtamu, Chalachaw Kassaw, Derebe Madoro, Wondwosen Molla, Aregahegn Wudneh, Lulu Abebe, Bereket DukoBackground Smartphone and social media use are supposed to be integral parts of university students’ daily lives. More specifically, smartphones and social media are frequently used for communication in daily life during the COVID-19 pandemic. Nonetheless, uninterrupted and persistent use of these technologies may lead to several psychological problems. Even though smartphones and social media were used more frequently during the pandemic, there is no evidence suggesting that the studies were not undertaken in low-income countries, including Ethiopia. Therefore, the current study aimed to assess problematic smartphone use and social media use among undergraduate university students in southern Ethiopia. Methods A cross-sectional study was carried out among 1,232 university students using a simple random sampling technique. The Bergen Social Media Addiction Scale and Smartphone Application-Based Addiction Scale were used to collect data on social media and smartphone use, respectively. The Beck Depression Inventory, Generalized Anxiety Assessment Tool, Rosenberg Self-Esteem Scale, and Pittsburg Sleep Quality Index were standardized tools used to measure other independent variables. To identify factors, simple and multiple linear regression analyses were performed. A p-value of 0.05 was used to determine statistical significance. Results The overall response rate was 95%. The mean scores for problematic smartphone and problematic social media use were 17 ± 3.3/36 and 12.7 ± 2.2/30, respectively. A linear regression model revealed that being female, first-year students and poor sleep quality were significantly associated with problematic smartphone use. Factors associated with problematic social media use (PSMU) were depression, substance use, and urban residence. Conclusions This study identified significant problems with smartphone and social media use among university students. Therefore, it is preferable to provide psychological counselling, educate students about safe, beneficial, and healthy internet use, and focus on recognized high-risk groups in order to give them special attention. It is also preferable to seek counselling about substance use. It is preferable to regularly screen and treat individuals with psychological problems in collaboration with stakeholders.
Læs mere Tjek på PubMedShun Sun Wong, Charng Choon Wong, Kwok Wen Ng, Mohammad F. Bostanudin, Suk Fei Tan
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Shun Sun Wong, Charng Choon Wong, Kwok Wen Ng, Mohammad F. Bostanudin, Suk Fei TanIntroduction This study aims to assess the impacts of COVID-19 pandemics among university students in Malaysia, by identifying the prevalence of depression, anxiety and stress among them and their respective predictors. Methodology An online cross-sectional study was conducted via non-probabilistic convenience sampling. Data were collected on sociodemographic characteristics, lifestyle, COVID-19 related influences. Mental health status was assessed with depression, anxiety, and stress scale (DASS-21). Results 388 students participated this study (72.4% female; 81.7% Bachelor’s student). The prevalence of moderate to severe depression, anxiety and stress among university students are 53.9%, 66.2% and 44.6%, respectively. Multivariable logistic regression analysis found that the odds of depression were lower among students who exercise at least 3 times per week (OR: 0.380, 95% CI: 0.203–0.711). The odd ratio of student who had no personal history of depression to had depression, anxiety and stress during this pandemic was also lower in comparison (OR: 0.489, 95% CI: 0.249–0.962; OR: 0.482, 95% CI: 0.241–0.963; OR: 0.252, 95% CI: 0.111–0.576). Surprisingly, students whose are currently pursuing Master study was associated with lower stress levels (OR: 0.188, 95% CI: 0.053–0.663). However, student who had poorer satisfaction of current learning experience were more likely to experience stress (OR: 1.644, 95% CI: 1.010–2.675). Limitations It is impossible to establish causal relationships between variables on mental health outcomes, and there is a risk of information bias. Conclusion The prevalence of mental health issues among university students is high. These findings present essential pieces of predictive information when promoting related awareness among them.
Læs mere Tjek på PubMedAlice Bertoletti, Mara Soncin, Marta Cannistrà, Tommaso Agasisti
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Alice Bertoletti, Mara Soncin, Marta Cannistrà, Tommaso AgasistiThe disruption caused by the Covid-19 pandemic generated an unprecedented situation, in which digital learning, in the form of Emergency Remote Teaching, was the only possible form of schooling. Italy soon decided to close schools as a measure to counter the spread of the virus. Although the Ministry of Education suggested general guidelines, school principals and teachers were autonomous in deciding how to best organise their educational activities. The first objective of our study is to identify subgroups of teachers, based on the use of digital tools during the Covid-19 emergency. Secondly, we explore how subgroups differ in terms of teachers’ satisfaction and students’ performance. To this end, we integrate information from an ad hoc survey completed by 1,407 primary and lower secondary teachers in Italy, with the students’ standardised test scores provided by INVALSI. Data have been analysed through a 3-step latent class analysis. The findings reveal that one third of the teachers showed resistance to the use of digital technologies and focused mainly on asynchronous teaching. Teachers that used a broader set of digital instruments, instead, were more satisfied with their teaching practices. A more articulated use of technology for teaching activities was also positively associated with higher students’ performance in 2021.
Læs mere Tjek på PubMedAntimicrobial Agents And Chemotherapy, 25.01.2023
Tilføjet 25.01.2023
Antimicrobial Agents And Chemotherapy, 25.01.2023
Tilføjet 25.01.2023
Infection, 25.01.2023
Tilføjet 25.01.2023
Abstract Purpose Sepsis in critically ill patients with injury bears a high morbidity and mortality. Extensive phenotypic monitoring of leucocyte subsets in critically ill patients at ICU admission and during sepsis development is still scarce. The main objective of this study was to identify early changes in leukocyte phenotype which would correlate with later development of sepsis. Methods Patients who were admitted in a tertiary ICU for organ support after severe injury (elective cardiac surgery, trauma, necessity of prolonged ventilation or stroke) were sampled on admission (T1) and 48–72 h later (T2) for phenotyping of leukocyte subsets by flow cytometry and cytokines measurements. Those who developed secondary sepsis or septic shock were sampled again on the day of sepsis diagnosis (Tx). Results Ninety-nine patients were included in the final analysis. Nineteen (19.2%) patients developed secondary sepsis or septic shock. They presented significantly higher absolute monocyte counts and CRP at T1 compared to non-septic patients (1030/µl versus 550/µl, p = 0.013 and 5.1 mg/ml versus 2.5 mg/ml, p = 0.046, respectively). They also presented elevated levels of monocytes with low expression of L-selectin (CD62Lneg monocytes) (OR[95%CI] 4.5 (1.4–14.5), p = 0.01) and higher SOFA score (p < 0.0001) at T1 and low mHLA-DR at T2 (OR[95%CI] 0.003 (0.00–0.17), p = 0.049). Stepwise logistic regression analysis showed that both monocyte markers and high SOFA score (> 8) were independently associated with nosocomial sepsis occurrence. No other leucocyte count or surface marker nor any cytokine measurement correlated with sepsis occurrence. Conclusion Monocyte counts and change of phenotype are associated with secondary sepsis occurrence in critically ill patients with injury.
Læs mere Tjek på PubMedInfection, 25.01.2023
Tilføjet 25.01.2023
Abstract Purpose To evaluate the impact of an optimal and reproducible cutoff value set according to a predefined lymphopenia scale as an early predictor of in-hospital mortality and other outcomes in patients hospitalized with pneumococcal pneumonia and positive urinary antigen at admission to the emergency department. Methods An observational cohort study was conducted based on analysis of a prospective registry of consecutive immunocompetent adults hospitalized for pneumococcal pneumonia in two tertiary hospitals. Generalized additive models were constructed to assess the smooth relationship between in-hospital mortality and lymphopenia. Results We included 1173 patients. Lymphopenia on admission was documented in 686 (58.4%). No significant differences were observed between groups regarding the presence of comorbidities. Overall, 299 (25.5%) patients were admitted to intensive care and 90 (7.6%) required invasive mechanical ventilation. Fifty-nine (5%) patients died, among them 23 (38.9%) in the first 72 h after admission. A lymphocyte count < 500/μL, documented in 282 (24%) patients, was the predefined cutoff point that best predicted in-hospital mortality. After adjustment, these patients had higher rates of intensive care admission (OR 2.9; 95% CI 1.9–4.3), invasive mechanical ventilation (OR 2.2; 95% CI 1.2–3.9), septic shock (OR 1.8; 95% CI 1.1–2.9), treatment failure (OR 2.1; 95% CI 1.2–3.5), and in-hospital mortality (OR 2.2; 95% 1.1–4.9). Severe lymphopenia outperformed PSI score in predicting early and 30-day mortality in patients classified in the higher-risk classes. Conclusion Lymphocyte count < 500/μL could be used as a reproducible predictor of complicated clinical course in patients with an early diagnosis of pneumococcal pneumonia.
Læs mere Tjek på PubMedTrends in Parasitology, 25.01.2023
Tilføjet 25.01.2023
Human height reflects a combination of an individual’s genotype (see Glossary) and environmental factors which influence phenotypic expression of that genotype. An estimated 149.2 million children under the age of 5 were physically stunted in 2020, defined as falling at least –2 standard deviations below the height-for-age World Health Organization (WHO) Child Growth Standards median [1]. Stunting is a visible indicator of a deficient environment, the consequences of which include child morbidity, including an increased risk of long-term chronic diseases, and in severe cases even mortality (Box 1) [2].
Læs mere Tjek på PubMedJournal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Journal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Journal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Journal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Infection and Immunity, 25.01.2023
Tilføjet 25.01.2023
Infection and Immunity, 25.01.2023
Tilføjet 25.01.2023
International Journal of Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
On 29 January 2020, the first SARS-CoV-2 case was notified in Italy [1,2] and, by 21 February 2022, almost 12 million confirmed cases and 150,000 deaths from COVID-19 had been recorded in the country [3].
Læs mere Tjek på PubMedClinical Microbiology and Infection, 24.01.2023
Tilføjet 25.01.2023
The COVID-19 pandemic has highlighted the high diagnostic accuracy of the nasopharyngeal swab (including in intensive care unit (ICU) patients. This study aimed to compare nasopharyngeal swab and bronchoalveolar lavage (BAL) results for non-SARS-CoV-2 viruses in patients with suspected pneumonia.
Læs mere Tjek på PubMedScience Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Clinical Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
Clinical Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
AbstractBackgroundCurrent understanding of severe RSV infections in adults is limited by clinical under-recognition. We compared the prevalence, clinical characteristics, and outcomes of RSV infections vs influenza in adults hospitalized with acute respiratory illnesses in a prospective national surveillance network.MethodsHospitalized adults who met a standardized ARI case definition were prospectively enrolled across three respiratory seasons from hospitals participating across all sites of the U.S. Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN, 2016-2019). All participants were tested for RSV and influenza by RT-PCR. Multivariable logistic regression was used to test associations between laboratory-confirmed infection and characteristics and clinical outcomes.ResultsAmong 10,311 hospitalized adults, 6% tested positive for RSV (n=622), 18.8% positive for influenza (n=1,940), and 75.1% negative for RSV and influenza (n=7,749). Congestive Heart Failure (CHF) or Chronic Obstructive Pulmonary Disease (COPD) was more frequent among adults with RSV than influenza (CHF: 37.3% vs. 28.8%, p<0.0001; COPD: 47.6% vs. 35.8%, p<0.0001). Patients with RSV more frequently had longer admissions [OR=1.38 (95% CI: 1.06-1.80) for stays >one week] and mechanical ventilation [OR=1.45 (95% CI: 1.09-1.93)] compared with influenza, but not compared to the influenza negative group [OR=1.03 (95% CI: 0.82-1.28); OR=1.17 (0.91-1.49), respectively.]ConclusionsThe prevalence of RSV across three recent respiratory illness seasons was considerable. Our findings suggest those with RSV might incur worse outcomes than influenza in hospitalized adults and frequently have pre-existing cardiopulmonary conditions. This study informs future vaccination strategies and underscores a need for RSV surveillance among adults experiencing severe ARI.
Læs mere Tjek på PubMedClinical Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
AbstractBackgroundWith the advent of efficacious oral Direct-acting antivirals (DAAs) for hepatitis C virus(HCV), identification of characteristics associated with adherence is critical to treatment success. We examined correlates of sub-optimal adherence to HCV therapy in a single-arm, multinational, clinical trial.MethodsACTG A5360 enrolled HCV treatment-naïve persons without decompensated cirrhosis from 5 countries. All participants received a 12-weeks course of sofosbuvir/velpatasvir at entry. In-person visits occurred at initiation and week 24, sustained virologic response (SVR) assessment. Adherence at week 4 was collected remotely and was dichotomized optimal (100%, no missed doses) versus sub-optimal (<100%). Correlates of sub-optimal adherence were explored using logistic regression.Results400 participants enrolled; 399 initiated treatment; 395/397 (99%) reported completing at week 24.. Median age was 47 years with 35% female. Among the 368 reporting optimal adherence at week 4 SVR was 96.5% (95% CI [94.1%, 97.9%]) vs. 77.8% (95% CI [59.2%, 89.4%]) p-value < 0.001. In the multivariate model age < 30 years and being a US participant were independently associated with early sub-optimal adherence. Participants < 30 years were 7.1 times more likely to have early sub-optimal adherence compared to their older counterparts.ConclusionSelf-reported optimal adherence at week 4 was associated with SVR. Early self-reported adherence could be used to identify those at higher risk of treatment failure and may benefit from additional support. Younger individuals < 30 years may also be prioritized for additional adherence support.
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