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Prediction of prognosis in patients with severe fever with thrombocytopenia syndrome. 预测严重发热伴血小板减少综合征患者的预后。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-09-30 DOI: 10.7883/yoken.JJID.2024.015
Yi Zhang, Lingtong Huang, Zheyue Shu, Wei Wu, Hongliu Cai, Yu Shi

This study aims to understand the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) and screen risk factors for the prognosis. This retrospective study collected the epidemiological, demographic, and clinical and laboratory data of 101 patients with SFTS. Patients were divided into survival and deceased groups, and then logistic regression model was used to evaluate the association between predictors and prognostic variables. A joint detection factor model was constructed, and a receiver operating characteristic (ROC) curve was drawn. A nomogram was established using the R language, and its efficiency in the diagnosis of SFTS was evaluated using the Calibrate curve. Patients in the deceased group were more likely to show an elder age, a shorter hospitalization stay, renal failure and multiple organ failure compared with that of the survival group. There were statistical differences in the neutrophil percentage, lymphocyte percentage, neutrophil-to-lymphocyte ratio, platelet (PLT), AST, AST/ALT, blood urea nitrogen, lactate dehydrogenase, hydroxybutyrate dehydrogenase, thromboplastin time and activated partial thromboplastin time between the two groups. Lymphocyte percentage, PLT, and AST/ALT were independent risk factors for mortality in SFTS patients. We established a prediction model for SFTS mortality with good efficiency.

本研究旨在了解严重发热伴血小板减少综合征(SFTS)的临床特征,并筛查预后的危险因素。这项回顾性研究收集了101名严重发热伴血小板减少综合征患者的流行病学、人口统计学、临床和实验室数据。将患者分为存活组和死亡组,然后使用逻辑回归模型评估预测因素与预后变量之间的关联。建立了联合检测因子模型,并绘制了接收者操作特征曲线(ROC)。使用 R 语言建立了一个提名图,并使用校准曲线评估了其在诊断 SFTS 中的效率。与存活组相比,死亡组患者的年龄更大、住院时间更短、肾功能衰竭和多器官功能衰竭的可能性更大。两组患者的中性粒细胞百分比、淋巴细胞百分比、中性粒细胞与淋巴细胞比率、血小板(PLT)、谷草转氨酶、谷草转氨酶/谷丙转氨酶、血尿素氮、乳酸脱氢酶、羟丁酸脱氢酶、凝血活酶时间和活化部分凝血活酶时间存在统计学差异。淋巴细胞百分比、PLT 和 AST/ALT 是 SFTS 患者死亡的独立风险因素。我们建立了一个有效的 SFTS 死亡率预测模型。
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引用次数: 0
Clinical Efficacy of Therapeutic Agents for Clostridioides difficile Infection Based on Four Severity Classifications. 基于四种严重程度分类的艰难梭菌感染治疗药物的临床疗效。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-09-19 Epub Date: 2024-03-29 DOI: 10.7883/yoken.JJID.2023.483
Mariko Ohtani, Sadako Yoshizawa, Taito Miyazaki, Eri Kumade, Shinobu Hirayama, Maki Sakamoto, Hinako Murakami, Tadashi Maeda, Yoshikazu Ishii, Takahiro Matsumoto, Kazuhiro Tateda

Japanese guidelines recommend metronidazole (MNZ) and vancomycin (VCM) for non-severe and severe cases of Clostridioides difficile infection (CDI), respectively. In the present study, we investigated the use of CDI antimicrobials and evaluated their clinical efficacy and validity using four severity classifications. A retrospective chart review was conducted using the data of 137 inpatients with initially positive C. difficile toxin test results and the initiation of CDI antimicrobials between April 2015 and March 2019. Patients treated with VCM or oral MNZ were included for clinical efficacy analysis of CDI antimicrobials and validation of severity classifications. The endpoints were CDI recurrence, 30-day mortality, and diarrhea cure rates. No significant differences were found between the VCM and oral MNZ groups in the CDI recurrence rate (10.4% vs. 12.7%, P = 0.707), 30-day mortality rate (12.5% vs. 5.6%, P = 0.162), and diarrhea cure rate (61.9% vs. 72.7%, P = 0.238), regardless of severity. Treatment with oral MNZ for non-severe cases was promising, confirming its usefulness according to Japanese guidelines. Further investigation of the clinical efficacy of oral MNZ in patients with first-episode CDI and evaluation of the preferred severity classification are warranted.

日本的艰难梭菌感染(CDI)治疗指南建议非重症病例使用甲硝唑(MNZ),重症病例使用万古霉素(VCM)。在此,我们调查了 CDI 抗菌药物的使用情况,并评估了它们在四种严重程度分类中的临床疗效以及这些分类的有效性。我们对2015年4月至2019年3月期间首次艰难梭菌毒素检测呈阳性并开始使用CDI抗菌药物的137名住院患者进行了回顾性病历审查。为了进行CDI抗菌药物的临床疗效分析和严重程度分类的验证,纳入了接受VCM或口服MNZ治疗的患者。终点为 CDI 复发率、30 天死亡率和腹泻治愈率。无论严重程度如何,VCM 组和口服 MNZ 组在 CDI 复发率(10.4% 对 12.7%,p = 0.707)、30 天死亡率(12.5% 对 5.6%,p = 0.162)和腹泻治愈率(61.9% 对 72.7%,p = 0.238)方面均无明显差异。对于非严重病例,口服 MNZ 的治疗效果良好,证实了根据日本指南进行治疗的有效性。有必要进一步研究口服 MNZ 对初发 CDI 患者的临床疗效,并评估更可取的严重程度分类。
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引用次数: 0
Time from admission to the onset of methicillin-resistant Staphylococcus aureus bacteremia in a single acute care hospital in Japan. 日本一家急诊医院从入院到出现耐甲氧西林金黄色葡萄球菌菌血症的时间。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-31 DOI: 10.7883/yoken.JJID.2024.159
Nobumasa Okumura, Shinya Tsuzuki, Jiefu Yu, Sho Saito, Norio Ohmagari

The spread of antimicrobial-resistant organisms (AROs) poses a major threat to animal and human health. In Japan, the estimated disability-adjusted life years (DALYs) due to infections with AROs is 137.9 per 100,000 persons, with methicillin-resistant Staphylococcus aureus (MRSA) being the main contributor. The factors that can contribute to DALYs in Japan include younger age and a higher number of deaths in patients with MRSA bacteremia. Moreover, longer hospital stays may contribute to higher rates of MRSA bacteremia in Japan than in Western countries. We reviewed diagnosis procedure combination data collected from January 1, 2016, to December 31, 2020, in an acute care hospital in Tokyo, Japan. We found that the median time from admission to MRSA bacteremia onset was 26 days, which is longer than that in Western countries but similar to that in South Korea. Further, our cohort was older than that in the United States and South Korea, potentially contributing to the higher number of years of life lost in Japan. These results underscore the need to develop strategies to reduce hospitalization in Japan. Larger multicenter studies are needed to comprehensively evaluate the economic and health burden of MRSA bacteremia in Japan.

耐抗菌生物(AROs)的传播对动物和人类健康构成了重大威胁。在日本,因感染 AROs 而导致的残疾调整寿命年(DALYs)估计为每 10 万人 137.9 年,其中耐甲氧西林金黄色葡萄球菌(MRSA)是主要致病菌。在日本,导致残疾调整寿命年数增加的因素包括年龄较小、MRSA 菌血症患者的死亡人数较多。此外,与西方国家相比,较长的住院时间也可能是导致日本 MRSA 菌血症发病率较高的原因。我们回顾了从 2016 年 1 月 1 日至 2020 年 12 月 31 日在日本东京一家急诊医院收集的诊断程序组合数据。我们发现,从入院到 MRSA 菌血症发病的中位时间为 26 天,长于西方国家,但与韩国相似。此外,我们的队列比美国和韩国的队列年龄更大,这可能是日本人寿命损失年数更多的原因。这些结果凸显了在日本制定减少住院治疗策略的必要性。需要进行更大规模的多中心研究,以全面评估 MRSA 菌血症在日本造成的经济和健康负担。
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引用次数: 0
Surveillance of SARS-CoV-2 Infection in Rodent Populations in Tokyo, Japan. 日本东京啮齿动物群体中 SARS-CoV-2 感染的监测。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-31 DOI: 10.7883/yoken.JJID.2024.143
Yudai Kuroda, Akitoyo Hotta, Masakatsu Taira, Nobuo Koizumi, Kango Tatemoto, Eun-Sil Park, Milagros Virhuez-Mendoza, Tsukasa Yamamoto, Noriyuki Komatsu, Keigo Shibo, Takeshi Sasaki, Yoshiyuki Mori, Kentaro Watanabe, Yasushi Kiyokawa, Yuya Eguchi, Azusa Banzai, Hirotaka Katahira, Tsutomu Tanikawa, Ken Maeda

The maintenance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among wildlife populations poses a potential risk for the emergence of novel variants. Therefore, monitoring SARS-CoV-2 infection among animals is crucial. As urban rodents live in close proximity to human habitats, there is concern that they may be a potential source of zoonoses. To examine the prevalence of SARS-CoV-2 in rodent populations, we analyzed 128 serum samples and 129 oral swabs collected from 128 brown rats (Rattus norvegicus) and 2 black rats (Rattus rattus) captured for pest control purposes in Tokyo, Japan, between May and December 2023. A virus-neutralizing test using the Omicron variant revealed no evidence of SARS-CoV-2 infection in these populations. Real-time RT-PCR from oral swabs did not detect any SARS-CoV-2 RNA-positive rats. These results indicate the low probability of SARS-CoV-2 circulation among rat populations in Tokyo.

严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)在野生动物群体中的持续存在为新型变种的出现带来了潜在风险。因此,监测动物中的 SARS-CoV-2 感染情况至关重要。由于城市啮齿类动物与人类的栖息地非常接近,人们担心它们可能成为人畜共患病的潜在来源。为了研究 SARS-CoV-2 在啮齿动物群体中的流行情况,我们分析了 2023 年 5 月至 12 月期间从日本东京捕获的 128 只棕鼠(Rattus norvegicus)和 2 只黑鼠(Rattus rattus)身上采集的 128 份血清样本和 129 份口腔拭子。使用 Omicron 变体进行的病毒中和试验显示,这些鼠群中没有 SARS-CoV-2 感染的迹象。口腔拭子的实时 RT-PCR 检测也没有发现任何 SARS-CoV-2 RNA 阳性的老鼠。这些结果表明,SARS-CoV-2 在东京的鼠群中流行的可能性很低。
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引用次数: 0
Continuous Renal Replacement Therapy Improves Indicators and Short-Term Survival in People with AIDS Manifesting Sepsis and Acute Kidney Injury. 持续性肾脏替代疗法可改善出现败血症和急性肾损伤的艾滋病患者的指标和短期存活率。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-24 Epub Date: 2024-02-29 DOI: 10.7883/yoken.JJID.2023.280
Jie Zheng, Qiu-Jin Yang, Fei Qi, Han-Zhang Shen, Le Zhang, Jia-Wei Xia

Patients with acquired immune deficiency syndrome (AIDS) are susceptible to numerous complications, such as sepsis and acute kidney injury (AKI), leading to adverse outcomes. Continuous renal replacement therapy (CRRT) is becoming increasingly popular for treating sepsis and AKI. This study aimed to verify the effectiveness of CRRT in the treatment of patients with AIDS with sepsis and AKI to provide new directions for the treatment of severe AIDS. Data of 74 people with AIDS, sepsis, and AKI were collected. The patients were divided into CRRT and non-CRRT groups. There was no difference in the indicators between the two groups at admission. Vital signs, pH, serum potassium level, renal function, blood lactate level, acute physiology and chronic health evaluation II score, and sequential organ failure assessment score in the CRRT group demonstrated significant improvements over those in the non-CRRT group at both 24 and 72 h after admission (P < 0.05). The levels of interleukin 6 and procalcitonin declined more significantly in the CRRT group at 72 h after admission (P < 0.05). The CRRT group had a higher 28-day survival rate than the non-CRRT group (P < 0.05). CRRT improves the clinical indicators and increases the short-term survival rate of patients with AIDS, sepsis, and AKI.

获得性免疫缺陷综合征(艾滋病)容易引发多种并发症,如败血症和急性肾损伤(AKI),导致不良后果。连续性肾脏替代疗法(CRRT)在治疗败血症和急性肾损伤方面越来越受欢迎。本研究旨在验证 CRRT 治疗艾滋病合并败血症和急性肾损伤的有效性,为重症艾滋病的治疗提供新的方向。研究收集了74名艾滋病合并败血症和AKI患者的数据。他们被分为CRRT组和非CRRT组。两组患者入院时各项指标无差异。CRRT组的生命体征、PH值、血清钾、肾功能、血乳酸、APACHE II评分和SOFA评分在入院后24小时和72小时均比非CRRT组有显著改善(P<0.05)。入院 72 小时后,CRRT 组的白细胞介素 6 和降钙素原水平下降更明显(P<0.05)。CRRT 组的 28 天存活率更高(P<0.05)。CRRT改善了艾滋病、脓毒症和AKI患者的临床指标,提高了短期生存率。
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引用次数: 0
Dissemination of Urinary Escherichia coli Phylogroup B2 in Provincial and Community Hospitals in Uthai Thani, Central Thailand. 泰国中部乌泰他尼府医院和社区医院尿液大肠埃希氏菌 B2 群的传播。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-23 Epub Date: 2024-02-29 DOI: 10.7883/yoken.JJID.2023.376
Chanihcha Anudit, Pornthip Saraisuwan, Chantana Kimterng, Chanakan Puangmanee, Nicharee Bamphensin, Anusak Kerdsin

Escherichia coli is a Gram-negative bacterium that causes a variety of clinical infections in humans, including diarrhea, sepsis, and urinary tract infection. This bacterium is a common multidrug-resistant threat in community and hospital settings worldwide. This study examined the antimicrobial susceptibility and genetic relationship based on Clermont phylotyping and enterobacterial repetitive intergenic consensus (ERIC)-PCR of 84 E. coli urinary isolates from provincial and community hospitals in Thailand. All isolates were susceptible to nitrofurantoin, and almost all isolates were susceptible to carbapenem, fosfomycin, and amikacin. High resistance rates to fluoroquinolone, ampicillin, and trimethoprim/sulfamethoxazole were observed. Clermont phylogroup B2 was predominant (n = 58). Subtyping of the B2 phylogroup revealed diverse subgroups, of which subgroup V (n = 11), VII (n = 9), III (n = 6), and II (n = 6) were most prevalent. ERIC-PCR showed that the strains of the B2 subgroups III and V were spread between provincial and community hospitals and between hospital wards. This evidence suggests the need for comprehensive infection control monitoring, with strong active surveillance at all hospital levels.

大肠埃希菌是一种革兰氏阴性细菌,主要引起人类的各种临床感染,如腹泻、败血症和尿路感染。这种细菌是全球社区和医院环境中常见的耐多药威胁。本研究根据克莱蒙系统分型和 ERIC-PCR 对泰国省级医院和社区医院的 84 个大肠杆菌尿液分离株进行了抗菌药敏感性和遗传关系研究。所有分离菌株都对硝基呋喃妥因完全敏感,而几乎所有分离菌株都对碳青霉烯类、磷霉素和阿米卡星敏感。对氟喹诺酮、氨苄西林和三甲氧苄青霉素/磺胺甲噁唑的耐药率很高。克莱蒙特菌群 B2 是主要菌群(n=58)。对 B2 系统群进行亚型分析后发现了不同的亚群,其中以 V 亚群(11 人)为主,其次是 VII 亚群(9 人)、III 亚群(6 人)和 II 亚群(6 人)。ERIC-PCR 显示,B2 亚群 III 和 V 的菌株在省级医院和社区医院之间以及医院病房之间传播。这些证据表明,有必要进行全面的感染控制监测,并在各级医院开展强有力的主动监测。
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引用次数: 0
Clinical Course and Molecular Characterization of Human Bocavirus Associated with Acute Lower Respiratory Tract Infections in a Tertiary Care Hospital in Northern India. 印度北部三级医院中与急性下呼吸道感染相关的人类博卡病毒的临床过程和分子特征。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-23 Epub Date: 2024-02-29 DOI: 10.7883/yoken.JJID.2023.251
Subhabrata Sarkar, Mannat Kang, Suresh Kumar Angurana, Shankar Prasad, Ishani Bora, Pankaj Singh, Vikrant Sharma, Meenakshi Rana, Bhartendu Singh, Muralidharan Jayashree, Radha Kanta Ratho

Respiratory samples from 139 hospitalized children were screened for the human bocavirus (HBoV) genome. Positive samples were sequenced for the partial VP1/VP2 gene followed by molecular and phylogenetic analyses. HBoV positivity was noted in 7.2% (10/139) of patients. All HBoV-positive children presented with fever, cough, and respiratory distress (90%, 9/10). Three children developed multisystemic viral illness, with one fatality. Eight children required intensive care management and five required mechanical ventilation. The nucleotide percent identity of the partial VP1/VP2 gene in the HBoV study strains ranged from 97.52% to 99.67%. Non-synonymous mutations in the VP1 protein were T591S (n = 8) and Y517S (n = 1) in the HBoV St1 strain and N475S (n = 8) and S591T (n = 2) in the HBoV St2 strain. One strain showed A556P, H556P, I561S, and M562R non-synonymous mutations. All the study strains belonged to the HBoV1 type. Seven HBoV strains belonged to the same lineage, and three belonged to another lineage. For evolutionary dynamics, GTR+I substitution model with uncorrelated relaxed lognormal clock and Bayesian Skyline tree prior showed 9.0 × 10-4 (95% highest probability density interval: 3.1 × 10-6, 2.1 × 10-3) nucleotide substitutions per site per year. Clinical suspicion and virological screening are necessary to identify HBoV infections in children.

对 139 名住院儿童的呼吸道样本进行了人类博卡病毒(HBoV)基因组筛查。对阳性样本进行了部分 VP1/VP2 基因测序,然后进行了分子和系统进化分析。7.2%的患者(10/139)HBoV呈阳性。所有 HBoV 阳性患儿均表现为发热,随后出现咳嗽和呼吸困难(90%;9/10)。三名患儿出现多系统病毒性疾病,其中一人死亡。8 名患儿需要重症监护,5 名患儿需要机械通气。HBoV研究菌株部分VP1/VP2基因的核苷酸相同率为97.52%至99.67%。与 HBoVSt1 株系相比,VP1 蛋白中的非同义氨基酸突变为 T591S(n=8)和 Y517S(n=1);与 HBoVSt2 株系相比,VP1 蛋白中的非同义氨基酸突变为 N475S(n=8)和 S591T(n=2)。一株研究菌株出现了 A556P、H556P、I561S 和 M562R 非同义突变。所有研究菌株均属于 HBoV1 型。7 株 HBoV 属于同一系,3 株属于另一系。在进化动力学方面,采用无相关松弛对数正态时钟和贝叶斯天际线树先验的 GTR+I 替代模型显示,核苷酸替代率为 9.0 x 10-4 [95% HPD 区间:3.1 x 10-6, 2.1 x 10-3]/位点/年。临床怀疑和病毒学筛查是识别儿童 HBoV 的必要条件。
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引用次数: 0
First Case of Necrotizing Fasciitis and Septicemia Caused by Pigmentibacter ruber. 首例由鲁氏猪杆菌(Pigmentibacter ruber)引起的坏死性筋膜炎和败血症。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-23 Epub Date: 2024-02-29 DOI: 10.7883/yoken.JJID.2023.370
Ayumi Niwa, Masahiro Hayashi, Jun Yonetamari, Motohiro Nakamura, Yuta Yokobori, Sodai Yokoyama, Mizuki Ogawa, Rina Ichioka, Ryosuke Kikuchi, Hiroyuki Okura, Shinji Ogura, Nobuyuki Tetsuka, Kaori Tanaka, Hisashi Baba

We report the first case of necrotizing fasciitis caused by Pigmentibacter ruber. The isolated strain could not be identified by biochemical characterization or matrix-assisted laser desorption/ionization time-of-flight mass spectrometry but was identified as P. ruber by 16S ribosomal RNA and whole-genome sequencing. Although much remains unknown about the pathogenicity of this bacterial species in humans, it has been shown to cause life-threatening infections such as septicemia and necrotizing fasciitis. Because the isolate was highly resistant to β-lactams, it was difficult to treat with antimicrobial therapy. Thus, further documentation of cases and analyses are required.

我们在此报告了首例由鲁氏猪杆菌(Pigmentibacter ruber)引起的坏死性筋膜炎病例。通过生化鉴定和基质辅助激光解吸/电离飞行时间质谱(MALDI-TOF MS)无法确定分离出的菌株。通过 16S 核糖体 RNA 和全基因组测序,确定分离出的菌株为 P. ruber。虽然这种细菌对人类的致病性仍有很多未知之处,但它已被揭示可导致危及生命的感染,如败血症和坏死性筋膜炎。由于该分离株对β-内酰胺类药物有很强的抗药性,因此很难通过抗菌疗法进行治疗。因此,需要进一步记录病例并进行分析。
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引用次数: 0
Characterization of proinflammatory cytokines profile during acute SARS-CoV-2 infection in people with human immunodeficiency virus. 人类免疫缺陷病毒感染者急性 SARS-CoV-2 感染期间促炎细胞因子的特征。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-28 DOI: 10.7883/yoken.JJID.2024.184
Alitzel Anzurez, Lucky Runtuwene, Thao Thi Thu Dang, Kaori Nakayama-Hosoya, Michiko Koga, Yukihiro Yoshimura, Hiroaki Sasaki, Nobuyuki Miyata, Kazuhito Miyazaki, Yoshimasa Takahashi, Tadaki Suzuki, Hiroshi Yotsuyanagi, Natsuo Tachikawa, Tetsuro Matano, Ai Kawana-Tachikawa

Persistent inflammation in chronic HIV infection may affect immune responses against SARS-CoV-2 infection. Plasma levels of multiple proinflammatory cytokines during acute SARS-CoV-2 infection were assessed in people with HIV (PWH) with effective cART. There were no significant differences in any of the tested cytokines between COVID-19 severity in PWH, while most of them were significantly higher in individuals with severe disease in HIV-uninfected individuals, suggesting that excess cytokines release by hyper-inflammatory responses does not occur in severe COVID-19 with HIV infection. The strong associations between the cytokines observed in HIV-uninfected individuals, especially between IFN-α/TNF-α and other cytokines, were lost in PWH. The steady state plasma levels of IP-10, ICAM-1, and CD62E were significantly higher in PWH, indicating that PWH are in an enhanced inflammatory state. Loss of the several inter-cytokine correlations were observed in in vitro LPS stimuli-driven cytokines production in PWH. These data suggest that inflammatory responses during SARS-CoV-2 infection in PWH are distinct from those in HIV-uninfected individuals, partially due to the underlying inflammatory state and/or impairment of innate immune cells.

慢性艾滋病病毒感染者的持续炎症可能会影响对 SARS-CoV-2 感染的免疫反应。我们评估了接受有效抗病毒治疗的艾滋病病毒感染者(PWH)在急性 SARS-CoV-2 感染期间血浆中多种促炎细胞因子的水平。PWH的COVID-19严重程度不同,所检测的细胞因子均无明显差异,而在未感染HIV的重症患者中,大多数细胞因子的水平明显较高,这表明在感染HIV的重症COVID-19患者中,高炎症反应不会释放过多的细胞因子。在艾滋病毒未感染者中观察到的细胞因子之间的密切联系,尤其是 IFN-α/TNF-α 与其他细胞因子之间的密切联系,在 PWH 中消失了。在 PWH 中,血浆中 IP-10、ICAM-1 和 CD62E 的稳态水平明显升高,这表明 PWH 处于一种强化的炎症状态。在体外 LPS 刺激驱动的细胞因子产生过程中,也观察到 PWH 中多种细胞因子之间的相关性丧失。这些数据表明,PWH 感染 SARS-CoV-2 期间的炎症反应与未感染 HIV 的人不同,部分原因是潜在的炎症状态和/或先天免疫细胞受损。
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引用次数: 0
An analysis of factors contributing to household transmission of COVID-19-using data from active epidemiological investigations performed in the Setagaya ward of Tokyo, Japan. 利用在日本东京世田谷区开展的主动流行病学调查数据,分析导致 COVID-19 家庭传播的因素。
IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-28 DOI: 10.7883/yoken.JJID.2023.342
Mutsumi Kadowaki, Keiko Yasuoka, Chika Takahashi, Haruko Mukoyama, Yoshihisa Shirayama, Motoyuki Yuasa

An active epidemiological investigation of COVID-19 cases in the Setagaya ward of Tokyo revealed that household transmission was the main route of infection spread. This study aimed to identify the factors affecting household transmission in patients diagnosed with COVID-19 and their cohabitants, during the wild type virus (December 2020) and alpha variant epidemic (May 2021). Index case factors significantly associated with household transmission for both wild type (WT) and alpha variant (AV), were at least 3 days from onset to diagnosis (WT: risk ratio [RR] 1.44, 95% confidence interval [CI] 1.16-1.79/AV: RR 1.66, CI 1.32-2.08), and a household size of three or more people (WT: RR 1.37, CI 1.10-1.72/AV: RR 1.29, CI 1.05-1.59). There were also significant differences in age ≥ 65 (RR 2.39, CI 1.26-4.54) and symptomatic at diagnosis (RR 3.05, CI 1.22-7.63) in index cases of WT. Among cohabitants, factors associated with household transmission for both strains were being the spouse/partner of the index case (WT: RR 1.68, CI 1.21-1.82/AV: RR 1.97, CI 1.59-2.43) and at least 3 days from onset to diagnosis of the index case (WT: RR 1.48, CI 1.34-2.10/ AV: RR 1.86, CI1.52-2.28). Early diagnosis and isolation are effective for preventing household transmission.

对东京世田谷区 COVID-19 病例进行的积极流行病学调查显示,家庭传播是感染传播的主要途径。本研究旨在确定在野生型病毒(2020 年 12 月)和阿尔法变异型病毒(2021 年 5 月)流行期间,影响 COVID-19 诊断患者及其同居者家庭传播的因素。在野生型(WT)和阿尔法变异型(AV)中,与家庭传播明显相关的指数病例因素是:从发病到确诊至少 3 天(WT:风险比 [RR]1.44,95% 置信区间 [CI]1.16-1.79/AV:RR 1.66,CI 1.32-2.08),以及家庭规模为 3 人或 3 人以上(WT:RR 1.37,CI 1.10-1.72/AV:RR 1.29,CI 1.05-1.59)。在 WT 指数病例中,年龄≥ 65 岁(RR 2.39,CI 1.26-4.54)和诊断时无症状(RR 3.05,CI 1.22-7.63)也有明显差异。在同居者中,与两种菌株的家庭传播相关的因素有:作为指数病例的配偶/伴侣(WT:RR 1.68,CI 1.21-1.82/AV:RR 1.97,CI 1.59-2.43)和指数病例从发病到确诊至少 3 天(WT:RR 1.48,CI 1.34-2.10/AV:RR 1.86,CI 1.52-2.28)。早期诊断和隔离可有效预防家庭传播。
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引用次数: 0
期刊
Japanese journal of infectious diseases
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