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Characterization of Lophomonas spp. Infection in a Population of Critical Care Patients. 重症监护患者群体中嗜酸单胞菌属感染的特征。
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2024-01-26 DOI: 10.3390/idr16010006
Francisco das Neves Coelho, João Borralho, Teresa Baptista-Fernandes, Cristina Toscano, Maria Eduarda Carmo

Lophomonas are flagellated protozoa that have been increasingly associated with upper and lower airway infection in humans. The prevalence and characterization of this disease in the critically ill remains poorly understood. We present a series of eleven ICU patients with confirmed Lophomonas spp. identification in respiratory samples.

嗜水气单胞菌是一种鞭毛原生动物,越来越多地与人类上呼吸道和下呼吸道感染有关。人们对这种疾病在重症患者中的发病率和特征仍然知之甚少。我们介绍了在呼吸道样本中确认了嗜水气单胞菌属的 11 名重症监护病房患者。
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引用次数: 0
Management of Cytomegalovirus Infections in the Era of the Novel Antiviral Players, Letermovir and Maribavir. 新型抗病毒药物 Letermovir 和 Maribavir 时代的巨细胞病毒感染管理。
IF 3.4 Q2 INFECTIOUS DISEASES Pub Date : 2024-01-18 DOI: 10.3390/idr16010005
Jocelyne Piret, Guy Boivin

Cytomegalovirus (CMV) infections may increase morbidity and mortality in immunocompromised patients. Until recently, standard antiviral drugs against CMV were limited to viral DNA polymerase inhibitors (val)ganciclovir, foscarnet and cidofovir with a risk for cross-resistance. These drugs may also cause serious side effects. This narrative review provides an update on new antiviral agents that were approved for the prevention and treatment of CMV infections in transplant recipients. Letermovir was approved in 2017 for CMV prophylaxis in CMV-seropositive adults who received an allogeneic hematopoietic stem cell transplant. Maribavir followed four years later, with an indication in the treatment of adult and pediatric transplant patients with refractory/resistant CMV disease. The target of letermovir is the CMV terminase complex (constituted of pUL56, pUL89 and pUL51 subunits). Letermovir prevents the cleavage of viral DNA and its packaging into capsids. Maribavir is a pUL97 kinase inhibitor, which interferes with the assembly of capsids and the egress of virions from the nucleus. Both drugs have activity against most CMV strains resistant to standard drugs and exhibit favorable safety profiles. However, high-level resistance mutations may arise more rapidly in the UL56 gene under letermovir than low-grade resistance mutations. Some mutations emerging in the UL97 gene under maribavir can be cross-resistant with ganciclovir. Thus, letermovir and maribavir now extend the drug arsenal available for the management of CMV infections and their respective niches are currently defined.

巨细胞病毒(CMV)感染会增加免疫力低下患者的发病率和死亡率。直到最近,针对巨细胞病毒的标准抗病毒药物还仅限于病毒 DNA 聚合酶抑制剂(val)更昔洛韦、福斯卡尼和西多福韦,但这些药物存在交叉耐药性的风险。这些药物还可能导致严重的副作用。本叙述性综述介绍了获批用于预防和治疗移植受者 CMV 感染的新型抗病毒药物的最新情况。来替莫韦于2017年获批用于接受异基因造血干细胞移植的CMV血清反应阳性成人的CMV预防。四年后,Maribavir 也获批用于治疗患有难治/耐药 CMV 疾病的成人和儿童移植患者。来替莫韦的靶点是 CMV 终止酶复合物(由 pUL56、pUL89 和 pUL51 亚基组成)。来替莫韦能阻止病毒 DNA 的裂解并将其包装成囊壳。Maribavir 是一种 pUL97 激酶抑制剂,可干扰囊壳的组装和病毒从细胞核中排出。这两种药物都对大多数对标准药物耐药的 CMV 株具有活性,并且安全性良好。然而,在来特莫韦作用下,UL56 基因会比低水平耐药突变更快出现高水平耐药突变。在马立巴韦作用下,UL97 基因中出现的一些突变会与更昔洛韦产生交叉耐药性。因此,来替莫韦和马瑞巴韦目前扩展了治疗 CMV 感染的药物库,它们各自的适应症目前已经确定。
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引用次数: 0
An Epidemic Model with Infection Age and Vaccination Age Structure 具有感染年龄和接种年龄结构的流行病模型
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2024-01-10 DOI: 10.3390/idr16010004
Glenn Webb, Xinyue Evelyn Zhao
A model of epidemic dynamics is developed that incorporates continuous variables for infection age and vaccination age. The model analyzes pre-symptomatic and symptomatic periods of an infected individual in terms of infection age. This property is shown to be of major importance in the severity of the epidemic, when the infectious period of an infected individual precedes the symptomatic period. The model also analyzes the efficacy of vaccination in terms of vaccination age. The immunity to infection of vaccinated individuals varies with vaccination age and is also of major significance in the severity of the epidemic. Application of the model to the 2003 SARS epidemic in Taiwan and the COVID-19 epidemic in New York provides insights into the dynamics of these diseases. It is shown that the SARS outbreak was effectively contained due to the complete overlap of infectious and symptomatic periods, allowing for the timely isolation of affected individuals. In contrast, the pre-symptomatic spread of COVID-19 in New York led to a rapid, uncontrolled epidemic. These findings underscore the critical importance of the pre-symptomatic infectious period and the vaccination strategies in influencing the dynamics of an epidemic.
本研究建立了一个包含感染年龄和接种年龄连续变量的流行病动态模型。该模型根据感染年龄分析了受感染个体的症状前和症状期。当感染个体的感染期早于症状期时,这一特性对疫情的严重程度具有重要意义。该模型还根据接种年龄分析了疫苗接种的有效性。接种疫苗的个体对感染的免疫力随接种年龄的变化而变化,这对疫情的严重程度也具有重要意义。将该模型应用于 2003 年台湾 SARS 疫情和纽约 COVID-19 疫情,可以深入了解这些疾病的动态。结果表明,由于感染期和症状期完全重叠,可以及时隔离受影响的个体,因此 SARS 疫情得到了有效控制。与此相反,COVID-19 在纽约无症状前的传播导致疫情迅速失控。这些发现强调了无症状前感染期和疫苗接种策略在影响疫情动态方面的至关重要性。
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引用次数: 0
Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing Escherichia coli Bacteremia. 使用头孢美唑和美罗培南进行抗菌治疗的不同方法对非重症广谱β-乳酰胺酶产气型大肠埃希菌菌血症缓解时间的影响
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-27 DOI: 10.3390/idr16010003
Takanobu Hoshi, Satoshi Fujii, Kei Watanabe, Yuta Fukumura, Koji Miyazaki, Madoka Takahashi, Sakae Taniguchi, Shingo Kimura, Arisa Saito, Naoki Wada, Masaji Saijo, Kazunori Yamada, Kuninori Iwayama, Marie Itaya, Hideki Sato

Carbapenems are antimicrobial agents commonly used to treat extended-spectrum β-lactamase (ESBL)-producing bacteria. Although cefmetazole (CMZ) is considered effective for ESBL-producing Escherichia coli (ESBL-EC) bacteremia, previous studies showed its limitations, including the influence of the initial antimicrobial agent. Here, we examined the effects of different approaches to antimicrobial therapy with CMZ and meropenem (MEPM) on the time to defervescence in ESBL-EC bacteremia. Notably, the influence of previous antimicrobial agents was excluded. Inpatients with ESBL-EC detected in blood cultures between April 2018 and March 2023 were included and assigned to CMZ (n = 14), MEPM (n = 8), de-escalation to CMZ (dCMZ; n = 9), or escalation to MEPM (eMEPM; n = 11) groups. The median time to defervescence was 3.5, 1.0, 2.0, and 4.0 days in the CMZ, MEPM, dCMZ, and eMEPM groups, respectively, with no significant differences. Cox proportional hazards analysis showed a significant difference in the hazard ratio (95% confidence interval) of 0.378 (0.145-0.984) for the time to defervescence with CMZ versus MEPM (p = 0.046). The extent of a delayed time to defervescence is greater with early CMZ administration than with MEPM administration in patients with non-severe ESBL-EC bacteremia.

碳青霉烯类是常用于治疗产扩展谱β-内酰胺酶(ESBL)细菌的抗菌药物。尽管头孢美唑(CMZ)被认为对产ESBL大肠埃希菌(ESBL-EC)菌血症有效,但之前的研究显示了其局限性,包括初始抗菌药物的影响。在此,我们研究了使用 CMZ 和美罗培南(MEPM)进行抗菌治疗的不同方法对 ESBL-EC 菌血症消退时间的影响。值得注意的是,该研究排除了之前使用的抗菌药物的影响。纳入了2018年4月至2023年3月期间在血液培养中检测到ESBL-EC的住院患者,并将其分配到CMZ组(n = 14)、MEPM组(n = 8)、降级至CMZ组(dCMZ;n = 9)或升级至MEPM组(eMEPM;n = 11)。CMZ组、MEPM组、dCMZ组和eMEPM组的恢复时间中位数分别为3.5天、1.0天、2.0天和4.0天,无显著差异。Cox 比例危险分析显示,CMZ 与 MEPM 相比,延迟时间的危险比(95% 置信区间)为 0.378(0.145-0.984),差异显著(p = 0.046)。在非重度ESBL-EC菌血症患者中,CMZ早期用药比MEPM用药的缓解时间延迟程度更大。
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引用次数: 0
Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value 小儿 COVID-19 肌炎患者尿素/肌酸酐比值与肌酸激酶正常化的相关性:评估预后和预测价值
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-25 DOI: 10.3390/idr16010002
Francesco Pizzo, Andrea Marino, A. Di Nora, Serena Spampinato, Giovanni Cacciaguerra, Giuseppe Costanza, Federica Scarlata, Arturo Biasco, M.C. Consentino, Riccardo Lubrano, B. Cacopardo, G. Nunnari, Martino Ruggieri, Piero Pavone
Coronavirus disease 2019 (COVID-19) has been chiefly linked with substantial respiratory complications. However, emerging studies have brought attention to the occurrence of severe muscle inflammation (myositis) related to COVID-19, potentially leading to multi-organ failure and increased mortality. Myositis is generally characterized by heightened serum creatine kinase (CK) levels. Acute myositis is characterized by an infiltration of viruses into calf muscle fibers, which may cause a subsequent inflammatory response leading to calf muscle pain. Symptomatic and supportive management, along with explanation and reassurance, is all that is required in managing this condition. While the association between myositis and severe outcomes has been recognized in adults, it remains less understood in the pediatric population. The current retrospective study, conducted at Policlinico San Marco University Hospital in Catania, aimed to analyze clinical and laboratory factors associated with myositis in pediatric patients with SARS-CoV-2 infection. Between January 2022 and January 2023, ten pediatric patients diagnosed with myositis and SARS-CoV-2 infection were evaluated. The study highlighted clinical manifestations such as fever, calf muscle pain, and abnormal gait. Lab results showed elevated CK levels among other findings. All patients underwent treatment, with the majority recovering without complications. A notable correlation was observed between CK levels, blood urea nitrogen (BUN), and the urea/creatinine ratio (UCR). The study also discusses potential pathophysiological mechanisms behind SARS-CoV-2’s impact on skeletal muscles, emphasizing an indirect inflammatory response. Our findings underscore that while myositis in children with SARS-CoV-2 infection appears to follow a benign and self-limiting trajectory, it is crucial to monitor specific markers for early intervention and management. Further research is warranted to elucidate the underlying mechanisms and improve clinical outcomes.
冠状病毒病 2019(COVID-19)主要与严重的呼吸系统并发症有关。然而,新出现的研究让人们注意到与 COVID-19 相关的严重肌肉炎症(肌炎)的发生,这可能会导致多器官衰竭和死亡率上升。肌炎通常以血清肌酸激酶(CK)水平升高为特征。急性肌炎的特点是病毒浸润小腿肌肉纤维,随后可能引起炎症反应,导致小腿肌肉疼痛。在治疗这种病症时,只需对症处理和支持性治疗,以及解释和安慰即可。虽然肌炎与严重后果之间的关系在成人中已得到认可,但在儿童群体中仍鲜为人知。本项回顾性研究在卡塔尼亚的 Policlinico San Marco 大学医院进行,旨在分析感染 SARS-CoV-2 的儿科患者中与肌炎相关的临床和实验室因素。研究评估了 2022 年 1 月至 2023 年 1 月期间确诊为肌炎和 SARS-CoV-2 感染的 10 名儿科患者。研究强调了发热、小腿肌肉疼痛和步态异常等临床表现。实验室结果显示 CK 水平升高。所有患者都接受了治疗,大多数患者都康复了,没有出现并发症。CK 水平、血尿素氮 (BUN) 和尿素/肌酐比值 (UCR) 之间存在明显的相关性。研究还讨论了 SARS-CoV-2 影响骨骼肌背后的潜在病理生理机制,强调了间接炎症反应。我们的研究结果强调,虽然感染 SARS-CoV-2 的儿童肌炎似乎遵循良性和自限性的轨迹,但监测特定标记物以进行早期干预和管理至关重要。我们有必要开展进一步研究,以阐明其潜在机制并改善临床结果。
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引用次数: 0
Trends and Spatiotemporal Patterns of Avian Influenza Outbreaks in Italy: A Data-Driven Approach 意大利禽流感爆发的趋势和时空模式:数据驱动法
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-19 DOI: 10.3390/idr16010001
Francesco Branda, Sandra Mazzoli, Massimo Pierini, Massimo Ciccozzi
In recent years, the unprecedented spread of the Avian Influenza Viruses (AIVs) among birds and mammals has caused devastation in animal populations, including poultry, wild birds, and some mammals, damaging farmers’ livelihoods and the food trade. Given the urgency of the situation, it is particularly important that scientists and the public can access research results and data as soon as possible. The main aim of this study is to present a global open-access dataset of Avian Influenza outbreaks to enable researchers and policymakers (i) to rapidly detect, and respond to animal outbreaks as the first line of defense; (ii) to conduct epidemiological and virological investigations around animal outbreaks and human infections; and (iii) to communicate the risk. We show the potential use of this dataset to the research community by analyzing the most updated information on past and current Highly Pathogenic Avian Influenza (HPAI) outbreaks in domestic poultry and wild birds over the period from October 2021 to July 2023 in Italy. In addition, we applied indices borrowed from Economics (such as Homogeneity, Specialization, and Location Index) to the wild birds dataset to show their possible usage in epidemiology.
近年来,禽流感病毒(AIVs)在鸟类和哺乳动物中史无前例地蔓延,给包括家禽、野生鸟类和一些哺乳动物在内的动物种群造成了破坏,损害了农民的生计和食品贸易。鉴于情况的紧迫性,科学家和公众能够尽快获得研究成果和数据尤为重要。本研究的主要目的是提供一个全球开放式禽流感疫情数据集,使研究人员和政策制定者能够:(i) 作为第一道防线快速检测和应对动物疫情;(ii) 围绕动物疫情和人类感染开展流行病学和病毒学调查;(iii) 传播风险信息。我们通过分析 2021 年 10 月至 2023 年 7 月期间意大利家禽和野生鸟类过去和当前高致病性禽流感(HPAI)疫情的最新信息,向研究界展示了该数据集的潜在用途。此外,我们还将从经济学中借鉴的指数(如同质性、专业化和位置指数)应用于野生鸟类数据集,以显示其在流行病学中的可能用途。
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引用次数: 0
Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems. 持续的阴影:揭开长 COVID-19 对呼吸、心血管和神经系统的影响。
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-15 DOI: 10.3390/idr15060072
Christina-Michailia Sideratou, Christos Papaneophytou

The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as 'long- COVID-19' (or simply 'long- COVID'), emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as 'post-acute sequelae of SARS-CoV-2 infection' (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review summarizes the primary effects of long COVID on the respiratory, cardiovascular, and nervous systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID's pathogenesis.

由人畜共患的严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引发的 2019 年冠状病毒病(COVID-19)从中国武汉的一次爆发迅速转变为全球范围的大流行。相当一部分患者在感染后出现了一种被称为 "长COVID-19"(或简称 "长COVID")的严重症状,表现为报告的 200 多种症状,涉及多个器官系统。这种病症也被称为 "SARS-CoV-2 感染急性后遗症"(PASC),临床表现令人困惑,影响深远,往往在急性期过后很长时间仍然存在。虽然最初的研究集中于病毒对肺部的直接影响,但 COVID-19 被认为是一种多器官干扰物,揭示了一系列长期和严重的健康问题。本综述总结了长效 COVID 对呼吸系统、心血管系统和神经系统的主要影响。它还深入探讨了这些影响的内在机制,并强调了全面了解长 COVID 致病机理的迫切需要。
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引用次数: 0
Bacterial Pneumonia and Cryptogenic Pleuritis after Probable Monkeypox Virus Infection: A Case Report. 可能感染猴痘病毒后出现细菌性肺炎和隐源性胸膜炎:病例报告。
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-13 DOI: 10.3390/idr15060071
Hubert Dawid Ciepłucha, Mateusz Bożejko, Paweł Piesiak, Sylwia Serafińska, Bartosz Szetela

A large number of monkeypox (MPOX) cases have been reported in Europe and North America in 2022, and a new outbreak of this disease was declared. We describe a case of a patient with probable monkeypox during the height of this epidemic in Poland. The patient's symptoms resolved within two weeks, but over the next two months, he developed community-acquired pneumonia requiring hospitalization and, subsequently, non-specific pleuritis. The simultaneous occurrence of such severe infections in a previously healthy young man is not typical and suggests a potential underlying cause. We believe the potential association of these diseases with probable monkeypox virus infection is very likely. Cases of monkeypox pneumonia, both viral and secondary bacterial, have already been reported in the literature. Cases of viral pleuritis in the course of MPOX in animals have also been described; however, to our knowledge, no similar cases have been described in humans to date. Our case indicates that it is important to monitor patients after MPOX in order to respond promptly to potentially life-threatening but, as of yet, not fully understood complications.

2022 年,欧洲和北美报告了大量猴痘病例,并宣布爆发新一轮猴痘疫情。我们描述了一例波兰猴痘疫情高峰期的疑似猴痘患者。患者的症状在两周内缓解,但在接下来的两个月中,他患上了社区获得性肺炎,需要住院治疗,随后又患上了非特异性胸膜炎。在一名原本健康的年轻人身上同时出现如此严重的感染并不典型,这表明可能存在潜在的病因。我们认为这些疾病很可能与猴痘病毒感染有关。猴痘病毒性肺炎和继发性细菌性肺炎的病例已有文献报道。也有动物在感染猴痘病毒后出现病毒性胸膜炎的病例,但据我们所知,迄今为止还没有人类出现类似病例的报道。我们的病例表明,对 MPOX 后的患者进行监测非常重要,以便及时应对可能危及生命但尚未完全明了的并发症。
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引用次数: 0
Bictegravir/Tenofovir Alafenamide/Emtricitabine: A Real-Life Experience in People Living with HIV (PLWH). Bictegravir/Tenofovir Alafenamide/Emtricitabine:艾滋病病毒感染者(PLWH)的真实体验。
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-11 DOI: 10.3390/idr15060069
Anna Gidari, Sara Benedetti, Sara Tordi, Anastasia Zoffoli, Debora Altobelli, Elisabetta Schiaroli, Giuseppe Vittorio De Socio, Daniela Francisci

Background: Bictegravir (BIC), a recently introduced integrase inhibitor, is available in a single tablet regimen with tenofovir alafenamide (TAF) and emtricitabine (FTC) (BIC-STR). This study aimed to describe a real-life experience with BIC-STR.

Methods: We retrospectively analyzed the data of people living with HIV (PLWH) on antiretroviral therapy (ART) with BIC-STR followed by the Clinic of Infectious Diseases of Perugia (Perugia, Italy) from September 2019 to February 2023.

Results: 270 PLWH were enrolled with a median follow-up time on BIC-STR of 2.2 years (IQR 1.2-2.7). In the overall population, in treatment-experienced (N = 242), in treatment-naïve (N = 28), and in population with age > 60 years old (N = 86), we observed that CD4 cell count improved in absolute number, percentage and CD4/CD8 ratio, under BIC-STR. Patients with viremia < 50 cp/mL increased in all groups. In the overall population, previous ART with TAF and nadir CD4 cell count favored immunological recovery. In the ART-experienced group, time in therapy with BIC-STR was associated with HIV-RNA undetectability. In the older group, previous opportunistic infection and advanced age were associated with lower CD4 count.

Conclusions: BIC-STR was demonstrated, in real-life, to be a valid option for a switch, such as initial ART.

背景:比特拉韦(BIC)是最近推出的一种整合酶抑制剂,可与替诺福韦-阿拉非那胺(TAF)和恩曲他滨(FTC)制成单片疗法(BIC-STR)。本研究旨在描述使用 BIC-STR 的真实体验:我们回顾性地分析了佩鲁贾传染病诊所(意大利佩鲁贾)在 2019 年 9 月至 2023 年 2 月期间采用 BIC-STR 进行抗逆转录病毒疗法(ART)的艾滋病病毒感染者(PLWH)的数据。在总体人群、有治疗经验人群(N = 242)、无治疗经验人群(N = 28)和年龄大于 60 岁人群(N = 86)中,我们观察到 CD4 细胞计数的绝对数、百分比和 CD4/CD8 比值在 BIC-STR 下均有所改善。病毒血症小于 50 cp/mL 的患者在所有组别中都有所增加。在所有人群中,先前接受过 TAF 抗逆转录病毒疗法的患者和 CD4 细胞计数达到最低值的患者有利于免疫学恢复。在有抗逆转录病毒疗法经验的组别中,使用 BIC-STR 治疗的时间与 HIV-RNA 检测不到有关。在老年组中,既往机会性感染和高龄与较低的 CD4 细胞计数有关:BIC-STR在现实生活中被证明是一种有效的转换方案,如初始抗逆转录病毒疗法。
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引用次数: 0
Effects of COVID-19-Associated Infection Control on the Pattern of Infections Imported by German Soldiers and Police Officers Returning from Predominantly Tropical Deployment Sites. 与 COVID-19 相关的感染控制对从主要热带部署地返回的德国士兵和警官感染模式的影响。
IF 3.2 Q2 INFECTIOUS DISEASES Pub Date : 2023-12-11 DOI: 10.3390/idr15060070
Dorothea Franziska Wiemer, Matthias Halfter, Ulrich Müseler, Marius Schawaller, Hagen Frickmann

In response to the COVID-19 pandemic, German public health authorities launched various infection control procedures. In line with this, anti-pandemic infection control was also implemented for German military and police deployments. The presented study assessed the impact of this increased infection control effort on deployment-associated infections in a holistic approach. To do so, the results of post-deployment assessments offered to German soldiers and police officers at the Department of Tropical Medicine and Infectious Diseases of the Bundeswehr Hospital Hamburg obtained during the pandemic period were compared to the results recorded during the pre-pandemic period in an exploratory, hypothesis-forming comparative study. In total, data from 1010 military deployments and 134 police deployments, predominantly to the African or the Eastern Mediterranean WHO regions, were included in the analyses. In the main results, a significant decrease in gastroenteritis in deployed soldiers (20.1% versus 61.3%, p < 0.0001) and at least a trend in the same direction in deployed police officers (25.7% versus 35.4%, p = 0.4026) were shown for the pandemic period, while no consistent tendency into the one or the other direction was detectable for febrile illness on deployment. In contrast to the finding of less frequently reported deployment-associated gastroenteritis, the detection rates of enteric microorganisms after deployment, including poor hygiene-related colonization with apathogenic protozoa, remained unchanged. Regarding non-enteric infections, the numbers of serologically confirmed malaria cases on deployment and as expected, due to increased airway protection, Mycobacterium tuberculosis-specific immune-conversion dropped significantly with p = 0.0037 and p = 0.009, respectively. As a side finding, soldiers and police officers with post-deployment medical assessments were more likely to be older and male during the pandemic compared to the pre-pandemic period. In summary, only minor changes in deployment-associated infection and colonization rates were seen in response to the increased infection control procedures during the pandemic period, apart from respiratory infections. In particular, the clinical finding of less gastroenteritis on deployment was not matched by a concordant decline in poor hygiene-related enteric colonization with apathogenic protozoa in the soldiers' guts, indicating that the fecal-oral transmission risk remained basically the same.

为应对 COVID-19 大流行,德国公共卫生当局启动了各种感染控制程序。与此同时,德国军方和警方也对部署人员实施了抗大流行感染控制。本研究以整体方法评估了加强感染控制工作对部署相关感染的影响。为此,汉堡联邦国防军医院热带医学和传染病部在大流行期间对德国军人和警察进行了部署后评估,并将评估结果与大流行前的评估结果进行了比较,这是一项探索性的假设比较研究。共有来自 1010 次军事部署和 134 次警察部署的数据被纳入分析,这些部署主要集中在非洲或东地中海世卫组织地区。主要结果显示,在大流行期间,部署士兵的肠胃炎发病率明显下降(20.1% 对 61.3%,p < 0.0001),部署警察的发病率至少也呈下降趋势(25.7% 对 35.4%,p = 0.4026)。与较少报告部署相关肠胃炎的结果相反,部署后肠道微生物的检出率(包括与卫生条件差有关的致病性原生动物定植)保持不变。关于非肠道传染病,部署后经血清学确诊的疟疾病例数和预期的结核分枝杆菌特异性免疫转化率由于气道保护的增强而显著下降,分别为 p = 0.0037 和 p = 0.009。另一个发现是,与大流行前相比,在大流行期间接受部署后医疗评估的士兵和警察更有可能是男性和老年人。总之,除呼吸道感染外,大流行期间感染控制程序的加强仅导致部署相关感染率和定植率出现轻微变化。特别是,临床发现部署期间肠胃炎较少,但士兵肠道中与卫生条件差有关的致病原生动物肠道定植率并没有相应下降,这表明粪口传播的风险基本保持不变。
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引用次数: 0
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Infectious Disease Reports
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