Pub Date : 2022-05-30DOI: 10.1080/23744235.2022.2083226
Eleonora Cottone, F. Van Hoecke, G. Martens, E. De Laere, Roos De Smedt, Steven Vervaeke, M. Vanhee, D. De Smet
Abstract Background Current method for diagnosis of SARS-CoV-2 infection is an RT-PCR test on the nasopharyngeal or oropharyngeal swab. Rapid diagnosis is essential for containing viral spread and triage of symptomatic patients presenting to hospital ER departments. As a faster alternative to RT-PCR, we evaluated a SARS-Cov-2 Rapid Antigen test in symptomatic patients presenting to hospital ER departments. Methods We evaluated the diagnostic performance of the Roche SARS-CoV-2 Rapid Antigen test (SD Biosensor) for detection of SARS-CoV-2 compared to RT-PCR. Results Our study showed inferior performance of the SARS-CoV-2 Rapid Antigen test for detection of SARS-CoV-2. Firstly, because of the lack of specificity, which is potentially life-threatening due to the association of nosocomial-acquired SARS-CoV-2 infection. Secondly, with a sensitivity of 45.5%, it is impossible to rule out SARS-CoV-2 infection, resulting in reflex PCR-testing. Comparison of viral load in RT-PCR positive samples with corresponding antigen results showed a significant difference between antigen positive and negative samples. COVID-19 infection will not be detected in patients admitted to the hospital in an early or late phase, typically associated with low viral loads. Sensitivity increases when testing within 5–7 symptomatic days, but the implementation of this cut-off is impractical in ER settings. However, diagnostic performance is better to detect high viral load (> = 5 log10 copies/mL) linked with contagiousness. Conclusion Our study showed inferior performance of the Roche SARS-CoV-2 Rapid Antigen test (SD Biosensor) for detection of SARS-CoV-2 which limits its use as a diagnostic gatekeeper in ER departments, but is able to differentiate contagious individuals.
{"title":"Pitfalls of SARS-CoV-2 antigen testing at emergency department","authors":"Eleonora Cottone, F. Van Hoecke, G. Martens, E. De Laere, Roos De Smedt, Steven Vervaeke, M. Vanhee, D. De Smet","doi":"10.1080/23744235.2022.2083226","DOIUrl":"https://doi.org/10.1080/23744235.2022.2083226","url":null,"abstract":"Abstract Background Current method for diagnosis of SARS-CoV-2 infection is an RT-PCR test on the nasopharyngeal or oropharyngeal swab. Rapid diagnosis is essential for containing viral spread and triage of symptomatic patients presenting to hospital ER departments. As a faster alternative to RT-PCR, we evaluated a SARS-Cov-2 Rapid Antigen test in symptomatic patients presenting to hospital ER departments. Methods We evaluated the diagnostic performance of the Roche SARS-CoV-2 Rapid Antigen test (SD Biosensor) for detection of SARS-CoV-2 compared to RT-PCR. Results Our study showed inferior performance of the SARS-CoV-2 Rapid Antigen test for detection of SARS-CoV-2. Firstly, because of the lack of specificity, which is potentially life-threatening due to the association of nosocomial-acquired SARS-CoV-2 infection. Secondly, with a sensitivity of 45.5%, it is impossible to rule out SARS-CoV-2 infection, resulting in reflex PCR-testing. Comparison of viral load in RT-PCR positive samples with corresponding antigen results showed a significant difference between antigen positive and negative samples. COVID-19 infection will not be detected in patients admitted to the hospital in an early or late phase, typically associated with low viral loads. Sensitivity increases when testing within 5–7 symptomatic days, but the implementation of this cut-off is impractical in ER settings. However, diagnostic performance is better to detect high viral load (> = 5 log10 copies/mL) linked with contagiousness. Conclusion Our study showed inferior performance of the Roche SARS-CoV-2 Rapid Antigen test (SD Biosensor) for detection of SARS-CoV-2 which limits its use as a diagnostic gatekeeper in ER departments, but is able to differentiate contagious individuals.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"731 - 737"},"PeriodicalIF":5.8,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43452595","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 : 2022-05-23DOI: 10.1080/23744235.2022.2078404
Aleyya Radjabaly Mandjee, L. Filippetti, F. Goehringer, X. Duval, E. Botelho-Nevers, C. Tribouilloy, R. Huguet, C. Chirouze, M. Erpelding, B. Hoen, C. Selton-Suty, Agrinier Nelly, B. Lefèvre
Abstract Background Infective endocarditis (IE) typically occurs in patients with underlying cardiac conditions (UCC). Little is known about IE in patients without UCC. We aimed to describe the clinical, microbiological and imaging characteristics, management, and in-hospital mortality of IE patients without UCC. Methods We analysed the data of patients with definite IE included in an observatory between 1st January 2009 and 31st December 2019. We described patients without UCC compared to those with UCC. Results Of 1502 IE patients, 475 (31.6%) had no UCC. They were younger (median 64.0 [19.0–101.0] vs. 70.0 [18.0–104.0] years, p < .001), more often on chronic haemodialysis (5.5% vs. 2.7%, p = .008), and had more often malignancy (22.5% vs. 17.3%, p = .017), immune deficiency (10.3% vs. 6.4%, p = .008), and an indwelling central venous line (14.5% vs. 7.0%, p < .001). They more often developed cerebral complications (34.7% vs. 27.5%, p = .004) and extracerebral embolism (48.6% vs. 36.1%, p < .001). Causative microorganisms were less often coagulase negative staphylococci (5.9% vs. 10.8%, p = .002) or enterococci (10.3% vs. 15.0%, p = .014) and more often group D streptococci (14.1% vs. 10.0%, p = .020). Vegetations were more common (92.8% vs. 77.0%, p < .001) and larger (14.0 [1.0–87.0], vs. 12.0 [0.5–60.0] mm, p = .002). They had more valve perforation or valve regurgitation (67.4% vs. 53.0%, p < .001) and underwent valve surgery more often (53.5% vs. 36.3%, p < .001). In-hospital mortality did not significantly differ between groups. Conclusion Patients with IE and no UCC were younger than those with UCC, had specific comorbidities and portals of entry, and a more severe disease course.
背景感染性心内膜炎(IE)通常发生在有潜在心脏疾病(UCC)的患者中。对于没有UCC的患者的IE知之甚少。我们的目的是描述没有UCC的IE患者的临床、微生物学和影像学特征、管理和住院死亡率。方法分析2009年1月1日至2019年12月31日在某观察站就诊的明确IE患者的资料。我们将无UCC的患者与有UCC的患者进行了比较。结果1502例IE患者中，475例(31.6%)无UCC。他们更年轻(中位数64.0[19.0-101.0]比70.0[18.0-104.0]岁，p < 0.001)，更常进行慢性血液透析(5.5%比2.7%，p = 0.008)，更常患有恶性肿瘤(22.5%比17.3%，p = 0.017)，免疫缺陷(10.3%比6.4%，p = 0.008)，中心静脉留置(14.5%比7.0%，p < 0.001)。他们更常发生脑并发症(34.7% vs. 27.5%， p = 0.004)和脑外栓塞(48.6% vs. 36.1%， p < 0.001)。致病性微生物以凝固酶阴性葡萄球菌(5.9%比10.8%，p = 0.002)或肠球菌(10.3%比15.0%，p = 0.014)较少，以D组链球菌(14.1%比10.0%，p = 0.020)较多。植被较多(92.8%比77.0%，p < 0.001)，面积较大(14.0[1.0 ~ 87.0]比12.0 [0.5 ~ 60.0]mm, p = 0.002)。他们有更多的瓣膜穿孔或瓣膜反流(67.4%比53.0%，p < 0.001)，接受瓣膜手术的频率更高(53.5%比36.3%，p < 0.001)。住院死亡率组间无显著差异。结论IE合并无UCC患者比UCC患者年龄更小，有特定的合并症和入路，病程更严重。
{"title":"Characteristics of patients with infective endocarditis and no underlying cardiac conditions","authors":"Aleyya Radjabaly Mandjee, L. Filippetti, F. Goehringer, X. Duval, E. Botelho-Nevers, C. Tribouilloy, R. Huguet, C. Chirouze, M. Erpelding, B. Hoen, C. Selton-Suty, Agrinier Nelly, B. Lefèvre","doi":"10.1080/23744235.2022.2078404","DOIUrl":"https://doi.org/10.1080/23744235.2022.2078404","url":null,"abstract":"Abstract Background Infective endocarditis (IE) typically occurs in patients with underlying cardiac conditions (UCC). Little is known about IE in patients without UCC. We aimed to describe the clinical, microbiological and imaging characteristics, management, and in-hospital mortality of IE patients without UCC. Methods We analysed the data of patients with definite IE included in an observatory between 1st January 2009 and 31st December 2019. We described patients without UCC compared to those with UCC. Results Of 1502 IE patients, 475 (31.6%) had no UCC. They were younger (median 64.0 [19.0–101.0] vs. 70.0 [18.0–104.0] years, p < .001), more often on chronic haemodialysis (5.5% vs. 2.7%, p = .008), and had more often malignancy (22.5% vs. 17.3%, p = .017), immune deficiency (10.3% vs. 6.4%, p = .008), and an indwelling central venous line (14.5% vs. 7.0%, p < .001). They more often developed cerebral complications (34.7% vs. 27.5%, p = .004) and extracerebral embolism (48.6% vs. 36.1%, p < .001). Causative microorganisms were less often coagulase negative staphylococci (5.9% vs. 10.8%, p = .002) or enterococci (10.3% vs. 15.0%, p = .014) and more often group D streptococci (14.1% vs. 10.0%, p = .020). Vegetations were more common (92.8% vs. 77.0%, p < .001) and larger (14.0 [1.0–87.0], vs. 12.0 [0.5–60.0] mm, p = .002). They had more valve perforation or valve regurgitation (67.4% vs. 53.0%, p < .001) and underwent valve surgery more often (53.5% vs. 36.3%, p < .001). In-hospital mortality did not significantly differ between groups. Conclusion Patients with IE and no UCC were younger than those with UCC, had specific comorbidities and portals of entry, and a more severe disease course.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"656 - 665"},"PeriodicalIF":5.8,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45065697","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 : 2022-05-19DOI: 10.1080/23744235.2022.2076903
Hadir Azaizi, Maria Louise Veimer Jensen, Ida Scheel Rasmussen, J. Jarløv, Jette Nygaard Jensen
Abstract Background The objective of this study was to compare antibiotic prescription rates in Denmark among elderly living in long-term care facilities to elderly living at home, with regards to total antibiotic use and antibiotic use for urinary tract infection. Methods This is an observational registry-based study. The study population included all elderly Danish residents aged ≥75 years in 2016. Linear regression models were used to examine the difference in antibiotic prescription rates between elderly living in long-term care facilities and elderly living at home. Results were adjusted for age, sex and comorbidity, the latter assessed via the Charlson Comorbidity Index. Results The study population consisted of 416,627 elderly. Regression models showed that elderly living in long-term care facilities were prescribed 1.7 [CI 1.7–1.7] prescriptions/individual/year more than elderly living at home. For urinary tract infections the difference between elderly living in long-term care facilities and elderly living at home was 1.2 [CI 1.2–1.3] prescriptions/individual/year. Conclusions Elderly living in long-term care facilities have a higher antibiotic prescribing rate than elderly living at home, despite controlling for age, sex and comorbidity. This indicates that long-term care facilities continuously should be a focus for antibiotic stewardship interventions.
{"title":"Antibiotic prescribing among elderly living in long-term care facilities versus elderly living at home: a Danish registry-based study","authors":"Hadir Azaizi, Maria Louise Veimer Jensen, Ida Scheel Rasmussen, J. Jarløv, Jette Nygaard Jensen","doi":"10.1080/23744235.2022.2076903","DOIUrl":"https://doi.org/10.1080/23744235.2022.2076903","url":null,"abstract":"Abstract Background The objective of this study was to compare antibiotic prescription rates in Denmark among elderly living in long-term care facilities to elderly living at home, with regards to total antibiotic use and antibiotic use for urinary tract infection. Methods This is an observational registry-based study. The study population included all elderly Danish residents aged ≥75 years in 2016. Linear regression models were used to examine the difference in antibiotic prescription rates between elderly living in long-term care facilities and elderly living at home. Results were adjusted for age, sex and comorbidity, the latter assessed via the Charlson Comorbidity Index. Results The study population consisted of 416,627 elderly. Regression models showed that elderly living in long-term care facilities were prescribed 1.7 [CI 1.7–1.7] prescriptions/individual/year more than elderly living at home. For urinary tract infections the difference between elderly living in long-term care facilities and elderly living at home was 1.2 [CI 1.2–1.3] prescriptions/individual/year. Conclusions Elderly living in long-term care facilities have a higher antibiotic prescribing rate than elderly living at home, despite controlling for age, sex and comorbidity. This indicates that long-term care facilities continuously should be a focus for antibiotic stewardship interventions.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"651 - 655"},"PeriodicalIF":5.8,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45737570","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 : 2022-05-17DOI: 10.1080/23744235.2022.2069857
K. Mizuta, T. Itagaki, Shuji Chikaoka, M. Wada, Toru Ikegami, D. Sendo, C. Iseki, Y. Shimizu, S. Abe, K. Komabayashi, Y. Aoki, T. Ikeda
Abstract Background Parechovirus A3 was first reported in 2004 and has been recognized as a causative agent of mild and severe infections in children. Since we first reported an outbreak of adult parechovirus A3-associated myalgia in Yamagata, Japan in 2008, this disease has since been recognized across Japan, but has not yet been reported from other countries. Aim We analysed 19 cases of parechovirus A3 infections identified in Yamagata in 2019 to further clarify the epidemiology of this disease. Methods We performed phylogenetic analyses of parechovirus A3 isolates and analysed the clinical manifestations and the genomic clusters. Results There were two clusters, with cluster 2019B replacing 2019 A around October/November. Phylogenetic analysis revealed that 2019B cluster strains and Australian recombinant strains, which appeared between 2012 and 2013, were grouped in one cluster at non-structural protein regions, suggesting that the ancestor to these regions of 2019B cluster strains were Australian recombinant lineage strains. The strains from both clusters caused various infections in children including myalgia. These findings strongly support that parechovirus A3 strains cause myalgia and other paediatric infections irrespective of the virus strains involved, including recombinant strains. Conclusions We have reported repeatedly sporadic cases of myalgia and here showed that recombinant strains also cause myalgia. We hope our experiences will help better understand these infections and possibly result in detection of more cases in the world.
{"title":"Recombinant parechovirus A3 possibly causes various clinical manifestations, including myalgia; findings in Yamagata, Japan in 2019","authors":"K. Mizuta, T. Itagaki, Shuji Chikaoka, M. Wada, Toru Ikegami, D. Sendo, C. Iseki, Y. Shimizu, S. Abe, K. Komabayashi, Y. Aoki, T. Ikeda","doi":"10.1080/23744235.2022.2069857","DOIUrl":"https://doi.org/10.1080/23744235.2022.2069857","url":null,"abstract":"Abstract Background Parechovirus A3 was first reported in 2004 and has been recognized as a causative agent of mild and severe infections in children. Since we first reported an outbreak of adult parechovirus A3-associated myalgia in Yamagata, Japan in 2008, this disease has since been recognized across Japan, but has not yet been reported from other countries. Aim We analysed 19 cases of parechovirus A3 infections identified in Yamagata in 2019 to further clarify the epidemiology of this disease. Methods We performed phylogenetic analyses of parechovirus A3 isolates and analysed the clinical manifestations and the genomic clusters. Results There were two clusters, with cluster 2019B replacing 2019 A around October/November. Phylogenetic analysis revealed that 2019B cluster strains and Australian recombinant strains, which appeared between 2012 and 2013, were grouped in one cluster at non-structural protein regions, suggesting that the ancestor to these regions of 2019B cluster strains were Australian recombinant lineage strains. The strains from both clusters caused various infections in children including myalgia. These findings strongly support that parechovirus A3 strains cause myalgia and other paediatric infections irrespective of the virus strains involved, including recombinant strains. Conclusions We have reported repeatedly sporadic cases of myalgia and here showed that recombinant strains also cause myalgia. We hope our experiences will help better understand these infections and possibly result in detection of more cases in the world.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"632 - 650"},"PeriodicalIF":5.8,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42237811","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 : 2022-05-12DOI: 10.1080/23744235.2022.2072521
G. Liatsos, A. Mavroudis, P. Iliakis, M. Karmpalioti, E. Koullias, D. Vassilopoulos
Abstract Background Several safe and effective vaccines against nCoV-19 have been developed to contain the pandemic with very few severe adverse-reactions reported. Vaccine-induced interstitial lung disease (ILD) is a very rare and difficult to recognise and diagnose adverse-reaction and is mostly associated with Influenza vaccines. Methods We report a 55-yr old male who presented with severe respiratory failure that required for several days oxygen supplementation with high flow nasal cannula, and myocardial infarction. Symptoms onset was eighteen days after the first shot of adenoviral AZD1222 vector vaccine. Possible SARS-CoV-2 natural infection post-vaccination was excluded with rigorous laboratory work-up including multiple nasopharengeal rt-qPCR tests for SARS-CoV-2 detection and close monitoring of his serum SARS-CoV-2 antibodies. Other potential infectious agents and alternate diagnoses were thoroughly investigated. Results Patient responded impressively to high dose steroids. A repeat chest CT nine days after the first one showed a remarkable resolution of the bilateral ground glass opacities. Except for his cardiology medication, no supplemental oxygen neither steroids were prescribed upon his discharge. On one month follow-up, no residual pulmonary dysfunction was noticed with patient preserving a SatO2 of 97–98% on ambient air. Conclusion Vaccine-induced ILD might constitute a rare nCoV-19 post-vaccination adverse-event. According to current restricted data, when post-vaccination ILD is early suspected and recognised, then prompt implementation of steroid treatment reverses significantly the lung lesions without progression to fibrosis.
{"title":"A case of adenoviral covid-19 vector vaccine possibly linked to severe but reversible interstitial lung injury post-vaccination","authors":"G. Liatsos, A. Mavroudis, P. Iliakis, M. Karmpalioti, E. Koullias, D. Vassilopoulos","doi":"10.1080/23744235.2022.2072521","DOIUrl":"https://doi.org/10.1080/23744235.2022.2072521","url":null,"abstract":"Abstract Background Several safe and effective vaccines against nCoV-19 have been developed to contain the pandemic with very few severe adverse-reactions reported. Vaccine-induced interstitial lung disease (ILD) is a very rare and difficult to recognise and diagnose adverse-reaction and is mostly associated with Influenza vaccines. Methods We report a 55-yr old male who presented with severe respiratory failure that required for several days oxygen supplementation with high flow nasal cannula, and myocardial infarction. Symptoms onset was eighteen days after the first shot of adenoviral AZD1222 vector vaccine. Possible SARS-CoV-2 natural infection post-vaccination was excluded with rigorous laboratory work-up including multiple nasopharengeal rt-qPCR tests for SARS-CoV-2 detection and close monitoring of his serum SARS-CoV-2 antibodies. Other potential infectious agents and alternate diagnoses were thoroughly investigated. Results Patient responded impressively to high dose steroids. A repeat chest CT nine days after the first one showed a remarkable resolution of the bilateral ground glass opacities. Except for his cardiology medication, no supplemental oxygen neither steroids were prescribed upon his discharge. On one month follow-up, no residual pulmonary dysfunction was noticed with patient preserving a SatO2 of 97–98% on ambient air. Conclusion Vaccine-induced ILD might constitute a rare nCoV-19 post-vaccination adverse-event. According to current restricted data, when post-vaccination ILD is early suspected and recognised, then prompt implementation of steroid treatment reverses significantly the lung lesions without progression to fibrosis.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"692 - 697"},"PeriodicalIF":5.8,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45027215","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 : 2022-05-09DOI: 10.1080/23744235.2022.2071461
Lovisa Ivarsson, Magdalena de Arriba Sánchez de la Campa, Karin Elfving, Hong Yin, Karolina Gullsby, L. Stark, Berit Andersen, S. Hoffmann, Å. Gylfe, M. Unemo, B. Herrmann
Abstract Background This study aimed to investigate what impact the COVID-19 pandemic and its associated restrictions had on Chlamydia trachomatis and Neisseria gonorrhoeae infections in Sweden, Denmark and Norway, countries with very different governmental strategies for handling this pandemic. Methods Retrospective analysis of data collected via requests to Swedish regions and to health authorities in Denmark and Norway. The data were collected for the years 2018–2020 and the data from Sweden were more detailed. Results When the pandemic restrictions were installed in 2020, the number of reported chlamydia cases decreased. The decline was most pronounced in Norway 10.8% (2019: n = 28,446; 2020: n = 25,444) while it was only 3.1% in Denmark (2019: n = 35,688; 2020: n = 34,689) and 4.3% in Sweden (2019: n = 34,726; 2020: n = 33,339). Nucleic acid amplifications tests for chlamydia decreased in Sweden (10%) and Norway (18%) in 2020 compared to 2019, while in Denmark a 21% decrease was noted in April 2020 but thereafter increased to a higher level than 2019. The number of reported gonorrhoea cases decreased in Sweden (17%) and in Norway (39%) in 2020 compared to 2019, while a 21% increase was noted in Denmark. Conclusions Pandemic restrictions had an impact on the number of reported chlamydia infections in all three countries, but only temporarily and did not seem to be correlated to the restriction levels. The number of reported gonorrhoea infections in Sweden and Norway significantly decreased but not in Denmark. Pandemic restrictions appear to have had a limited effect on the spread of chlamydia and gonorrhoea.
{"title":"Changes in testing and incidence of Chlamydia trachomatis and Neisseria gonorrhoeae – the possible impact of the COVID-19 pandemic in the three Scandinavian countries","authors":"Lovisa Ivarsson, Magdalena de Arriba Sánchez de la Campa, Karin Elfving, Hong Yin, Karolina Gullsby, L. Stark, Berit Andersen, S. Hoffmann, Å. Gylfe, M. Unemo, B. Herrmann","doi":"10.1080/23744235.2022.2071461","DOIUrl":"https://doi.org/10.1080/23744235.2022.2071461","url":null,"abstract":"Abstract Background This study aimed to investigate what impact the COVID-19 pandemic and its associated restrictions had on Chlamydia trachomatis and Neisseria gonorrhoeae infections in Sweden, Denmark and Norway, countries with very different governmental strategies for handling this pandemic. Methods Retrospective analysis of data collected via requests to Swedish regions and to health authorities in Denmark and Norway. The data were collected for the years 2018–2020 and the data from Sweden were more detailed. Results When the pandemic restrictions were installed in 2020, the number of reported chlamydia cases decreased. The decline was most pronounced in Norway 10.8% (2019: n = 28,446; 2020: n = 25,444) while it was only 3.1% in Denmark (2019: n = 35,688; 2020: n = 34,689) and 4.3% in Sweden (2019: n = 34,726; 2020: n = 33,339). Nucleic acid amplifications tests for chlamydia decreased in Sweden (10%) and Norway (18%) in 2020 compared to 2019, while in Denmark a 21% decrease was noted in April 2020 but thereafter increased to a higher level than 2019. The number of reported gonorrhoea cases decreased in Sweden (17%) and in Norway (39%) in 2020 compared to 2019, while a 21% increase was noted in Denmark. Conclusions Pandemic restrictions had an impact on the number of reported chlamydia infections in all three countries, but only temporarily and did not seem to be correlated to the restriction levels. The number of reported gonorrhoea infections in Sweden and Norway significantly decreased but not in Denmark. Pandemic restrictions appear to have had a limited effect on the spread of chlamydia and gonorrhoea.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"623 - 631"},"PeriodicalIF":5.8,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44837712","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 : 2022-05-06DOI: 10.1080/23744235.2022.2070273
E. Taherifard, Hamed Movahed, Sima Kiani Salmi, A. Taherifard, S. Abdollahifard, Erfan Taherifard
Abstract Background Dysfunction of both the innate and the adaptive immune systems is observed in severe coronavirus disease 2019 which, together with administration of immunosuppressive drugs, could lead to cytomegalovirus coinfection or reactivation associated with a poorer outcome. The current study aimed to systematically review the pattern, presentations, clinical course and outcome of patients with severe acute respiratory syndrome coronavirus 2 and cytomegalovirus coinfection. Methods Three online databases, PubMed, Scopus and Web of Science, were searched, and after excluding duplicates and irrelevant reports, eligible articles were identified. Information about patients’ age and gender, comorbidities, presentations of coronavirus disease 2019 and cytomegalovirus, treatment courses and outcomes were extracted. Results A total of 34 reports with 59 patients with coinfection were considered to be eligible for data extraction. A majority of patients were middle-aged or elderly (84.5%). More than three-fourths (79.2%) had at least one comorbidity. Cytomegalovirus viremia was documented in 43 patients. The most common end organ involved was the gastrointestinal tract in 13 patients (48.1% of 27 patients with end organ involvement), mostly as cytomegalovirus colitis, followed by the respiratory tract in 12 patients. There was a significant association between intubation and fatal outcome (p = .011). Conclusion We comprehensively reviewed published cases with coronavirus disease 2019 and cytomegalovirus reactivation. The findings may assist in appraising signs and symptoms for early suspicion, detection and treatment in patients with unusual clinical courses or with severe, prolonged or unexplained deterioration of end organ function.
摘要背景在2019年严重冠状病毒病中观察到先天免疫系统和适应性免疫系统的功能障碍，再加上免疫抑制药物的使用，可能导致巨细胞病毒合并感染或再激活，结果较差。本研究旨在系统回顾严重急性呼吸综合征冠状病毒2型和巨细胞病毒合并感染患者的模式、表现、临床病程和结果。方法检索PubMed、Scopus和Web of Science三个在线数据库，在排除重复和无关报道后，确定符合条件的文章。提取了患者的年龄和性别、合并症、2019冠状病毒病和巨细胞病毒的表现、治疗过程和结果等信息。结果共有34份报告，59名合并感染患者被认为符合数据提取条件。大多数患者是中老年人（84.5%）。超过四分之三（79.2%）的患者至少有一种合并症。43例患者出现巨细胞病毒血症。最常见的末端器官受累是13名患者的胃肠道（占27名末端器官受累患者的48.1%），主要是巨细胞病毒性结肠炎，其次是12名患者的呼吸道。插管与死亡结局之间存在显著相关性（p = .011）。结论我们全面回顾了已发表的2019冠状病毒病和巨细胞病毒再激活病例。这些发现可能有助于评估体征和症状，以便对临床病程异常或末端器官功能严重、长期或不明原因恶化的患者进行早期怀疑、检测和治疗。
{"title":"Cytomegalovirus coinfection in patients with severe acute respiratory syndrome coronavirus 2 infection: a systematic review of reported cases","authors":"E. Taherifard, Hamed Movahed, Sima Kiani Salmi, A. Taherifard, S. Abdollahifard, Erfan Taherifard","doi":"10.1080/23744235.2022.2070273","DOIUrl":"https://doi.org/10.1080/23744235.2022.2070273","url":null,"abstract":"Abstract Background Dysfunction of both the innate and the adaptive immune systems is observed in severe coronavirus disease 2019 which, together with administration of immunosuppressive drugs, could lead to cytomegalovirus coinfection or reactivation associated with a poorer outcome. The current study aimed to systematically review the pattern, presentations, clinical course and outcome of patients with severe acute respiratory syndrome coronavirus 2 and cytomegalovirus coinfection. Methods Three online databases, PubMed, Scopus and Web of Science, were searched, and after excluding duplicates and irrelevant reports, eligible articles were identified. Information about patients’ age and gender, comorbidities, presentations of coronavirus disease 2019 and cytomegalovirus, treatment courses and outcomes were extracted. Results A total of 34 reports with 59 patients with coinfection were considered to be eligible for data extraction. A majority of patients were middle-aged or elderly (84.5%). More than three-fourths (79.2%) had at least one comorbidity. Cytomegalovirus viremia was documented in 43 patients. The most common end organ involved was the gastrointestinal tract in 13 patients (48.1% of 27 patients with end organ involvement), mostly as cytomegalovirus colitis, followed by the respiratory tract in 12 patients. There was a significant association between intubation and fatal outcome (p = .011). Conclusion We comprehensively reviewed published cases with coronavirus disease 2019 and cytomegalovirus reactivation. The findings may assist in appraising signs and symptoms for early suspicion, detection and treatment in patients with unusual clinical courses or with severe, prolonged or unexplained deterioration of end organ function.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"543 - 557"},"PeriodicalIF":5.8,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45579756","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 : 2022-04-19DOI: 10.1080/23744235.2022.2064544
M. Sharif, S. Aslam, Z. Saleem
{"title":"Point prevalence survey to estimate antimicrobial use in a tertiary care university hospital in Pakistan using WHO methodology: findings and implications","authors":"M. Sharif, S. Aslam, Z. Saleem","doi":"10.1080/23744235.2022.2064544","DOIUrl":"https://doi.org/10.1080/23744235.2022.2064544","url":null,"abstract":"","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"698 - 701"},"PeriodicalIF":5.8,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42351795","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 : 2022-04-08DOI: 10.1080/23744235.2022.2060304
Gustav Mattsson, Margareta Gonzalez Lindh, R. Razmi, Mia Forslin, F. Parenmark, A. Bandert, C. Ehrenborg, A. Palm
Abstract Background The coronavirus disease 2019 pandemic makes proper resource allocation and prioritisation important. Frailty increases the risk of adverse outcomes and can be quantified using the Clinical frailty scale. The aim of this study was to determine the role of the Clinical frailty scale, in patients ≥65 years of age with coronavirus disease 2019, as a risk factor either for critical coronavirus disease 2019 measured as intensive care unit admission or death or as a risk factor for death. Methods This was a retrospective observational study on patients ≥65 years hospitalised with coronavirus disease 2019 verified by polymerase chain reaction between 5 March 5 and 5 July 2020. The association between Clinical frailty scale and the composite primary outcome intensive care unit admission or death within 30 days post hospitalisation and the secondary outcome death within 30 days post hospitalisation was analysed using multivariable logistic regression models adjusting for gender, age, body mass index, hypertension, and diabetes. Clinical frailty scale was used as a categorical variable (fit score 1–4, frail score 5–6, and severely frail score 7–9). Results In total, 169 patients were included (47.3% women, mean age 79.2 ± 7.8 years). In the fully adjusted model, adjusted odds ratio for intensive care unit admission or death was 1.84 (95%-confidence interval 0.67–5.03, p = .234) for frail and 6.08 (1.70–21.81, p = .006) for severely frail compared to fit patients. For death, adjusted odds ratio was 2.81 (0.89–8.88, p = .079) for frail and 9.82 (2.53–38.10, p = .001) for severely frail compared to fit patients. Conclusions A high Clinical frailty scale score was an independent risk factor for the composite outcome intensive care unit admission or death and for the secondary outcome death.
{"title":"Clinical frailty scale as a predictor of disease severity in patients hospitalised with COVID-19 – an observational cohort study","authors":"Gustav Mattsson, Margareta Gonzalez Lindh, R. Razmi, Mia Forslin, F. Parenmark, A. Bandert, C. Ehrenborg, A. Palm","doi":"10.1080/23744235.2022.2060304","DOIUrl":"https://doi.org/10.1080/23744235.2022.2060304","url":null,"abstract":"Abstract Background The coronavirus disease 2019 pandemic makes proper resource allocation and prioritisation important. Frailty increases the risk of adverse outcomes and can be quantified using the Clinical frailty scale. The aim of this study was to determine the role of the Clinical frailty scale, in patients ≥65 years of age with coronavirus disease 2019, as a risk factor either for critical coronavirus disease 2019 measured as intensive care unit admission or death or as a risk factor for death. Methods This was a retrospective observational study on patients ≥65 years hospitalised with coronavirus disease 2019 verified by polymerase chain reaction between 5 March 5 and 5 July 2020. The association between Clinical frailty scale and the composite primary outcome intensive care unit admission or death within 30 days post hospitalisation and the secondary outcome death within 30 days post hospitalisation was analysed using multivariable logistic regression models adjusting for gender, age, body mass index, hypertension, and diabetes. Clinical frailty scale was used as a categorical variable (fit score 1–4, frail score 5–6, and severely frail score 7–9). Results In total, 169 patients were included (47.3% women, mean age 79.2 ± 7.8 years). In the fully adjusted model, adjusted odds ratio for intensive care unit admission or death was 1.84 (95%-confidence interval 0.67–5.03, p = .234) for frail and 6.08 (1.70–21.81, p = .006) for severely frail compared to fit patients. For death, adjusted odds ratio was 2.81 (0.89–8.88, p = .079) for frail and 9.82 (2.53–38.10, p = .001) for severely frail compared to fit patients. Conclusions A high Clinical frailty scale score was an independent risk factor for the composite outcome intensive care unit admission or death and for the secondary outcome death.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"583 - 590"},"PeriodicalIF":5.8,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45242572","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 : 2022-04-08DOI: 10.1080/23744235.2022.2059561
A. García‐Salido, I. Leoz-Gordillo, A. González Brabin, M. Garcia-Teresa, Amelia Martínez-de-Azagra-Garde, M. Iglesias-Bouzas, M. Cabrero-Hernández, G. de Lama Caro-Patón, J. L. Unzueta-Roch, A. Castillo-Robleda, M. Ramírez‐Orellana, M. Nieto-Moro
Abstract Background A new clinical syndrome named Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) has been described. This new disease is a leading cause of hospital and paediatric intensive care unit (PICU). It has been related to immunity dysregulation. Methods Prospective-retrospective observational study to describe the innate cell signature and immunophenotype of children admitted to PICU because of PIMS-TS (from March 2020 to September 2020). The immunophenotype was done through the expression analysis of these proteins of mononuclear cells: CD64, CD18, CD11a and CD11b. They were compared with previous healthy controls and children admitted to PICU because of bacterial infection, viral infection and Kawasaki disease (KD). Two hundred and forty-seven children were studied: 183 healthy controls, 25 viral infections, 20 bacterial infections, 6 KD and 13 PIMS-TS. Results PIMT-TS showed the lowest percentage of lymphocytes and monocytes with higher relative numbers of CD4+ (p = .000). Monocytes and neutrophils in PIMS-TS showed higher levels of CD64 expression (p = .000). Also, CD11a and CD11b were highly expressed (p =,000). Conclusion We observed a differential cell innate signature in PIMS-TS. These findings are consistent with a proinflammatory status (CD64 elevated expression) and lymphocyte trafficking to tissues (CD11a and CD11b). More studies should be carried out to confirm our results.
{"title":"PIMS-TS immunophenotype: description and comparison with healthy children, Kawasaki disease and severe viral and bacterial infections","authors":"A. García‐Salido, I. Leoz-Gordillo, A. González Brabin, M. Garcia-Teresa, Amelia Martínez-de-Azagra-Garde, M. Iglesias-Bouzas, M. Cabrero-Hernández, G. de Lama Caro-Patón, J. L. Unzueta-Roch, A. Castillo-Robleda, M. Ramírez‐Orellana, M. Nieto-Moro","doi":"10.1080/23744235.2022.2059561","DOIUrl":"https://doi.org/10.1080/23744235.2022.2059561","url":null,"abstract":"Abstract Background A new clinical syndrome named Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) has been described. This new disease is a leading cause of hospital and paediatric intensive care unit (PICU). It has been related to immunity dysregulation. Methods Prospective-retrospective observational study to describe the innate cell signature and immunophenotype of children admitted to PICU because of PIMS-TS (from March 2020 to September 2020). The immunophenotype was done through the expression analysis of these proteins of mononuclear cells: CD64, CD18, CD11a and CD11b. They were compared with previous healthy controls and children admitted to PICU because of bacterial infection, viral infection and Kawasaki disease (KD). Two hundred and forty-seven children were studied: 183 healthy controls, 25 viral infections, 20 bacterial infections, 6 KD and 13 PIMS-TS. Results PIMT-TS showed the lowest percentage of lymphocytes and monocytes with higher relative numbers of CD4+ (p = .000). Monocytes and neutrophils in PIMS-TS showed higher levels of CD64 expression (p = .000). Also, CD11a and CD11b were highly expressed (p =,000). Conclusion We observed a differential cell innate signature in PIMS-TS. These findings are consistent with a proinflammatory status (CD64 elevated expression) and lymphocyte trafficking to tissues (CD11a and CD11b). More studies should be carried out to confirm our results.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"54 1","pages":"687 - 691"},"PeriodicalIF":5.8,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45434878","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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