Infectious Medicine最新文献

Background

The main objective of the present study was to compare the diagnostic performance of the commercial LightMix Modular Monkeypox Virus (MPXV) qPCR (TIB Molbiol, Germany) assay with the in-house nonvariola orthopox/monkeypox generic real-time PCR assay (ICMR-NIV, Pune) for the screening of (MPXV) cases at Medical Research Institute (MRI) in Sri Lanka. Furthermore, clinical and sociodemographic data of suspected /confirmed cases received at MRI for the MPXV screening were also analyzed.

Methods

The diagnostic performance of the commercial LightMix Modular MPXV qPCR assay with the in-house nonvariola orthopox/monkeypox generic real-time PCR assay for the screening of suspected MXPV cases was evaluated using standard methods with minor modifications. Socio-demographic and clinical profiles of suspected and confirmed MPXV cases were also analyzed.

Results

The commercial LightMix Modular MPXV assay was able to detect MPXV with 100% sensitivity and specificity with non-variola orthopox/monkeypox generic rtPCR assay. During the period of study, from the total of 25 samples tested, only 2 were MPXV-positive (males). The most common symptoms of suspected MPXV cases were lesions or rashes (92%).

Conclusions

With the continually increasing number of cases, access to MPXV testing should be made more widely available. The commercial LightMix Modular MPXV (TIB Molbiol) qPCR assay offers comparable performance to the non-variola orthopox/monkeypox generic real time PCR assay for MPXV detection during the present outbreak.

In May 2022, the world witnessed the re-emergence of the zoonotic disease monkeypox. While this was not the first epidemic of this disease, what differentiated the outbreak was the rapid global spread and increase of cases, which led the WHO to declare monkeypox a global health emergency. Although the disease spreads mainly through inadequately cooked meat of various rodent species, this virus also shows droplet, respiratory, sexual, and even vertical transmission. Monkeypox further multiplies in lymphoproliferative organs and presents with a classical smallpox-like rash, fever, headache, and muscle aches. Diagnosis is confirmed with a polymerase-chain-reaction test and is managed largely supportively with possible usage of some antivirals and immunoglobulins. Moreover, some pre-exposure and postexposure prophylactic vaccines have been developed. This paper aims to conduct an in-depth review of the historical epidemics, transmission, pathophysiology, clinical presentation, and management of the monkeypox disease.

An increasing number of studies are suggesting that hepatitis B virus (HBV) infection may be associated with an increased risk of not only hepatocellular carcinoma but also gastric cancer (GC). Whether HBV infection can be a risk factor for GC remains to be explored. In this study, we systematically searched for all eligible literature in 7 databases (China National Knowledge Infrastructure, WanFang, China Science and Technology Journal, PubMed, Cochrane Library, Web of Science and Embase). Eligible studies were required to have a case-control or cohort design. Sixteen studies were included and a meta-analysis was performed using Stata version 17.0. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The association between HBV infection and risk of GC was quantified by calculating the odds ratio and 95% confidence interval. The proportion of high-quality studies was 87.5% (14/16). The risk of GC was higher when HBV infection was present than when it was not (combined odds ratio 1.29, 95% confidence interval 1.16–1.44; I² = 62.7%, p < 0.001). The results of subgroup analyses were consistent with the main results. In conclusion, this systematic review and meta-analysis identified a positive association between HBV infection and an increased risk of GC.

The French National Immunization Program was updated in 2013 for vaccination against diphtheria, tetanus, pertussis, and poliomyelitis. Our previous findings on the evolution of age-specific booster vaccination coverage rates (VCRs) up to 2017 suggested suboptimal vaccination coverages due to the pre-2013 recommendation-residual vaccination practices. In the current analysis, we evaluated all age-specific booster VCR and distribution of age at vaccination visits in 2018. In this retrospective observational cohort study, the cumulative booster VCRs were updated at all vaccination visits up to 2018 among the people who were eligible for a booster vaccination, using a 1/97th random sample of French national healthcare reimbursement databases. The cumulative booster VCR for individuals from all age groups increased from 2017 to 2018, except for 85-years-old vaccination visit. Majority of the individuals from all age groups were vaccinated (boosted) with a vaccine containing the pertussis valence. In 2018, sharp peaks corresponding to the recommended ages for booster vaccination visits were observed for individuals aged 6, 11 to 13, 25, 45, and 65 years. Our study reiterates suboptimal coverages in France and implies the need for booster vaccination throughout life for the protection of the population.

Background

COVID-19 outbreaks in residential care homes for the elderly (RCHEs) and for persons with disability (RCHDs) have caused significant morbidity and mortality during 5th epidemic in Hong Kong. This article reviewed COVID-19 outbreaks situation and estimated the effectiveness of receiving at least two-dose of COVID-19 vaccine in preventing severe outcomes.

Methods

To estimate attack rates and vaccination coverage, documentation on COVID-19 infection and their vaccination records of residential care homes (RCH) residents reported between December 31, 2021 and May 31, 2022 were reviewed, and infected cases were follow-up for 4 weeks for severe outcomes or death. Correlation between vaccination coverage against attack rate by types of homes was examined. Infected RCH residents with available information were included in the analysis of vaccine effectiveness against severe outcomes and death.

Results

COVID-19 vaccination coverage was low in RCHDs (median 0.46, IQR: 0.24–0.76) and very low in RCHEs (median 0.08, IQR: 0.00–0.19). Higher attack rates were recorded among RCHE residents (median 0.84, IQR: 0.64–0.93) and higher case fatality rate (CFR: 28.1%) than in RCHDs (median 0.58, IQR: 0.31–0.84; CFR: 3.9%). The attack rate decreased when vaccination coverage increased for both RCHEs (ρ = −0.131, p < 0.001) and RCHDs (ρ = −0.333, p < 0.001). Comparing with infected residents who were unvaccinated/vaccinated with one-dose, receiving at least two-dose was estimated to be effective in reducing severe outcomes in 31% and 36% of infected RCHE and RCHD residents respectively; with greater reduction in mortality among RCHD than RCHE residents (54% and 38%, respectively). Vaccine effectiveness of two-dose of BNT162b2 against severe outcomes and death are higher than that of CoronaVac.

Conclusions

Increasing COVID-19 vaccination could have significant impact on reducing the risk of COVID-19 outbreaks in RCHs. At least two-dose of COVID-19 vaccine is still effective in reducing severe outcomes and death among infected residents in RCHs during Omicron epidemic.

Background

During the recent decades, dengue virus infection has been emerged as a major public health problem. Dengue is one of the important mosquito borne infections causing high mortality and morbidity of humans. Methods: This study was carried out from October 2018 to December 2020. A total of 354 serum samples of clinically suspected dengue patients were tested for immunoglobulin M (IgM) anti-dengue antibodies by dengue monoclonal antibody capture enzyme-linked immunosorbent assay (NIV DEN IgM Capture MAC ELISA). Seasonal variations, age and sex wise incidences were also determined.

Results

Total of 354 serum samples were processed from October 2018 to December 2020. Each year males were mostly infected with Dengue 08, 10, and 03 in 2018, 2019, and 2020, respectively. Age group 11–20 was found to be mostly infected by Dengue in case of both male and female. The prevalence of Dengue in each year was from July to November might be due to the rainy season. Clinical characteristics of patients such as fever, headache, abdominal pain and nausea/vomiting, retro-orbital pain, epistaxis, petechiae, altered sensorium, positive tourniquet test were reported.

Conclusions

Continuous dengue virus surveillance is required for monitoring of dengue virus so that early detection can be carried out. Effective vector control measures should be implemented for early detection of impending outbreak and to initiate timely control measures.

Background

Studies have demonstrated improved clinical outcomes with extended infusion (EI) piperacillin/tazobactam (TZP) compared to standard infusion (SI). However, there is less evidence on its benefits in noncritically-ill patients. Hospital-wide EI TZP was implemented at our site on February 21, 2012. Our objectives were to compare clinical, safety and economic outcomes between EI and SI TZP.

Methods

A retrospective cohort study of all adult patients who received EI TZP (3.375 g IV q8h infused over 4 hours and SI TZP for ≥ 48 hours during 3 years pre-and postimplementation was conducted. The primary study outcome was 14-day mortality while secondary outcomes included length of hospital stay (LOS), nursing plus pharmacy cost, occurrence of Clostridioides difficile infection, readmission within 30 days and change in Pseudomonas aeruginosa minimum inhibitory concentration (MIC) distribution for TZP. The primary outcome and binary secondary outcomes were analyzed using a logistic regression model. LOS was examined using time to event analysis. Cost was examined using linear regression modelling.

Results

Overall, 2034 patients received EI TZP and 1364 patients received SI TZP. EI TZP was associated with lower odds of mortality (OR 0.76, 95% CI 0.63–0.91), lower odds of C. difficile infection (OR 0.59, 95% CI 0.41–0.84) and 8% lower cost (estimate 0.92, 95% CI 0.87–0.98) compared to SI TZP.

Conclusions

Hospital-wide implementation of EI TZP was associated with lower odds of 14-day mortality and incidence of C. difficile infection with cost savings at our institution.

Background

Dengue is a major arthropod-borne viral disease spreading rapidly across the globe. The absence of vaccines and inadequate vector control measures leads to further expansion of dengue in many regions globally. Hence, the identification of genes involved in the pathogenesis of dengue will help to understand the molecular basis of the disease and the genes responsible for the disease progression.

Methods

In the present study, a meta-analysis was carried out using dengue gene expression data obtained from Gene Expression Omnibus repository. The differentially expressed genes such as CCNB1 and CCNB2 (G2/mitotic-specific cyclin-B2 and B1) were upregulated in dengue fever to control (DF-CO) and severe dengue (dengue hemorrhagic fever [DHF]) to control (DHF-CO) were identified as key genes for controlling the major pathways (cell cycle, oocyte meiosis, p53 signaling pathway, cellular senescence and progesterone-mediated oocyte maturation). Similarly, interferon alpha-inducible (IFI27) genes, type-I and type-III interferon (IFN) signaling genes (STAT1 and STAT2), B cell activation and survival genes (TNFSF13B, TNFRSF17) and toll like receptor (TLR7) genes were differentially up activated during DF-CO and DHF-CO. Followed by, Cytoscape was used to identify the immune system process and topological analysis.

Results

The results showed that the top differentially expressed genes under the statistical significance p <0.001, which is majorly involved in Kyoto Encyclopedia of Genes and Genomes orthology K05868 and K21770 with gene names CCNB1 and CCNB2. In addition to this, the immune system profile showed up-regulation of IL12A, CXCR3, TNFSF13B, IFI27, TNFRSF17, STAT, STAT2, and TLR7 genes in DF-CO and DHF-CO act as immunological signatures for inducing the immune response towards dengue infection.

Conclusions

The current study could aid in understanding of molecular pathogenesis, genes and corresponding pathway upon dengue infection, and could facilitate for identification of novel drug targets and prognostic markers.