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The roles of unrecognized monkeypox cases, contact isolation and vaccination in determining epidemic size in Belgium. A modelling study 未识别猴痘病例、接触隔离和疫苗接种在确定比利时流行规模中的作用。模型研究
C. Van Dijck, N. Hens, C. Kenyon, A. Tsoumanis
We used a network model to simulate a monkeypox epidemic among men who have sex with men. Our findings suggest that unrecognized infections have an important impact on the epidemic, and that vaccination of individuals at highest risk of infection reduces epidemic size more than post-exposure vaccination of sexual partners.
我们使用网络模型来模拟猴痘在男男性行为者中的流行。我们的研究结果表明,未被识别的感染对流行病有重要影响,并且感染风险最高的个体接种疫苗比暴露后性伴侣接种疫苗更能减少流行病的规模。
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引用次数: 11
Reply to Author. 回复作者。
Lin Qiu, Lan Zhu
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引用次数: 0
Lower Risk of Multisystem Inflammatory Syndrome in Children (MIS-C) with the Delta and Omicron variants of SARS-CoV-2 携带SARS-CoV-2的Delta和Omicron变体的儿童多系统炎症综合征(MIS-C)的风险较低
Jonathan M Cohen, Michael Carter, C. Ronny Cheung, S. Ladhani
Abstract Little is known about the MIS-C risk with different SARS-CoV-2 variants. In Southeast England, MIS-C rates per confirmed SARS-CoV-2 infections in 0-16 years-olds were 56% lower (rate ratio, 0.34; 95%CI, 0.23-0.50) during pre-vaccine Delta, 66% lower (0.44; 0.28-0.69) during post-vaccine Delta and 95% lower (0.05; 0.02-0.10) during the Omicron period.
不同SARS-CoV-2变体的MIS-C风险知之甚少。在英格兰东南部,0-16岁儿童确诊SARS-CoV-2感染的MIS-C率低56%(比率比0.34;95%CI, 0.23-0.50),比疫苗前δ期低66% (0.44;0.28-0.69),降低95% (0.05;0.02-0.10)在欧米克隆时期。
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引用次数: 28
A Nasty Human Immunodeficiency Virus Type 1 (HIV-1) Variant. 令人讨厌的人类免疫缺陷病毒1型(HIV-1)变体。
S. Deresinski
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引用次数: 0
Persistent circulating SARS-CoV-2 spike is associated with post-acute COVID-19 sequelae 持续循环的SARS-CoV-2尖峰与急性后COVID-19后遗症有关
Z. Swank, Y. Senussi, Z. Manickas-Hill, Xu G. Yu, Jonathan Z. Li, G. Alter, David R. Walt
The diagnosis and management of post-acute sequelae of COVID-19 (PASC) poses an ongoing medical challenge. Identifying biomarkers associated with PASC would immensely improve the classification of PASC patients and provide the means to evaluate treatment strategies. We analyzed plasma samples collected from a cohort of PASC and COVID-19 patients (n = 63) to quantify circulating viral antigens and inflammatory markers. Strikingly, we detect SARS-CoV-2 spike antigen in a majority of PASC patients up to 12 months post-diagnosis, suggesting the presence of an active persistent SARS-CoV-2 viral reservoir. Furthermore, temporal antigen profiles for many patients show the presence of spike at multiple time points over several months, highlighting the potential utility of the SARS-CoV-2 full spike protein as a biomarker for PASC.
COVID-19急性后后遗症(PASC)的诊断和治疗是一项持续的医学挑战。识别与PASC相关的生物标志物将极大地改善PASC患者的分类,并提供评估治疗策略的手段。我们分析了从PASC和COVID-19患者队列(n = 63)收集的血浆样本,以量化循环病毒抗原和炎症标志物。引人注目的是,我们在大多数PASC患者诊断后12个月检测到SARS-CoV-2刺突抗原,这表明存在活跃的持久性SARS-CoV-2病毒库。此外,许多患者的时间抗原谱显示在几个月内的多个时间点存在刺突,这突出了SARS-CoV-2全刺突蛋白作为PASC生物标志物的潜在效用。
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引用次数: 75
A 58-Year-old Man With Multifocal Pulmonary Nodules. 58岁男性多灶性肺结节。
Mitchell McClean, S. K. Gupta, R. Relich
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引用次数: 0
Correction to: A Rare Mutation in SPLUNC1 Affects Bacterial Adherence and Invasion in Meningococcal Disease 更正:SPLUNC1的罕见突变影响脑膜炎球菌病的细菌粘附和侵袭
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引用次数: 1
Correction to: Severe Dysbiosis and Specific Haemophilus and Neisseria Signatures as Hallmarks of the Oropharyngeal Microbiome in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients 更正:2019冠状病毒病(COVID-19)危重患者口咽微生物组的严重生态失调和特异性嗜血杆菌和奈瑟菌特征
J. de Castilhos, Eli Zamir, T. Hippchen, R. Rohrbach, Sabine Schmidt, Silvana Hengler, Hanna Schumacher, Melanie Neubauer, Sabrina Kunz, Tonia Müller-Esch, A. Hiergeist, A. Gessner, D. Khalid, R. Gaiser, N. Cullin, Stamatia M Papagiannarou, B. Beuthien-Baumann, A. Krämer, R. Bartenschlager, D. Jäger, Michael Müller, F. Herth, D. Duerschmied, J. Schneider, R. Schmid, Johann F Eberhardt, Y. Khodamoradi, M. Vehreschild, A. Teufel, M. Ebert, P. Hau, B. Salzberger, P. Schnitzler, Hendrik Poeck, E. Elinav, U. Merle, C. Stein-Thoeringer
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引用次数: 1
Clinical implementation of routine whole-genome sequencing for hospital infection control of multi-drug resistant pathogens 临床实施常规全基因组测序用于多药耐药病原菌医院感染控制
B. Forde, H. Bergh, Thom Cuddihy, K. Hajkowicz, Trish Hurst, E. Playford, B. Henderson, N. Runnegar, J. Clark, A. Jennison, S. Moss, A. Hume, Hugo Leroux, S. Beatson, D. Paterson, P. Harris
Background: Prospective whole-genome sequencing (WGS)-based surveillance may be the optimal approach to rapidly identify transmission of multi-drug resistant (MDR) bacteria in the healthcare setting. Materials/methods: We prospectively collected methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), carbapenem-resistant Acinetobacter baumannii (CRAB), extended-spectrum beta-lactamase (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) isolated from blood cultures, sterile sites or screening specimens across three large tertiary referral hospitals (2 adult, 1 paediatric) in Brisbane, Australia. WGS was used to determine in silico multi-locus sequence typing (MSLT) and resistance gene profiling via a bespoke genomic analysis pipeline. Putative transmission events were identified by comparison of core genome single nucleotide polymorphisms (SNPs). Relevant clinical meta-data were combined with genomic analyses via customised automation, collated into hospital-specific reports regularly distributed to infection control teams. Results: Over four years (April 2017 to July 2021) 2,660 isolates were sequenced. This included MDR gram-negative bacilli (n=293 CPE, n=1309 ESBL), MRSA (n=620) and VRE (n=433). A total of 379 clinical reports were issued. Core genome SNP data identified that 33% of isolates formed 76 distinct clusters. Of the 76 clusters, 43 were contained to the three target hospitals, suggesting ongoing transmission within the clinical environment. The remaining 33 clusters represented possible inter-hospital transmission events or strains circulating in the community. In one hospital, proven negligible transmission of non-multi-resistant MRSA enabled changes to infection control policy. Conclusions: Implementation of routine WGS for MDR pathogens in clinical laboratories is feasible and can enable targeted infection prevention and control interventions.
背景:基于前瞻性全基因组测序(WGS)的监测可能是快速识别医疗保健环境中多重耐药(MDR)细菌传播的最佳方法。材料/方法:我们前瞻性地收集了澳大利亚布里斯班三家大型三级转诊医院(2家成人医院,1家儿科医院)从血液培养、无菌地点或筛选标本中分离到的耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素肠球菌(VRE)、耐碳青霉烯类鲍曼不动杆菌(CRAB)、广谱β -内酰胺酶(esble)和产碳青霉烯酶肠杆菌(CPE)。WGS用于通过定制的基因组分析管道确定硅多位点序列分型(MSLT)和抗性基因谱。通过比较核心基因组单核苷酸多态性(snp)来确定可能的传播事件。相关临床元数据通过定制自动化与基因组分析相结合,整理成医院特定报告,定期分发给感染控制团队。结果:4年间(2017年4月至2021年7月)对2660株菌株进行了测序。其中包括MDR革兰氏阴性杆菌(n=293 CPE, n=1309 ESBL), MRSA (n=620)和VRE (n=433)。共发表临床报告379份。核心基因组SNP数据确定33%的分离株形成76个不同的簇。在76例聚集性病例中,有43例被控制在三家目标医院,表明在临床环境中正在进行传播。其余33个聚集性病例代表可能的医院间传播事件或在社区中流行的菌株。在一家医院,非多重耐药MRSA的传播被证明可以忽略不计,从而改变了感染控制政策。结论:临床实验室对耐多药病原菌实施常规WGS检测是可行的,可实现有针对性的感染防控干预。
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引用次数: 16
Hospitalized patients with severe COVID-19 during the Omicron wave in Israel – benefits of a fourth vaccine dose 以色列奥米克隆波期间患有严重COVID-19的住院患者-第四剂疫苗的益处
Tal Brosh-Nissimov, K. Hussein, Y. Wiener‐Well, E. Orenbuch-Harroch, Meital Elbaz, Shelly Lipman-Arens, Y. Maor, Y. Yagel, B. Chazan, M. Hershman-Sarafov, G. Rahav, O. Zimhony, Adi Zaidman Shimshovitz, M. Chowers
Importance: Waning immunity against COVID-19 in parallel with an increased incidence during the Omicron outbreak led the Israeli Ministry of Health to recommend a second booster dose of BNT162b2 (Pfizer) to high-risk individuals. Israel was the first country to recommend this, allowing evaluation of the added protection of a fourth vaccine dose to hospitalized patients with severe diseases. Objective: To assess the effect of a fourth dose for hospitalized patients with severe/critical breakthrough COVID-19. Design: A cohort study of hospitalized adults from 01/15/2022-01/31/2022. Settings: A multi center study of 14 medical centers in Israel. Participants: Hospitalized adult patients with PCR-confirmed severe/critical COVID-19. Excluded were patients lacking data on vaccination status. Exposure: Cases were divided according to the total number of vaccine doses received up to 7 days before diagnosis. Unvaccinated adults and single-dose recipients were grouped into an unvaccinated group. Main Outcome: A composite of mechanical ventilation or in-hospital death was defined as poor outcome. Outcomes were compared between 3- and 4-dose vaccinees. Results: Included were 1,049 patients with severe/critical COVID-19, median age 80 (IQR 69-87), 51% males. Among them, 360 unvaccinated, 34, 172, 386 and 88 were after 1, 2, 3 or 4 doses, respectively. Patients after 3 doses were older, had more males and immunosuppression, but with similar outcomes, 49% vs. 51% compared to unvaccinated patients (p=0.72). Patients after 4 doses were similarly older and immunosuppressed, but had improved outcomes compared to unvaccinated patients, 34% vs. 51% (p<0.01). We proceeded to examine independent predictors for poor outcome in fully-vaccinated patients with either 3 doses given a median of 161 (IQR 147-168) days earlier, or 4 doses given a median of 14 (IQR 10-18) days before diagnoses. Receipt of the fourth dose conferred significant protection: OR 0.51 (95%CI 0.30.87). Conclusion and Relevance: Within a population of hospitalized patients with severe/critical breakthrough COVID-19, a recent fourth dose was associated with significant protection against mechanical ventilation or death, compared to fully-vaccinated single boosted individuals.
重要性:在Omicron爆发期间,对COVID-19的免疫力下降,同时发病率增加,导致以色列卫生部向高危人群推荐第二剂BNT162b2(辉瑞)加强剂。以色列是第一个提出这一建议的国家,它允许评估第四剂疫苗对住院重症患者的额外保护作用。目的:评价新冠肺炎重症/危重型突破住院患者第四次用药的效果。设计:对2022年1月15日至2022年1月31日住院的成年人进行队列研究。环境:以色列14个医疗中心的多中心研究。参与者:经pcr确诊的重症/危重型COVID-19住院成人患者。排除了缺乏疫苗接种状况数据的患者。暴露:根据诊断前7天内接受的疫苗剂量总数对病例进行分类。未接种疫苗的成年人和单次接种者被分为未接种组。主要转归:机械通气或院内死亡的组合被定义为不良转归。比较了3剂和4剂疫苗接种者的结果。结果:纳入重症/危重型COVID-19患者1049例,中位年龄80岁(IQR 69 ~ 87),男性占51%。其中未接种者360人,接种1剂、2剂、3剂、4剂者分别为34人、172人、386人、88人。接种3次疫苗的患者年龄较大,男性较多,免疫抑制较多,但与未接种疫苗的患者相比,结果相似,分别为49%和51% (p=0.72)。接种4次疫苗的患者同样年龄较大且免疫抑制,但与未接种疫苗的患者相比,结果有所改善,34% vs. 51% (p<0.01)。我们进一步检查了完全接种疫苗的患者预后不良的独立预测因素,这些患者在诊断前3次接种的中位数为161 (IQR 147-168)天,或4次接种的中位数为14 (IQR 10-18)天。接受第四剂具有显著的保护作用:OR 0.51 (95%CI 0.30.87)。结论和相关性:在COVID-19重症/危重突破住院患者人群中,与完全接种单次疫苗的个体相比,最近接种的第四剂疫苗与防止机械通气或死亡的显着保护相关。
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引用次数: 13
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Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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