Infectious Diseases最新文献_第6页

Mortality of COVID-19 is associated with comorbidity in patients with chronic obstructive pulmonary disease 慢性阻塞性肺疾病患者的COVID-19死亡率与合并症相关

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-03-14 DOI: 10.1080/23744235.2022.2050422

N. Andreen, L. Andersson, N. Sundell, L. Gustavsson, J. Westin

Abstract Background The aim of this study was to compare the outcome of coronavirus disease 2019 (COVID-19) in hospitalised patients with chronic obstructive pulmonary disease (COPD) with the outcome in matched COVID-19 patients without COPD. Methods Sixty-three COPD patients hospitalised for acute COVID-19 from March through August 2020 were retrospectively identified and 63 hospitalised COVID-19 patients without COPD were selected and matched for age, gender and month of hospital admission. Results COPD patients had a higher rate of comorbidities, especially cardiovascular disease, and a trend towards a higher 30-day mortality than control patients (35% vs. 22%). In the COPD group, high Charlson comorbidity index (p = 0.03) and previous cerebrovascular disease (p = 0.04) were associated with 30-day mortality in univariate analysis. Inhaled corticosteroids maintenance therapy was not associated with lower mortality. Conclusion COPD patients hospitalised for acute COVID-19 disease had significantly more comorbidities and a high risk of severe outcome and death within 30 days. Comorbidity, especially cardiovascular diseases, was associated with mortality among COPD patients.

摘要背景本研究的目的是比较2019冠状病毒病（新冠肺炎）在慢性阻塞性肺病（COPD）住院患者中的结果与匹配的无COPD的新冠肺炎患者的结果。方法回顾性分析2020年3月至8月因急性新冠肺炎住院的63例慢阻肺患者，选择63例非慢阻肺住院的新冠肺炎患者，并对其年龄、性别和住院月份进行匹配。结果COPD患者合并症发生率较高，尤其是心血管疾病，30天死亡率高于对照组（35%对22%）。在COPD组中，高Charlson合并症指数（p = 0.03）和既往脑血管疾病（p = 0.04）与30天死亡率相关。吸入皮质类固醇维持治疗与降低死亡率无关。结论因急性新冠肺炎疾病住院的COPD患者在30天内合并症明显增多，严重后果和死亡风险较高天。合并症，尤其是心血管疾病，与COPD患者的死亡率相关。

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引用次数: 6

Untargeted lipidomic differences between clinical strains of methicillin-sensitive and methicillin-resistant Staphylococcus aureus 甲氧西林敏感和耐甲氧西林金黄色葡萄球菌临床菌株非靶向脂质组学差异

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-03-11 DOI: 10.1080/23744235.2022.2049863

Philip Nikolic, Poonam Mudgil, D. Harman, J. Whitehall

Abstract Background Staphylococcus aureus is a common cause of infectious diseases in humans. It has become resistant to many antibacterial agents making management of infections difficult. A better understanding of differences among S. aureus strains that are sensitive and resistant to antibiotics may offer insights into the resistant phenotype and identify new antimicrobial targets. This study aimed at comparing general differences in lipid profiles among clinical strains of S. aureus sensitive and resistant to antibiotics. The cell wall thickness and cell surface charge were also compared. Methods Five methicillin sensitive (MSSA) and five methicillin resistant (MRSA) S. aureus strains were compared both individually and as MSSA and MRSA groups in the absence of antibiotics. Lipids were compared by ultra-performance liquid chromatography-mass spectrometry, cell wall thickness was compared by scanning transmission electron microscopy and whole-cell surface charge was compared using a cytochrome c binding assay. Results Twenty-two lipid species were identified in all ten strains of S. aureus. The abundance of three lipid species (two lysyl-phosphatidylglycerol and one diglycosyldiacylglycerol) were found to be different between MSSA and MRSA. Differences in cell wall thickness were identified between strains but not between MSSA and MRSA. No difference in whole-cell surface charge was observed between MSSA and MRSA. Conclusion This study shows differences in membrane lipids between antibiotic sensitive and antibiotic resistant clinical strains of S aureus that may affect resistance mechanisms related to cell membrane structure and fluidity. Further research on these differences may identify new drug targets against resistant strains.

摘要背景金黄色葡萄球菌是人类感染性疾病的常见病因。它已对许多抗菌剂产生耐药性，使感染管理变得困难。更好地了解对抗生素敏感和耐药的金黄色葡萄球菌菌株之间的差异可能有助于了解耐药表型并确定新的抗菌靶点。本研究旨在比较对抗生素敏感和耐药的金黄色葡萄球菌临床菌株的脂质谱的一般差异。比较了细胞壁厚度和细胞表面电荷。方法对5株甲氧西林敏感(MSSA)金黄色葡萄球菌和5株耐药(MRSA)金黄色葡萄球菌进行单独比较，并在无抗生素情况下分别作为MSSA组和MRSA组进行比较。用超高效液相色谱-质谱法比较脂质，用扫描透射电镜比较细胞壁厚度，用细胞色素c结合法比较全细胞表面电荷。结果10株金黄色葡萄球菌共鉴定出22种脂质。三种脂类(两种赖基磷脂酰甘油和一种二糖基二酰甘油)的丰度在MSSA和MRSA之间存在差异。菌株之间细胞壁厚度存在差异，但MSSA与MRSA之间没有差异。msa和MRSA在全细胞表面电荷上没有差异。结论临床金黄色葡萄球菌对抗生素敏感和耐药菌株的膜脂含量存在差异，可能影响其耐药机制与细胞膜结构和流动性有关。对这些差异的进一步研究可能会发现针对耐药菌株的新药物靶点。

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引用次数: 7

Risk stratification score screening for infective endocarditis in patients with Gram-positive bacteraemia 革兰氏阳性菌血症患者感染性心内膜炎的风险分层评分筛查

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-03-11 DOI: 10.1080/23744235.2022.2049360

H. Lindberg, Emma Löfström, M. Rasmussen

Abstract Background A feared cause of bacteraemia with Gram-positives is infective endocarditis. Risk stratification scores can aid clinicians in determining the risk of endocarditis. Six proposed scores for the use in bacteraemia; Staphylococcus aureus (PREDICT, VIRSTA, POSITIVE), non-β-haemolytic streptococci (HANDOC) and Enterococcus faecalis (NOVA, DENOVA) were validated for predictive ability and the utilization of echocardiography was investigated. Methods Hospitalized adult patients with Gram-positive bacteraemia during 2017–2019 were evaluated retrospectively through medical records and the Swedish Death Registry. Baseline and score-specific data, definite endocarditis and echocardiographies performed were recorded. Sensitivity, specificity, negative and positive predictive values and echocardiography utilization were determined. Results 480 patients with bacteraemia were included and definite endocarditis was diagnosed in 20 (7.5%), 10 (6.6%), and 2 (3.2%) patients with S. aureus, non-β-haemolytic streptococci and E. faecalis, respectively. The sensitivities of the scores were 80–100% and specificities 8–77%. Negative predictive values of the six scores were 98–100%. VIRSTA, HANDOC, NOVA and DENOVA identified all, the PREDICT5 score missed 1/20 and the POSITIVE score missed 4/20 cases of endocarditis. Transoesophageal echocardiography was performed in 141 patients (29%). Thus, the risk stratification scores suggested an increase of 3–63 (7–77%) investigations with echocardiography. Conclusions All scores had negative-predictive values over 98%, therefore it can be concluded that PREDICT5, VIRSTA, POSITIVE, HANDOC and DENOVA are reasonable screening tools for endocarditis early on in Gram-positive bacteraemia. The use of risk stratification scores will lead to more echocardiographies.

背景:感染性心内膜炎是引起革兰氏阳性菌血症的一个令人担忧的原因。风险分层评分可以帮助临床医生确定心内膜炎的风险。推荐用于菌血症的6个评分;验证了金黄色葡萄球菌(PREDICT, VIRSTA, POSITIVE)、非β溶血性链球菌(HANDOC)和粪肠球菌(NOVA, DENOVA)的预测能力，并对超声心动图的应用进行了研究。方法通过医疗记录和瑞典死亡登记处对2017-2019年住院的革兰氏阳性菌血症成年患者进行回顾性评估。记录基线和评分特异性数据，明确的心内膜炎和超声心动图检查。测定灵敏度、特异度、阴性和阳性预测值及超声心动图利用率。结果共纳入480例菌血症患者，确诊心内膜炎患者分别为金黄色葡萄球菌20例(7.5%)、非β溶血性链球菌10例(6.6%)、粪肠球菌2例(3.2%)。评分敏感性80 ~ 100%，特异性8 ~ 77%。6项评分的阴性预测值为98 ~ 100%。VIRSTA、HANDOC、NOVA和DENOVA均未发现，PREDICT5评分漏报1/20,POSITIVE评分漏报4/20。141例(29%)患者行经食管超声心动图检查。因此，风险分层评分显示超声心动图检查增加了3-63例(7-77%)。结论所有评分的阴性预测值均在98%以上，因此可以认为PREDICT5、VIRSTA、POSITIVE、HANDOC和DENOVA是革兰氏阳性菌血症早期心内膜炎的合理筛查工具。风险分层评分的使用将导致更多的超声心动图检查。

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引用次数: 3

Assessment of the feasibility of pool testing for SARS-CoV-2 infection screening SARS-CoV-2感染筛查池检测可行性评价

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-03-03 DOI: 10.1080/23744235.2022.2044512

Irene Paganini, C. Sani, Chiara Chilleri, M. Baccini, Alberto Antonelli, S. Bisanzi, E. Burroni, F. Cellai, M. Coppi, F. Mealli, G. Pompeo, Jessica Viti, G. Rossolini, F. Carozzi

Abstract Background SARS-CoV-2 pandemic represented a huge challenge for national health systems worldwide. Pooling nasopharyngeal (NP) swabs seems to be a promising strategy, saving time and resources, but it could reduce the sensitivity of the RT-PCR and exacerbate samples management in terms of automation and tracing. In this study, taking advantage of the routine implementation of a screening plan on health workers, we evaluated the feasibility of pool testing for SARS-CoV-2 infection diagnosis in the presence of low viral load samples. Method Pools were prepared with an automated instrument, mixing 4, 6 or 20 NP specimens, including one, two or none positive samples. Ct values of positive samples were on average about 35 for the four genes analyzed. Results The overall sensitivity of 4-samples and 6-samples pools was 93.1 and 90.0%, respectively. Focussing on pools including one sample with Ct value ≥35 for all analyzed genes, sensitivity decreased to 77.8 and 75.0% for 4- and 6-samples, respectively; pools including two positive samples, resulted positive in any size as well as pools including positive samples with Ct values <35. Conclusion Pool testing strategy should account the balance between cost-effectiveness, dilution effect and prevalence of the infection. Our study demonstrated the good performances in terms of sensitivity and saving resources of pool testing mixing 4 or 6 samples, even including low viral load specimens, in a real screening context possibly affected by prevalence fluctuation. In conclusion, pool testing strategy represents an efficient and resources saving surveillance and tracing tool, especially in specific context like schools, even for monitoring changes in prevalence associated to vaccination campaign.

背景SARS-CoV-2大流行是全球各国卫生系统面临的巨大挑战。汇集鼻咽拭子似乎是一种很有前途的策略，可以节省时间和资源，但它可能降低RT-PCR的敏感性，并在自动化和追踪方面加剧样本管理。在本研究中，利用卫生工作者筛查计划的常规实施，我们评估了在存在低病毒载量样本的情况下进行SARS-CoV-2感染诊断的池检测的可行性。方法用自动仪器配制池，混合4、6或20份NP标本，包括1份、2份或无阳性标本。阳性样本的Ct值平均约为35。结果4个样本池和6个样本池的总灵敏度分别为93.1%和90.0%。当所有分析基因的Ct值≥35的样本均为一个样本时，4个样本和6个样本的敏感性分别降至77.8和75.0%;包含两个阳性样本的池，结果为任何大小的阳性样本，以及包含Ct值<35的阳性样本的池。结论池检测策略应兼顾成本-效果、稀释效应和感染流行之间的平衡。我们的研究表明，在可能受流行率波动影响的真实筛选环境中，混合4或6个样本(甚至包括低病毒载量样本)的池检测在灵敏度和节省资源方面具有良好的性能。总之，集中检测战略是一种有效和节省资源的监测和追踪工具，特别是在学校等特定环境中，甚至用于监测与疫苗接种运动相关的流行率变化。

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引用次数: 1

Epidemiology and Risk Factors of Healthcare-Associated Infections in Critically Ill Patients in a Tertiary Care Teaching Hospital in Nepal: A Prospective Cohort Study. 尼泊尔三级护理教学医院危重病人卫生保健相关感染的流行病学和危险因素:一项前瞻性队列研究

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-01-25 eCollection Date: 2022-01-01 DOI: 10.1177/11786337211071120

Sailesh Kumar Shrestha, Andrew Trotter, Pradeep Krishna Shrestha

Background: Healthcare-associated infection (HAI) is an important public health problem, particularly in intensive care units (ICUs). We aimed to examine the epidemiology and risk factors of HAIs in our ICUs and study their microbiological profile.

Methods: We evaluated 100 consecutive patients in 3 medical and surgical ICUs of a tertiary care teaching hospital daily starting in January 2016 using the Centers for Disease Control and Prevention definitions and methods. We determined the incidence and sites of HAIs, identified the causative microorganism, and studied their antibiotic sensitivity profiles. We investigated risk factors for the development of an HAI using a multiple logistic regression model.

Results: Of 300 patients, 129 patients (43%) developed HAIs (55.96 HAI events per 1000 ICU-days). Pneumonia was the most common type of HAI (57, 41%). Escherichia coli was the most frequently isolated microorganism (20, 29%) and 74% of the pathogens isolated were multi-drug resistant. The presence of an invasive device (Odds Ratio, 4.29; 95% Confidence Interval, 2.52-7.51) and use of sedation (Odds Ratio, 2.24; 95% Confidence Interval, 1.31-3.87) were the statistically significant risk factors for HAIs.

Conclusions: We found a high incidence of HAIs in our ICUs and a high burden of multidrug-resistant microorganisms highlighting the importance of infection control and antibiotic stewardship.

背景:医疗保健相关感染(HAI)是一个重要的公共卫生问题，特别是在重症监护病房(icu)。我们的目的是检查icu中HAIs的流行病学和危险因素，并研究其微生物谱。方法:自2016年1月起，采用美国疾病控制与预防中心的定义和方法，对某三级教学医院3个内科和外科icu每天连续100例患者进行评估。我们确定了HAIs的发生率和部位，鉴定了致病微生物，并研究了它们的抗生素敏感性谱。我们使用多元逻辑回归模型调查了HAI发展的危险因素。结果:300例患者中，129例(43%)发生HAIs(每1000 icu天发生55.96例HAI事件)。肺炎是最常见的HAI类型(57,41%)。大肠杆菌是最常见的分离微生物(20.29%)，74%的分离病原菌为多药耐药。有创装置的存在(优势比，4.29;95%可信区间，2.52-7.51)和镇静的使用(优势比，2.24;95%可信区间(1.31-3.87)为HAIs的有统计学意义的危险因素。结论:我们发现重症监护病房中HAIs的发生率很高，多重耐药微生物的负担也很高，这突出了感染控制和抗生素管理的重要性。

{"title":"Epidemiology and Risk Factors of Healthcare-Associated Infections in Critically Ill Patients in a Tertiary Care Teaching Hospital in Nepal: A Prospective Cohort Study.","authors":"Sailesh Kumar Shrestha, Andrew Trotter, Pradeep Krishna Shrestha","doi":"10.1177/11786337211071120","DOIUrl":"https://doi.org/10.1177/11786337211071120","url":null,"abstract":"Background: Healthcare-associated infection (HAI) is an important public health problem, particularly in intensive care units (ICUs). We aimed to examine the epidemiology and risk factors of HAIs in our ICUs and study their microbiological profile.Methods: We evaluated 100 consecutive patients in 3 medical and surgical ICUs of a tertiary care teaching hospital daily starting in January 2016 using the Centers for Disease Control and Prevention definitions and methods. We determined the incidence and sites of HAIs, identified the causative microorganism, and studied their antibiotic sensitivity profiles. We investigated risk factors for the development of an HAI using a multiple logistic regression model.Results: Of 300 patients, 129 patients (43%) developed HAIs (55.96 HAI events per 1000 ICU-days). Pneumonia was the most common type of HAI (57, 41%). Escherichia coli was the most frequently isolated microorganism (20, 29%) and 74% of the pathogens isolated were multi-drug resistant. The presence of an invasive device (Odds Ratio, 4.29; 95% Confidence Interval, 2.52-7.51) and use of sedation (Odds Ratio, 2.24; 95% Confidence Interval, 1.31-3.87) were the statistically significant risk factors for HAIs.Conclusions: We found a high incidence of HAIs in our ICUs and a high burden of multidrug-resistant microorganisms highlighting the importance of infection control and antibiotic stewardship.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"15 ","pages":"11786337211071120"},"PeriodicalIF":5.8,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/89/10.1177_11786337211071120.PMC8793418.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39733764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Plasmid Carrying bla _CTX-M-15, bla _PER-1, and bla _TEM-1 Genes in Citrobacter spp. From Regional Hospital in Mexico. 墨西哥地区医院柠檬酸杆菌中携带bla CTX-M-15、bla PER-1和bla TEM-1基因的质粒

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-01-18 eCollection Date: 2022-01-01 DOI: 10.1177/11786337211065750

Cindy Negrete-González, Edgar Turrubiartes-Martínez, Miriam Briano-Macias, Daniel Noyola, Luis Fernando Pérez-González, Roberto González-Amaro, Perla Niño-Moreno

Introduction: Citrobacter spp. is an opportunistic bacteria that have been recognized as significant pathogens in patients with underlying diseases or immunocompromised status. The aim of this study was to identify extended-spectrum β-lactamases in clinical isolates of Citrobacter spp.

Methods: This cross-sectional study was conducted at Hospital Central "Dr. Ignacio Morones Prieto" in San Luis Potosi, Mexico. Nineteen isolates of Citrobacter spp. were obtained from clinical specimens between April to December 2015. Four isolates were resistant to third-generation cephalosporins. The presence of genes encoding ESBL (bla _CTX-M-15, bla _TEM-1, bla _VEB-1, bla _SHV, and bla _PER-1) was analyzed by PCR. For this purpose, plasmid DNA was extracted and horizontally transferred to recipient E. coli Top 10.

Results: bla _CTX-M-15 and bla _VEB-1 genes were detected in Citrobacter freundii and Citrobacter sedlakii, whereas bla _PER-1 gene was identified in 1 isolate of Citrobacter freundii. In contrast, bla _SHV gene was not detected in any isolate. One strain carried bla _CTX-M-15, bla _TEM-1, bla _VEB-1, and bla _PER-1 genes, most in a 275-kb plasmid.

Conclusion: This study shows the presence of different types of ESBL in clinical isolates of Citrobacter freundii and Citrobacter sedlakii, which confer resistance to broad-spectrum β-lactams. The plasmid identified in this study harboring ESBL genes could play an important role in the dissemination of antibiotic resistance.

柠檬酸杆菌是一种机会性细菌，已被认为是潜在疾病或免疫功能低下患者的重要病原体。本研究的目的是鉴定临床分离的柠檬酸杆菌属的广谱β-内酰胺酶。方法:本横断面研究在墨西哥圣路易斯波托西的中心医院“Dr. Ignacio Morones Prieto”进行。2015年4 - 12月从临床标本中分离到枸橼酸杆菌19株。4株对第三代头孢菌素耐药。PCR分析ESBL编码基因(bla CTX-M-15、bla TEM-1、bla VEB-1、bla SHV和bla PER-1)的存在。为此，提取质粒DNA并水平转移到受体大肠杆菌Top 10。结果:在弗氏Citrobacter freundii和Citrobacter sedlakii中检测到bla CTX-M-15和bla VEB-1基因，在1株弗氏Citrobacter freundii分离物中检测到bla PER-1基因。相比之下，bla SHV基因未在任何分离物中检测到。其中一个菌株携带bla CTX-M-15、bla TEM-1、bla VEB-1和bla PER-1基因，大部分在一个275 kb的质粒中。结论:本研究表明，临床分离的弗氏Citrobacter freundii和Citrobacter sedlakii存在不同类型的ESBL，这使得它们对广谱β-内酰胺具有耐药性。本研究中发现的含有ESBL基因的质粒可能在抗生素耐药性的传播中发挥重要作用。

{"title":"Plasmid Carrying bla CTX-M-15, bla PER-1, and bla TEM-1 Genes in Citrobacter spp. From Regional Hospital in Mexico.","authors":"Cindy Negrete-González, Edgar Turrubiartes-Martínez, Miriam Briano-Macias, Daniel Noyola, Luis Fernando Pérez-González, Roberto González-Amaro, Perla Niño-Moreno","doi":"10.1177/11786337211065750","DOIUrl":"https://doi.org/10.1177/11786337211065750","url":null,"abstract":"Introduction: Citrobacter spp. is an opportunistic bacteria that have been recognized as significant pathogens in patients with underlying diseases or immunocompromised status. The aim of this study was to identify extended-spectrum β-lactamases in clinical isolates of Citrobacter spp.Methods: This cross-sectional study was conducted at Hospital Central \"Dr. Ignacio Morones Prieto\" in San Luis Potosi, Mexico. Nineteen isolates of Citrobacter spp. were obtained from clinical specimens between April to December 2015. Four isolates were resistant to third-generation cephalosporins. The presence of genes encoding ESBL (bla CTX-M-15, bla TEM-1, bla VEB-1, bla SHV, and bla PER-1) was analyzed by PCR. For this purpose, plasmid DNA was extracted and horizontally transferred to recipient E. coli Top 10.Results: bla CTX-M-15 and bla VEB-1 genes were detected in Citrobacter freundii and Citrobacter sedlakii, whereas bla PER-1 gene was identified in 1 isolate of Citrobacter freundii. In contrast, bla SHV gene was not detected in any isolate. One strain carried bla CTX-M-15, bla TEM-1, bla VEB-1, and bla PER-1 genes, most in a 275-kb plasmid.Conclusion: This study shows the presence of different types of ESBL in clinical isolates of Citrobacter freundii and Citrobacter sedlakii, which confer resistance to broad-spectrum β-lactams. The plasmid identified in this study harboring ESBL genes could play an important role in the dissemination of antibiotic resistance.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"15 ","pages":"11786337211065750"},"PeriodicalIF":5.8,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/81/10.1177_11786337211065750.PMC8771733.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39962609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia. 埃塞俄比亚东部公共卫生机构医护人员中HBV血清流行率及其相关因素

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-01-08 eCollection Date: 2022-01-01 DOI: 10.1177/11786337211062622

Degu Abate, Abebe Tolera, Behailu Hawulte, Tewodros Tesfa, Ayele Geleto

Background: Healthcare providers are in high occupational risk of Hepatitis B virus infection than that of the general population because of the high risk of occupational exposure to patients' body fluids and accidental sharp injuries. There are no large facility-based studies conducted on the prevalence of HBV infection and its associated factors among health care providers in eastern Ethiopia.

Objective: This study aimed at investigating the seroprevalence of Hepatitis B Virus and its associated factors among the healthcare providers in public health facilities in eastern Ethiopia.

Methods: A facility-based cross-sectional study was conducted among 438 randomly selected healthcare providers in eastern Ethiopia from March to June 2018. Pretested structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. In addition, a 2.5 ml blood was collected and the serum was analyzed for Hepatitis B surface antigen using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Descriptive summary measures were used. Bivariate and multivariable logistic regression was conducted at 95% CI. An association at P-value <.05 was considered statistically significant.

Results: A total of 438 (92.02% response rate) health care providers have participated in this study. The prevalence of hepatitis B virus infection was 9.6%. There were no significant differences in the HBV infection rates among healthcare providers with respect to socio-demographic characteristics (P-value >.05). After adjusting for some variables, the following variables remained statistically significantly associated with HBsAg positive result in the multivariable analysis: exposure to body fluids (AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury (AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery (AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner (AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95% CI [2.75, 13.51]).

Conclusion: This study showed a high prevalence of HBV infection among health care providers in eastern Ethiopia. This is significant because health professionals may be at increased risk of chronic complications and may also be source of infection for their clients and general population during their healthcare practice. Management commitment that should focus on occupational safety and health promotions is necessary.

背景:由于职业接触患者体液和意外锐器伤害的高风险，卫生保健提供者比一般人群具有较高的乙型肝炎病毒感染职业风险。在埃塞俄比亚东部的卫生保健提供者中，没有对乙型肝炎病毒感染的流行及其相关因素进行大规模的以设施为基础的研究。目的:本研究旨在调查乙型肝炎病毒的血清阳性率及其相关因素在埃塞俄比亚东部公共卫生机构的卫生保健提供者。方法:2018年3月至6月，在埃塞俄比亚东部随机选择438名医疗服务提供者进行了一项基于设施的横断面研究。采用预先测试的结构化问卷收集社会人口特征和其他危险因素的数据。此外，采集2.5 ml血液，使用即时乙肝表面抗原试剂盒分析血清乙型肝炎表面抗原。使用Epidata 3.1版本录入数据，使用SPSS 22版本统计软件包进行分析。采用描述性总结测量法。双变量和多变量logistic回归为95% CI。p值相关性结果:共有438名卫生保健提供者参与了本研究(有效率为92.02%)。乙型肝炎病毒感染率为9.6%。医护人员HBV感染率在社会人口学特征方面无显著差异(p值> 0.05)。在对一些变量进行调整后，在多变量分析中，以下变量与HBsAg阳性结果仍有统计学显著相关:暴露于体液(AOR = 3.0;95% CI[1.25, 7.05])、针刺损伤史(AOR = 4.70;95% CI[2.10, 10.55])、手术/手术史(AOR = 4.88, 95% CI[1.43, 16.62])、多个性伴侣史(AOR = 7.48;95% CI[2.08, 26.96])和未接种疫苗(AOR = 6.09;95% ci[2.75, 13.51])。结论:这项研究表明，在埃塞俄比亚东部的卫生保健提供者中HBV感染的流行率很高。这一点很重要，因为卫生专业人员在其保健实践中可能面临慢性并发症的风险增加，也可能成为其客户和一般人群的感染源。管理承诺应侧重于职业安全和健康促进，这是必要的。

{"title":"Sero-Prevalence of HBV and its Associated Factors Among Healthcare Providers in Public Health Facilities in Eastern Ethiopia.","authors":"Degu Abate, Abebe Tolera, Behailu Hawulte, Tewodros Tesfa, Ayele Geleto","doi":"10.1177/11786337211062622","DOIUrl":"https://doi.org/10.1177/11786337211062622","url":null,"abstract":"Background: Healthcare providers are in high occupational risk of Hepatitis B virus infection than that of the general population because of the high risk of occupational exposure to patients' body fluids and accidental sharp injuries. There are no large facility-based studies conducted on the prevalence of HBV infection and its associated factors among health care providers in eastern Ethiopia.Objective: This study aimed at investigating the seroprevalence of Hepatitis B Virus and its associated factors among the healthcare providers in public health facilities in eastern Ethiopia.Methods: A facility-based cross-sectional study was conducted among 438 randomly selected healthcare providers in eastern Ethiopia from March to June 2018. Pretested structured questionnaire was used to collect data on socio-demographic characteristics and other risk factors. In addition, a 2.5 ml blood was collected and the serum was analyzed for Hepatitis B surface antigen using the Instant Hepatitis B surface antigen kit. Data were entered using Epidata version 3.1 and analyzed using SPSS statistical packages version 22. Descriptive summary measures were used. Bivariate and multivariable logistic regression was conducted at 95% CI. An association at P-value <.05 was considered statistically significant.Results: A total of 438 (92.02% response rate) health care providers have participated in this study. The prevalence of hepatitis B virus infection was 9.6%. There were no significant differences in the HBV infection rates among healthcare providers with respect to socio-demographic characteristics (P-value >.05). After adjusting for some variables, the following variables remained statistically significantly associated with HBsAg positive result in the multivariable analysis: exposure to body fluids (AOR = 3.0; 95% CI [1.25, 7.05]), history of needle stick injury (AOR = 4.70; 95% CI [2.10, 10.55]), history of operation/surgery (AOR = 4.88, 95% CI [1.43, 16.62]), history of multiple sexual partner (AOR = 7.48; 95% CI [2.08, 26.96]), and being unvaccinated (AOR = 6.09; 95% CI [2.75, 13.51]).Conclusion: This study showed a high prevalence of HBV infection among health care providers in eastern Ethiopia. This is significant because health professionals may be at increased risk of chronic complications and may also be source of infection for their clients and general population during their healthcare practice. Management commitment that should focus on occupational safety and health promotions is necessary.","PeriodicalId":13671,"journal":{"name":"Infectious Diseases","volume":"15 ","pages":"11786337211062622"},"PeriodicalIF":5.8,"publicationDate":"2022-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/a2/10.1177_11786337211062622.PMC8744165.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39816310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Confirmed SARS-CoV-2 Reinfection After 1 Year in a Patient with X-linked Agammaglobulinaemia 1例x连锁无球蛋白血症患者1年后确诊的SARS-CoV-2再感染

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-01-01 DOI: 10.17925/id.2022.1.1.35

G. Rieke, M. Monin, S. Breitschwerdt, C. Boesecke, S. Schlabe

Though a comprehensive analysis of the immunity following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been performed, little is known about the duration of this protection and the risk of reinfection. This lack of knowledge is of particular interest for patients with impaired immune function. In this report, we describe the course of infection of a 30-year-old male patient with X-linked agammaglobulinaemia, who was reinfected with SARS-CoV-2 after a primary infection 12 months earlier. The initial course of infection took place in April 2020 with the typical symptoms of an upper respiratory tract infection accompanied by compatible changes in laboratory values and computed tomography. With no anti-viral treatment options at that time of the pandemic, only symptomatic therapy could be offered. Twelve months later (April 2021), the patient presented with a short course of fever and headache. Laboratory testing showed elevated C-reactive protein levels, while leukocytes, lymphocytes and lactate dehydrogenase levels were within range. The patient was admitted, and antibiotic treatment was started partially because procalcitonin levels were slightly elevated as well. The SARS-CoV-2 polymerase chain reaction was positive, and therapy with the monoclonal SARS-CoV-2 antibodies casirivimab/imdevimab (1,200 mg/1,200 mg, respectively) were initiated. The course of infection was mild, but low-flow oxygen had to be administered. It was not possible to distinguish between the contribution of the administered antibodies and the role of cytotoxic T-cells in the course of infection. Variant screenings confirmed the Wuhan strain of the virus for the first episode and the alpha variant for the second episode, thus confirming reinfection and ruling out long-term shedding. Neutralizing antibodies seem to play a crucial role in viral clearance and infection prevention, assuming patients with agammaglobulinaemia are at higher risk for a severe course of coronavirus disease 2019. Still, the specific role of neutralizing antibodies and cytotoxic T-cells is not fully understood. Reinfection among this patient population has only been described occasionally. Our case described a reinfection, which was confirmed by variant-testing. In addition, it gave insight into the rapid progression of testing and into specific anti-viral therapy over 1 year of the pandemic.

虽然已经对严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染后的免疫进行了全面分析，但对这种保护的持续时间和再次感染的风险知之甚少。这种知识的缺乏对免疫功能受损的患者特别感兴趣。在本报告中，我们描述了一名30岁男性x -连锁无球蛋白血症患者的感染过程，该患者在12个月前首次感染后再次感染SARS-CoV-2。最初的感染过程发生在2020年4月，具有上呼吸道感染的典型症状，并伴有实验室值和计算机断层扫描的相应变化。在大流行期间，由于没有抗病毒治疗方案，只能提供对症治疗。12个月后(2021年4月)，患者出现短期发热和头痛。实验室检测显示c反应蛋白水平升高，而白细胞、淋巴细胞和乳酸脱氢酶水平在范围内。患者入院，并开始抗生素治疗，部分原因是降钙素原水平也略有升高。SARS-CoV-2聚合酶链反应阳性，开始使用单克隆抗体casirivimab/imdevimab(分别为1200 mg/ 1200 mg)治疗。感染过程轻微，但必须给予低流量氧气。在感染过程中，不可能区分给药抗体的作用和细胞毒性t细胞的作用。变异筛查在第一次发作时确认为武汉病毒株，在第二次发作时确认为α变异，从而确认再次感染并排除长期脱落的可能性。假设无球蛋白血症患者患2019冠状病毒病严重病程的风险更高，中和抗体似乎在病毒清除和感染预防中起着至关重要的作用。然而，中和抗体和细胞毒性t细胞的具体作用尚未完全了解。在这一患者群体中，再感染仅偶有报道。我们的病例描述了一次再感染，并通过变异检测得到证实。此外，它还深入了解了在大流行的一年中检测和特定抗病毒治疗的快速进展。

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引用次数: 0

Streptococcal Infections [Working Title] 链球菌感染〔暂定名〕

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-01-01 DOI: 10.5772/intechopen.95133

引用次数: 0

Bictegravir/emtricitabine/tenofovir Alafenamide for the Treatment of People Living with HIV 比替格拉韦/恩曲他滨/替诺福韦阿拉芬胺治疗艾滋病毒感染者

IF 5.8 4区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases

Pub Date : 2022-01-01 DOI: 10.17925/id.2022.1.1.12

J. Mallolas

引用次数: 0