{"title":"Advancements in HIV Vaccine Development","authors":"Lawrence Corey","doi":"10.17925/id.2023.2.1.3","DOIUrl":"https://doi.org/10.17925/id.2023.2.1.3","url":null,"abstract":"<p />","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67594038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Safety and Efficacy of Lonafarnib Boosted with Ritonavir with or without Peginterferon Alfa in Patients with Chronic Hepatitis Delta","authors":"Ohad Etzion","doi":"10.17925/id.2023.3.1.5","DOIUrl":"https://doi.org/10.17925/id.2023.3.1.5","url":null,"abstract":"<p />","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134982764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erythrasma is a common superficial cutaneous bacterial infection caused by Corynebacterium minutissimum, a normal inhabitant of the skin surface. Under favourable conditions, the organism invades the stratum corneum, where it multiplies and produces clinically evident lesions. Increasing age, excessive sweating, diabetes mellitus, obesity, overcrowding and immunosuppression, including HIV, are risk factors for the disease. The condition can be confused with other infectious and non-infectious skin diseases, chiefly dermatophytosis. Erythrasma clinically presents in the groin, axilla, submammary, inguinal, intergluteal cleft and web spaces between the toes. Coinfection with fungi and superinfection upon primary dermatosis are common. Erythrasma can be diagnosed with a characteristic coral-pink fluorescence with Wood‘s lamp examination. Smears, biopsy and cultures are seldom required but are useful when the Wood‘s lamp test is negative. Atypical presentations do occur and require astute clinical judgment. This condition should be distinguished from other dermatosis as treatment is different. Treatment is with topical or oral antimicrobials, depending on the site and extent of the lesions. Recurrence can occur, and methods to prevent it should be in place. Novel treatments need robust testing prior to inclusion in the therapeutic armamentarium.
{"title":"Erythrasma: A Superficial Cutaneous Bacterial Infection Overlooked in Clinical Practice","authors":"Venkatraman Rajkumar","doi":"10.17925/id.2023.2.1.19","DOIUrl":"https://doi.org/10.17925/id.2023.2.1.19","url":null,"abstract":"Erythrasma is a common superficial cutaneous bacterial infection caused by <italic>Corynebacterium minutissimum</italic>, a normal inhabitant of the skin surface. Under favourable conditions, the organism invades the stratum corneum, where it multiplies and produces clinically evident lesions. Increasing age, excessive sweating, diabetes mellitus, obesity, overcrowding and immunosuppression, including HIV, are risk factors for the disease. The condition can be confused with other infectious and non-infectious skin diseases, chiefly dermatophytosis. Erythrasma clinically presents in the groin, axilla, submammary, inguinal, intergluteal cleft and web spaces between the toes. Coinfection with fungi and superinfection upon primary dermatosis are common. Erythrasma can be diagnosed with a characteristic coral-pink fluorescence with Wood‘s lamp examination. Smears, biopsy and cultures are seldom required but are useful when the Wood‘s lamp test is negative. Atypical presentations do occur and require astute clinical judgment. This condition should be distinguished from other dermatosis as treatment is different. Treatment is with topical or oral antimicrobials, depending on the site and extent of the lesions. Recurrence can occur, and methods to prevent it should be in place. Novel treatments need robust testing prior to inclusion in the therapeutic armamentarium.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134982765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Mosaico HIV Vaccine Study: A Step Back or a Stepping Stone for Future Vaccine Development?","authors":"Stephaun E Wallace","doi":"10.17925/id.2023.2.1.2","DOIUrl":"https://doi.org/10.17925/id.2023.2.1.2","url":null,"abstract":"<p />","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67593979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristina Russu, S. Schlabe, D. Kütting, G. Rieke, Vera Schäfer, U. Klein, C. Lange, C. Boesecke
In this case study, we present a 53-year-old Ukrainian refugee with reactivation of multidrug-resistant tuberculosis, which was treated in Ukraine 4 years before he fled the country following the Russian invasion of Ukraine. The patient had a chronic HIV infection that had been treated with antiretroviral therapy and was newly diagnosed with severe acute respiratory syndrome coronavirus 2019 infection, hepatitis C infection and liver cirrhosis. Therefore, tuberculostatic therapy was individualized because of resistance against rifampicin, isoniazid, bedaquiline, and clofazimine and pre-existing liver cirrhosis and neuropathy. The latter was a sequela of a former tuberculosis treatment taken 4 years earlier. The treatment of the patient was complicated by superinfection of the lung cavity with carbapenemase-resistant Klebsiella pneumoniae and a life-threatening massive haemoptysis. He received a selective angiographic examination and bronchial artery embolization. This case report illustrates the complex management of several coinfections in the context of a humanitarian crisis following the on-going military conflict in Ukraine.
{"title":"Management of Multidrug-resistant Tuberculosis in a Ukrainian Refugee with HIV/HCV Coinfection: A Case Report","authors":"Kristina Russu, S. Schlabe, D. Kütting, G. Rieke, Vera Schäfer, U. Klein, C. Lange, C. Boesecke","doi":"10.17925/id.2023.2.1.4","DOIUrl":"https://doi.org/10.17925/id.2023.2.1.4","url":null,"abstract":"In this case study, we present a 53-year-old Ukrainian refugee with reactivation of multidrug-resistant tuberculosis, which was treated in Ukraine 4 years before he fled the country following the Russian invasion of Ukraine. The patient had a chronic HIV infection that had been treated with antiretroviral therapy and was newly diagnosed with severe acute respiratory syndrome coronavirus 2019 infection, hepatitis C infection and liver cirrhosis. Therefore, tuberculostatic therapy was individualized because of resistance against rifampicin, isoniazid, bedaquiline, and clofazimine and pre-existing liver cirrhosis and neuropathy. The latter was a sequela of a former tuberculosis treatment taken 4 years earlier. The treatment of the patient was complicated by superinfection of the lung cavity with carbapenemase-resistant Klebsiella pneumoniae and a life-threatening massive haemoptysis. He received a selective angiographic examination and bronchial artery embolization. This case report illustrates the complex management of several coinfections in the context of a humanitarian crisis following the on-going military conflict in Ukraine.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67594058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-16DOI: 10.1080/23744235.2022.2083672
B. Waagsbø, Nora Stuve, J. Afset, P. Klepstad, S. Mo, L. Heggelund, J. Damås
Abstract Background Bloodstream infections (BSI) occur frequently and are associated with severe outcomes. In this study we aimed to investigate proportions of patients that received discordant empirical antimicrobial therapy and its association to mortality. Methods A retrospective cohort study model was undertaken to outline BSI in an intensive care, single centre, and low antimicrobial resistance prevalence setting. We used descriptive statistics to delineate proportions of patients that received discordant empirical antimicrobial therapy, and a correlation model and a logistic regression model to calculate the association with mortality and predictors of receiving discordant therapy, respectively. Results From 2014 to 2018 we included 270 BSI episodes, of which one third were hospital-acquired. Gram negative, Gram positive, and anaerobic pathogens were detected in 49.0%, 45.3% and 5.7% respectively. The proportion of isolates that conferred extended-spectrum beta-lactamase (ESBL) properties were 5.9% among enterobactereales, and no methicillin-resistant Staphylococcus aureus isolates were detected. Empirical antimicrobial therapy for community-acquired (CA) and hospital-acquired (HA) BSI were discordant at day 0 in 6.5% and 24.4%, respectively (p<.001). Discordant therapy was significantly associated with mortality at day 28 (p=.041). HA-onset BSI, enterococcal BSI and BSI of intraabdominal origin were statistically significant predictors of receiving discordant therapy. Conclusion A significant proportion of HA-BSI did not receive effective antimicrobial therapy and this was significantly associated with mortality. The results underscore the need for more accurate diagnostic tools, improved communication between the microbiological laboratory and the clinicians, and antimicrobial stewardship measures.
{"title":"High levels of discordant antimicrobial therapy in hospital-acquired bloodstream infections is associated with increased mortality in an intensive care, low antimicrobial resistance setting","authors":"B. Waagsbø, Nora Stuve, J. Afset, P. Klepstad, S. Mo, L. Heggelund, J. Damås","doi":"10.1080/23744235.2022.2083672","DOIUrl":"https://doi.org/10.1080/23744235.2022.2083672","url":null,"abstract":"Abstract Background Bloodstream infections (BSI) occur frequently and are associated with severe outcomes. In this study we aimed to investigate proportions of patients that received discordant empirical antimicrobial therapy and its association to mortality. Methods A retrospective cohort study model was undertaken to outline BSI in an intensive care, single centre, and low antimicrobial resistance prevalence setting. We used descriptive statistics to delineate proportions of patients that received discordant empirical antimicrobial therapy, and a correlation model and a logistic regression model to calculate the association with mortality and predictors of receiving discordant therapy, respectively. Results From 2014 to 2018 we included 270 BSI episodes, of which one third were hospital-acquired. Gram negative, Gram positive, and anaerobic pathogens were detected in 49.0%, 45.3% and 5.7% respectively. The proportion of isolates that conferred extended-spectrum beta-lactamase (ESBL) properties were 5.9% among enterobactereales, and no methicillin-resistant Staphylococcus aureus isolates were detected. Empirical antimicrobial therapy for community-acquired (CA) and hospital-acquired (HA) BSI were discordant at day 0 in 6.5% and 24.4%, respectively (p<.001). Discordant therapy was significantly associated with mortality at day 28 (p=.041). HA-onset BSI, enterococcal BSI and BSI of intraabdominal origin were statistically significant predictors of receiving discordant therapy. Conclusion A significant proportion of HA-BSI did not receive effective antimicrobial therapy and this was significantly associated with mortality. The results underscore the need for more accurate diagnostic tools, improved communication between the microbiological laboratory and the clinicians, and antimicrobial stewardship measures.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"738 - 747"},"PeriodicalIF":5.8,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45633828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-16DOI: 10.1080/23744235.2022.2081716
B. Sourander, L. Andersson, Magnus Brink, A. Yilmaz, N. Sundell, E. Marklund, S. Nilsson, M. Lindh, J. Robertson, M. Gisslén
Abstract Background The viral kinetics of SARS-CoV-2 has been considered clinically important. While remdesivir and corticosteroids are recommended for COVID-19 patients requiring oxygen support, there is a limited number of published reports on viral kinetics in hospitalised patients with COVID-19 treated with remdesivir or corticosteroids. Methods We conducted a retrospective study by collecting longitudinal samples from the nasopharynx/throat of 123 hospitalised patients (median age 55 years, 74% male) with COVID-19, to evaluate the effects of remdesivir and corticosteroid treatment on viral RNA levels. The subjects were divided into four groups: those receiving remdesivir (n = 25), betamethasone (n = 41), both (n = 15), or neither (n = 42). Time to viral RNA clearance was analysed using Kaplan-Meier plots, categorical data were analysed using Fisher’s exact test, and Kruskal-Wallis for continuous data. Viral RNA decline rate was analysed using a mixed effect model. Results We found no significant difference in SARS-CoV-2 RNA decline rate or time to SARS-CoV-2 RNA clearance between the groups. Moreover, clinical status at baseline was not correlated with time to viral clearance. Conclusions Since SARS-CoV-2 RNA kinetics was not affected by treatment, repeated sampling from the upper respiratory tract cannot be used to evaluate treatment response.
{"title":"No effect of remdesivir or betamethasone on upper respiratory tract SARS-CoV-2 RNA kinetics in hospitalised COVID-19 patients: a retrospective observational study","authors":"B. Sourander, L. Andersson, Magnus Brink, A. Yilmaz, N. Sundell, E. Marklund, S. Nilsson, M. Lindh, J. Robertson, M. Gisslén","doi":"10.1080/23744235.2022.2081716","DOIUrl":"https://doi.org/10.1080/23744235.2022.2081716","url":null,"abstract":"Abstract Background The viral kinetics of SARS-CoV-2 has been considered clinically important. While remdesivir and corticosteroids are recommended for COVID-19 patients requiring oxygen support, there is a limited number of published reports on viral kinetics in hospitalised patients with COVID-19 treated with remdesivir or corticosteroids. Methods We conducted a retrospective study by collecting longitudinal samples from the nasopharynx/throat of 123 hospitalised patients (median age 55 years, 74% male) with COVID-19, to evaluate the effects of remdesivir and corticosteroid treatment on viral RNA levels. The subjects were divided into four groups: those receiving remdesivir (n = 25), betamethasone (n = 41), both (n = 15), or neither (n = 42). Time to viral RNA clearance was analysed using Kaplan-Meier plots, categorical data were analysed using Fisher’s exact test, and Kruskal-Wallis for continuous data. Viral RNA decline rate was analysed using a mixed effect model. Results We found no significant difference in SARS-CoV-2 RNA decline rate or time to SARS-CoV-2 RNA clearance between the groups. Moreover, clinical status at baseline was not correlated with time to viral clearance. Conclusions Since SARS-CoV-2 RNA kinetics was not affected by treatment, repeated sampling from the upper respiratory tract cannot be used to evaluate treatment response.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"703 - 712"},"PeriodicalIF":5.8,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47114618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1080/23744235.2022.2080249
Stefan Malmberg, Taha Khan, R. Gunnarsson, Gunnar Jacobsson, Pär-Daniel Sundvall
Abstract Background Vital signs are critical in assessing the severity and prognosis of infections, for example, COVID-19, influenza, sepsis, and pneumonia. This study aimed to evaluate a new method for rapid camera-based non-contact measurement of heart rate, blood oxygen saturation, respiratory rate, and blood pressure. Methods Consecutive adult patients attending a hospital emergency department for suspected COVID-19 infection were invited to participate. Vital signs measured with a new camera-based method were compared to the corresponding standard reference methods. The camera device observed the patient's face for 30 s from ∼1 m. Results Between 1 April and 1 October 2020, 214 subjects were included in the trial, 131 female (61%) and 83 male (39%). The mean age was 44 years (range 18–81 years). The new camera-based device’s vital signs measurements were, on average, very close to the gold standard but the random variation was larger than the reference methods. Conclusions The principle of contactless measurement of blood pressure, pulse, respiratory rate, and oxygen saturation works, which is very promising. However, technical improvements to the equipment used in this study to reduce its random variability is required before clinical implementation. This will likely be a game changer once this is sorted out. Clinical trial registration Universal Trial Number (UTN) U1111-1251-4114 and the ClinicalTrials.gov Identifier NCT04383457.
{"title":"Remote investigation and assessment of vital signs (RIA-VS)—proof of concept for contactless estimation of blood pressure, pulse, respiratory rate, and oxygen saturation in patients with suspicion of COVID-19","authors":"Stefan Malmberg, Taha Khan, R. Gunnarsson, Gunnar Jacobsson, Pär-Daniel Sundvall","doi":"10.1080/23744235.2022.2080249","DOIUrl":"https://doi.org/10.1080/23744235.2022.2080249","url":null,"abstract":"Abstract Background Vital signs are critical in assessing the severity and prognosis of infections, for example, COVID-19, influenza, sepsis, and pneumonia. This study aimed to evaluate a new method for rapid camera-based non-contact measurement of heart rate, blood oxygen saturation, respiratory rate, and blood pressure. Methods Consecutive adult patients attending a hospital emergency department for suspected COVID-19 infection were invited to participate. Vital signs measured with a new camera-based method were compared to the corresponding standard reference methods. The camera device observed the patient's face for 30 s from ∼1 m. Results Between 1 April and 1 October 2020, 214 subjects were included in the trial, 131 female (61%) and 83 male (39%). The mean age was 44 years (range 18–81 years). The new camera-based device’s vital signs measurements were, on average, very close to the gold standard but the random variation was larger than the reference methods. Conclusions The principle of contactless measurement of blood pressure, pulse, respiratory rate, and oxygen saturation works, which is very promising. However, technical improvements to the equipment used in this study to reduce its random variability is required before clinical implementation. This will likely be a game changer once this is sorted out. Clinical trial registration Universal Trial Number (UTN) U1111-1251-4114 and the ClinicalTrials.gov Identifier NCT04383457.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"677 - 686"},"PeriodicalIF":5.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41508187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-31DOI: 10.1080/23744235.2022.2080250
J. Kanji, L. Nguyen, S. Plitt, C. Charlton, J. Fenton, S. Braun, Carol Marohn, Cheryl Lau, L. Svenson, Deena Hinshaw, Christie Lutsiak, N. Zelyas, Michael Mengel, G. Tipples
Abstract Background The COVID-19 pandemic has necessitated the need to rapidly make public health decisions. We systematically evaluated SARS-CoV-2 seropositivity to understand local COVID-19 epidemiology and support evidence-based public health decision making. Methods Residual blood samples were collected for SARS-CoV-2 receptor binding domain (RBD) IgG testing over a 1–5 day period monthly from 26 February 2021–9 July 2021 from six clinical laboratories across the province of Alberta, Canada. Monthly crude and adjusted (for age and gender) seropositivity were calculated. Results were linked to provincial administrative, laboratory, and vaccine databases. Results 60,632 individual blood samples were tested. Vaccination data were available for 98.8% of samples. Adjusted RBD IgG positivity rose from 11.9% (95% confidence interval [CI] 11.9–12.0%) in March 2021 to 70.2% (95% CI 70.2–70.3%) in July 2021 (p < .0001). Seropositivity rose from 9.4% (95% CI 9.3–9.4%) in March 2021 to 20.2% (95% CI 20.1–20.2%) in July 2021 in unvaccinated Albertans. Unvaccinated seropositive individuals were from geographic areas with significantly (p < .001) lower median household income, lower proportion of married/common-law relationships, larger average household size and higher proportions of visible minorities compared to seronegative unvaccinated individuals. In July 2021, the age groups with the lowest and highest seropositivity in unvaccinated Albertans were those ≥80 years (12.0%, 95% CI 5.3–18.6%) and 20–29 years (24.2%, 95% CI 19.6–28.8%), respectively. Of seropositive unvaccinated individuals, 50.2% (95% CI 45.9–54.5%) had no record of prior SARS-CoV-2 molecular testing. Conclusions Longitudinal surveillance of SARS-CoV-2 seropositivity with data linkage is valuable for decision-making during the pandemic.
背景2019冠状病毒病大流行迫切需要快速做出公共卫生决策。我们系统评估SARS-CoV-2血清阳性，以了解当地COVID-19流行病学，为循证公共卫生决策提供支持。方法于2021年2月26日至2021年7月9日在加拿大艾伯塔省6个临床实验室采集残血，每月1-5天检测SARS-CoV-2受体结合域(RBD) IgG。计算每月的原始和调整(年龄和性别)血清阳性。结果与省级行政、实验室和疫苗数据库相关联。结果共检测了60632份血样。98.8%的样本可获得疫苗接种资料。调整后的RBD IgG阳性从2021年3月的11.9%(95%可信区间[CI] 11.9-12.0%)上升到2021年7月的70.2% (95% CI 70.2-70.3%) (p < 0.0001)。未接种疫苗的艾伯塔省人的血清阳性从2021年3月的9.4% (95% CI 9.3-9.4%)上升到2021年7月的20.2% (95% CI 20.1-20.2%)。与未接种疫苗的血清阴性个体相比，未接种疫苗的血清阳性个体来自家庭收入中位数显著(p < 0.001)较低、已婚/普通法关系比例较低、平均家庭规模较大和少数族裔比例较高的地理区域。2021年7月，未接种疫苗的艾伯塔省人血清阳性率最低和最高的年龄组分别为≥80岁(12.0%，95% CI 5.3-18.6%)和20-29岁(24.2%，95% CI 19.6-28.8%)。在未接种疫苗的血清阳性个体中，50.2% (95% CI 45.9-54.5%)没有先前的SARS-CoV-2分子检测记录。结论对SARS-CoV-2血清学阳性进行纵向监测，具有数据联系性，对大流行期间的决策有一定的参考价值。
{"title":"Seropositivity to SARS-CoV-2 in Alberta, Canada in a post-vaccination period (March 2021–July 2021)","authors":"J. Kanji, L. Nguyen, S. Plitt, C. Charlton, J. Fenton, S. Braun, Carol Marohn, Cheryl Lau, L. Svenson, Deena Hinshaw, Christie Lutsiak, N. Zelyas, Michael Mengel, G. Tipples","doi":"10.1080/23744235.2022.2080250","DOIUrl":"https://doi.org/10.1080/23744235.2022.2080250","url":null,"abstract":"Abstract Background The COVID-19 pandemic has necessitated the need to rapidly make public health decisions. We systematically evaluated SARS-CoV-2 seropositivity to understand local COVID-19 epidemiology and support evidence-based public health decision making. Methods Residual blood samples were collected for SARS-CoV-2 receptor binding domain (RBD) IgG testing over a 1–5 day period monthly from 26 February 2021–9 July 2021 from six clinical laboratories across the province of Alberta, Canada. Monthly crude and adjusted (for age and gender) seropositivity were calculated. Results were linked to provincial administrative, laboratory, and vaccine databases. Results 60,632 individual blood samples were tested. Vaccination data were available for 98.8% of samples. Adjusted RBD IgG positivity rose from 11.9% (95% confidence interval [CI] 11.9–12.0%) in March 2021 to 70.2% (95% CI 70.2–70.3%) in July 2021 (p < .0001). Seropositivity rose from 9.4% (95% CI 9.3–9.4%) in March 2021 to 20.2% (95% CI 20.1–20.2%) in July 2021 in unvaccinated Albertans. Unvaccinated seropositive individuals were from geographic areas with significantly (p < .001) lower median household income, lower proportion of married/common-law relationships, larger average household size and higher proportions of visible minorities compared to seronegative unvaccinated individuals. In July 2021, the age groups with the lowest and highest seropositivity in unvaccinated Albertans were those ≥80 years (12.0%, 95% CI 5.3–18.6%) and 20–29 years (24.2%, 95% CI 19.6–28.8%), respectively. Of seropositive unvaccinated individuals, 50.2% (95% CI 45.9–54.5%) had no record of prior SARS-CoV-2 molecular testing. Conclusions Longitudinal surveillance of SARS-CoV-2 seropositivity with data linkage is valuable for decision-making during the pandemic.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"666 - 676"},"PeriodicalIF":5.8,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45508366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-30DOI: 10.1080/23744235.2022.2081717
F. Sjövall, Morgan Edström, S. Walther, H. Hanberger
Abstract Background Around 70% of all ICU patients are treated with antibiotics whereas up to 30% are suggested as unnecessary. Measuring antibiotic consumption is a prerequisite to improving its use and the purpose of the present investigation was to explore the use of antibiotics in Swedish ICUs. Material and methods Daily Defined Doses (DDDs) of antimicrobials delivered to Swedish ICUs, 2016–2018, were retrieved from Swedish pharmacies. From the Swedish Intensive Care Registry, we extracted data on a number of patient admissions, occupied bed days and Simplified Acute Physiology Score (SAPS)3. Results There was a similar annual rate of total DDDs per admission of 3.7, 3.5, 3.8 and total DDDs per 100 occupied bed days of 111, 111, and 115 but with an approximately 6-fold difference of DDDs per occupied bed days (61–366) between the ICUs. The most frequently used antibiotics were isoxazolyl penicillins (J01CF), penicillins with betalactamase-inhibitors, mainly piperacillin/tazobactam (J01CR), 3rd and 4th generation cephalosporins (J01DD + DE) and carbapenems (J01DH). Together these four classes accounted for a median of 52% of all antibiotic use. The use of carbapenems had a moderate positive correlation with the mean SAPS3 score (r = 0.6, p = .01). The use of other broad-spectrum antibiotics showed no such correlation. Conclusion Overall antibiotic use remained similar in Swedish ICUs during the years 2016–2018. Broad-spectrum antibiotics accounted for 50% of all DDDs but with a large inter-ICU variation which only partly can be explained by differences in patient case mix and microbial resistance. Presumably, it also reflects varying local prescribing practices.
{"title":"A nationwide evaluation of antibiotics consumption in Swedish intensive care units","authors":"F. Sjövall, Morgan Edström, S. Walther, H. Hanberger","doi":"10.1080/23744235.2022.2081717","DOIUrl":"https://doi.org/10.1080/23744235.2022.2081717","url":null,"abstract":"Abstract Background Around 70% of all ICU patients are treated with antibiotics whereas up to 30% are suggested as unnecessary. Measuring antibiotic consumption is a prerequisite to improving its use and the purpose of the present investigation was to explore the use of antibiotics in Swedish ICUs. Material and methods Daily Defined Doses (DDDs) of antimicrobials delivered to Swedish ICUs, 2016–2018, were retrieved from Swedish pharmacies. From the Swedish Intensive Care Registry, we extracted data on a number of patient admissions, occupied bed days and Simplified Acute Physiology Score (SAPS)3. Results There was a similar annual rate of total DDDs per admission of 3.7, 3.5, 3.8 and total DDDs per 100 occupied bed days of 111, 111, and 115 but with an approximately 6-fold difference of DDDs per occupied bed days (61–366) between the ICUs. The most frequently used antibiotics were isoxazolyl penicillins (J01CF), penicillins with betalactamase-inhibitors, mainly piperacillin/tazobactam (J01CR), 3rd and 4th generation cephalosporins (J01DD + DE) and carbapenems (J01DH). Together these four classes accounted for a median of 52% of all antibiotic use. The use of carbapenems had a moderate positive correlation with the mean SAPS3 score (r = 0.6, p = .01). The use of other broad-spectrum antibiotics showed no such correlation. Conclusion Overall antibiotic use remained similar in Swedish ICUs during the years 2016–2018. Broad-spectrum antibiotics accounted for 50% of all DDDs but with a large inter-ICU variation which only partly can be explained by differences in patient case mix and microbial resistance. Presumably, it also reflects varying local prescribing practices.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"713 - 721"},"PeriodicalIF":5.8,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41860560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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