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Fatal acute liver failure following norovirus gastroenteritis in a child: A case report
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-20 DOI: 10.1016/j.jiph.2025.102675
Rabab Taha , Noura Elazhary , Sarah Alqhtani , Walaa Almansouri
Norovirus is the leading cause of acute gastroenteritis and rarely present with extra-intestinal manifestations. There are few reported cases of hepatitis following norovirus gastroenteritis, with no documented fatalities. We present a case of fatal acute hepatitis following norovirus gastroenteritis in a child. The patient was a previously healthy 6-year-old boy who presented with diarrhea, vomiting, and fever. He was admitted and treated supportively as a case of acute gastroenteritis. Despite treatment, he rapidly developed acute liver failure in the course of gastroenteritis. Other potential causes including drugs and other possible viral infections were ruled out, only norovirus was isolated from his stool. The patient’s liver function continued to deteriorate leading to fulminant liver failure and death within days.
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引用次数: 0
Long-term assessment of anti-SARS-CoV-2 antibody levels post-pandemic: Tracking the dynamics after two, three, and four COVID-19 vaccine doses
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-19 DOI: 10.1016/j.jiph.2025.102676
Fatemeh Ashrafian , Mostafa Salehi-Vaziri , Ehsan Mostafavi , Saiedeh Haji Maghsoudi , Sarah Dahmardeh , Anahita Bavand , Ladan Moradi , Parinaz Tajmehrabi Namini , Mahsan Zali , Zahra Tahmasebi , Mona Sadat Larijani , Amitis Ramezani

Background

Given the limited available data about to the number of vaccine doses administered over an extended time in Iran, the immune status of vaccinated individuals and any potential disparities in this regard among those who received different numbers of vaccine doses remain unknown. Therefore, this study aimed to assess humoral immunity of individuals who received different doses of the COVID-19 vaccines in Iran.

Methods

This study was conducted from February, 2022 to December 2023 including 605 vaccinated subjects. The durability of anti-spike, anti-nucleocapsid (NCP), neutralizing antibody, and interferon-γ (IFN-γ) was evaluated at least 6 months after the last vaccination, as well as 60 and 120 days after it, in individuals who received two or three doses of the COVID-19 vaccine. Furthermore, the evaluation of humoral and cellular response was performed before the fourth dose (second booster) as well as 21 and 60 days thereafter.

Results

The 3-dose group showed significantly higher levels of anti-spike, neutralizing antibodies, and IFN-γ compared to the 2-dose group. Both the 2-dose and 3-dose groups experienced a slight decrease in the dynamic of SARS-CoV-2 Abs, though the associated levels remained within a positive range. After receiving the fourth dose of PastoCovac, most participants had significantly high levels of anti-spike, neutralizing antibodies, and IFN-γ, regardless of the type of three-dose regimen they had previously received. The average antibody titer decreased after 60 days from the fourth dose, but remained relatively stable during the follow-up period.

Conclusion

This study found that the level of anti-SARS-CoV-2 antibodies and IFN-γ, as well as their durability, were still within a positive range in 2-dose and 3-dose vaccinated groups over the long-term follow-up. Furthermore, PastoCovac vaccine enhanced humoral and cellular immune responses and could be recommended as a booster dose for individuals previously vaccinated with any previously administered COVID-19 vaccine.
{"title":"Long-term assessment of anti-SARS-CoV-2 antibody levels post-pandemic: Tracking the dynamics after two, three, and four COVID-19 vaccine doses","authors":"Fatemeh Ashrafian ,&nbsp;Mostafa Salehi-Vaziri ,&nbsp;Ehsan Mostafavi ,&nbsp;Saiedeh Haji Maghsoudi ,&nbsp;Sarah Dahmardeh ,&nbsp;Anahita Bavand ,&nbsp;Ladan Moradi ,&nbsp;Parinaz Tajmehrabi Namini ,&nbsp;Mahsan Zali ,&nbsp;Zahra Tahmasebi ,&nbsp;Mona Sadat Larijani ,&nbsp;Amitis Ramezani","doi":"10.1016/j.jiph.2025.102676","DOIUrl":"10.1016/j.jiph.2025.102676","url":null,"abstract":"<div><h3>Background</h3><div>Given the limited available data about to the number of vaccine doses administered over an extended time in Iran, the immune status of vaccinated individuals and any potential disparities in this regard among those who received different numbers of vaccine doses remain unknown. Therefore, this study aimed to assess humoral immunity of individuals who received different doses of the COVID-19 vaccines in Iran.</div></div><div><h3>Methods</h3><div>This study was conducted from February, 2022 to December 2023 including 605 vaccinated subjects. The durability of anti-spike, anti-nucleocapsid (NCP), neutralizing antibody, and interferon-γ (IFN-γ) was evaluated at least 6 months after the last vaccination, as well as 60 and 120 days after it, in individuals who received two or three doses of the COVID-19 vaccine. Furthermore, the evaluation of humoral and cellular response was performed before the fourth dose (second booster) as well as 21 and 60 days thereafter.</div></div><div><h3>Results</h3><div>The 3-dose group showed significantly higher levels of anti-spike, neutralizing antibodies, and IFN-γ compared to the 2-dose group. Both the 2-dose and 3-dose groups experienced a slight decrease in the dynamic of SARS-CoV-2 Abs, though the associated levels remained within a positive range. After receiving the fourth dose of PastoCovac, most participants had significantly high levels of anti-spike, neutralizing antibodies, and IFN-γ, regardless of the type of three-dose regimen they had previously received. The average antibody titer decreased after 60 days from the fourth dose, but remained relatively stable during the follow-up period.</div></div><div><h3>Conclusion</h3><div>This study found that the level of anti-SARS-CoV-2 antibodies and IFN-γ, as well as their durability, were still within a positive range in 2-dose and 3-dose vaccinated groups over the long-term follow-up. Furthermore, PastoCovac vaccine enhanced humoral and cellular immune responses and could be recommended as a booster dose for individuals previously vaccinated with any previously administered COVID-19 vaccine.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102676"},"PeriodicalIF":4.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
A region-structured model for early warning of Plasmodium vivax malaria transmission risk in the Republic of Korea
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-17 DOI: 10.1016/j.jiph.2025.102665
Boyeon Kim , Jung Ho Kim , Jeehyun Lee , Joon-Sup Yeom

Background

Malaria cases in the Republic of Korea decreased during the coronavirus disease 2019 pandemic but surged in 2023. Current models inadequately address spatial heterogeneity in transmission dynamics. This study aimed to address this by designing a region-structured model considering spatial heterogeneity based on regional malaria data from high-risk areas.

Methods

Malaria-risk areas were identified using data from the Korea Disease Control and Prevention Agency (KDCA), with eight regions designated as hotspots. The population heterogeneity of the model by region was represented using the “Who Acquires Infection From Whom” matrix. The model was calibrated using 2014–2018 KDCA civilian malaria-case data. The reproduction number (Rt) of each region was then calculated using the estimated parameters and predicted malaria dynamics.

Results

In the hotspots, the value of Rt rose along with the number of long-latency patients, followed by an increase in short-latency patients. The points where Rt exceeded and fell below one varied by region. Ganghwa-gun exhibited the longest period (Rt>1), whereas Deokyang-gu had the shortest. Maximum Rt values ranged from 1.1 in Deokyang-gu to 2.7 in Ganghwa-gun. A criterion was established to estimate the timing of Rt>1 based on the weekly cumulative incidence per 100,000 people.

Conclusion

This study constructed a region-structured model reflecting spatial heterogeneity using actual data. By estimating Rt and an easily accessible index for each region, the model provides an indicator that assists in implementing effective malaria management policies at the regional level.
{"title":"A region-structured model for early warning of Plasmodium vivax malaria transmission risk in the Republic of Korea","authors":"Boyeon Kim ,&nbsp;Jung Ho Kim ,&nbsp;Jeehyun Lee ,&nbsp;Joon-Sup Yeom","doi":"10.1016/j.jiph.2025.102665","DOIUrl":"10.1016/j.jiph.2025.102665","url":null,"abstract":"<div><h3>Background</h3><div>Malaria cases in the Republic of Korea decreased during the coronavirus disease 2019 pandemic but surged in 2023. Current models inadequately address spatial heterogeneity in transmission dynamics. This study aimed to address this by designing a region-structured model considering spatial heterogeneity based on regional malaria data from high-risk areas.</div></div><div><h3>Methods</h3><div>Malaria-risk areas were identified using data from the Korea Disease Control and Prevention Agency (KDCA), with eight regions designated as hotspots. The population heterogeneity of the model by region was represented using the “Who Acquires Infection From Whom” matrix. The model was calibrated using 2014–2018 KDCA civilian malaria-case data. The reproduction number (<span><math><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub></math></span>) of each region was then calculated using the estimated parameters and predicted malaria dynamics.</div></div><div><h3>Results</h3><div>In the hotspots, the value of <span><math><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub></math></span> rose along with the number of long-latency patients, followed by an increase in short-latency patients. The points where <span><math><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub></math></span> exceeded and fell below one varied by region. Ganghwa-gun exhibited the longest period (<span><math><mrow><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub><mo>&gt;</mo><mn>1</mn></mrow></math></span>), whereas Deokyang-gu had the shortest. Maximum <span><math><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub></math></span> values ranged from 1.1 in Deokyang-gu to 2.7 in Ganghwa-gun. A criterion was established to estimate the timing of <span><math><mrow><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub><mo>&gt;</mo><mn>1</mn></mrow></math></span> based on the weekly cumulative incidence per 100,000 people.</div></div><div><h3>Conclusion</h3><div>This study constructed a region-structured model reflecting spatial heterogeneity using actual data. By estimating <span><math><msub><mrow><mi>R</mi></mrow><mrow><mi>t</mi></mrow></msub></math></span> and an easily accessible index for each region, the model provides an indicator that assists in implementing effective malaria management policies at the regional level.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102665"},"PeriodicalIF":4.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Assessing post-COVID-19 functional recovery in healthcare workers: Insights from the 6-minute walking test and DLCO analysis
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-16 DOI: 10.1016/j.jiph.2025.102664
Salma AlBahrani , Ali AlBarrak , Jaber S. Alqahtani , Nawal AlGubaisi , Hamoud Alkurdi , Dalia Alburaiki , Abdulrahaman AlGhamdi , Mohammed AlOthaiqy , Osama Faqihi , Meshael Musaed Almershad , Fatimah Hassan Hakami , Asmaa AlAbbadi , Mariam Hassan Hakami , Alaa AlMaimouni , Zechariah Jebakumar Arulanantham , Jaffar A. Al-Tawfiq

Introduction

The COVID-19 pandemic has impacted healthcare workers (HCWs) worldwide, necessitating an understanding of its effects on their health and functional capacity. This study utilized the 6-Minute Walk Test (6MWT) and pulmonary function test (PFT) to evaluate post-infection recovery of HCWs, and analyzed the results in relation to comorbidities, symptoms, and healthcare admission.

Methods

HCWs who previously tested positive for SARS-CoV-2 were recruited, and the 6MWT and PFT were conducted. Clinical data, including comorbidities, symptoms, hospitalization history, intensive care unit (ICU) admission, and mechanical ventilation, were collected. Binary logistic regression analysis and Fisher's exact test were employed to examine the associations between these factors and diffusing capacity of the lungs for carbon monoxide (DLCO) and the 6MWT.

Results

The study comprised 80 HCWs, with various comorbidities and various presenting symptoms. On average, 167.24 days (± 63.83 days) post-SARS-CoV-2 infection, 34 (42.5 %) had a DLCO% < 80 % of the predicted value, while 46 (57.5 %) had a DLCO% of ≥ 80 %. The mean six-minute-walk distance (6MWD) was 400.6 ± 54.1 m. No significant associations were found between DLCO% and most of the factors examined, except for Forced Expiratory Flow 25–75 % (FEF25–75 %), although this was not statistically significant (P=0.069).

Conclusion

The study provides significant data regarding the functional recovery of HCWs who have recovered from COVID-19 using the 6MWT. Importantly, the findings demonstrated that SARS-CoV-2 infection did not substantially impair the pulmonary functional capacity of HCWs.
{"title":"Assessing post-COVID-19 functional recovery in healthcare workers: Insights from the 6-minute walking test and DLCO analysis","authors":"Salma AlBahrani ,&nbsp;Ali AlBarrak ,&nbsp;Jaber S. Alqahtani ,&nbsp;Nawal AlGubaisi ,&nbsp;Hamoud Alkurdi ,&nbsp;Dalia Alburaiki ,&nbsp;Abdulrahaman AlGhamdi ,&nbsp;Mohammed AlOthaiqy ,&nbsp;Osama Faqihi ,&nbsp;Meshael Musaed Almershad ,&nbsp;Fatimah Hassan Hakami ,&nbsp;Asmaa AlAbbadi ,&nbsp;Mariam Hassan Hakami ,&nbsp;Alaa AlMaimouni ,&nbsp;Zechariah Jebakumar Arulanantham ,&nbsp;Jaffar A. Al-Tawfiq","doi":"10.1016/j.jiph.2025.102664","DOIUrl":"10.1016/j.jiph.2025.102664","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic has impacted healthcare workers (HCWs) worldwide, necessitating an understanding of its effects on their health and functional capacity. This study utilized the 6-Minute Walk Test (6MWT) and pulmonary function test (PFT) to evaluate post-infection recovery of HCWs, and analyzed the results in relation to comorbidities, symptoms, and healthcare admission.</div></div><div><h3>Methods</h3><div>HCWs who previously tested positive for SARS-CoV-2 were recruited, and the 6MWT and PFT were conducted. Clinical data, including comorbidities, symptoms, hospitalization history, intensive care unit (ICU) admission, and mechanical ventilation, were collected. Binary logistic regression analysis and Fisher's exact test were employed to examine the associations between these factors and diffusing capacity of the lungs for carbon monoxide (DLCO) and the 6MWT.</div></div><div><h3>Results</h3><div>The study comprised 80 HCWs, with various comorbidities and various presenting symptoms. On average, 167.24 days (± 63.83 days) post-SARS-CoV-2 infection, 34 (42.5 %) had a DLCO% &lt; 80 % of the predicted value, while 46 (57.5 %) had a DLCO% of ≥ 80 %. The mean six-minute-walk distance (6MWD) was 400.6 ± 54.1 m. No significant associations were found between DLCO% and most of the factors examined, except for Forced Expiratory Flow 25–75 % (FEF25–75 %), although this was not statistically significant (P=0.069).</div></div><div><h3>Conclusion</h3><div>The study provides significant data regarding the functional recovery of HCWs who have recovered from COVID-19 using the 6MWT. Importantly, the findings demonstrated that SARS-CoV-2 infection did not substantially impair the pulmonary functional capacity of HCWs.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102664"},"PeriodicalIF":4.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-13 DOI: 10.1016/j.jiph.2025.102662
Hwa Young Choi , Kyung-Ah Kim , Bo Young Park , Bo Youl Choi , Moran Ki

Background

This study examines Hepatitis C virus (HCV) screening scenarios to meet World Health Organization (WHO) elimination targets (incidence ≤5 per 100,000, mortality ≤2 per 100,000) and assesses their timeframes and cost-effectiveness.

Methods

A closed cohort model of Koreans aged 30–79 in 2020 projected HCV incidence and mortality over 20 years. Economic evaluations used a dynamic transmission model, considering prevalent and annual incident cases. This approach addresses the limitations of previous models that neglected annual new HCV infections. Nine scenarios with varying screening intervals were created considering health checkup uptake, treatment rates, and HCV incidence reduction. Economic evaluations from the healthcare system's perspective employed cost-utility and cost-benefit analyses.

Results

Without national HCV screening, incidence slightly decreases, whereas mortality triples over 20 years. Introducing HCV screening offers five scenarios to meet WHO targets in 20 years. The quickest, involving biennial screening, high uptake, and a 30% incidence reduction, meets the incidence target at 6 years and mortality target at 14 years. For the most cost-efficient scenario, screening every 4 years with moderate uptake and a 20% incidence reduction meets the incidence target at 17 years and mortality target at 18 years. The Incremental Cost-Effectiveness Ratio (ICER) is $8,867 per quality-adjusted life-year (QALY), with a Benefit-Cost Ratio (BCR) of 1.60.

Conclusion

The absence of HCV screening impedes elimination goals and increases mortality. Biennial screening, with high participation and treatment rates, rapidly achieves targets but is less economically efficient. Screening every 4 years with moderate uptake and treatment rates is economically feasible and meets elimination goals within 20 years. Rapid screening implementation is crucial for effective HCV elimination.
{"title":"Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea","authors":"Hwa Young Choi ,&nbsp;Kyung-Ah Kim ,&nbsp;Bo Young Park ,&nbsp;Bo Youl Choi ,&nbsp;Moran Ki","doi":"10.1016/j.jiph.2025.102662","DOIUrl":"10.1016/j.jiph.2025.102662","url":null,"abstract":"<div><h3>Background</h3><div>This study examines Hepatitis C virus (HCV) screening scenarios to meet World Health Organization (WHO) elimination targets (incidence ≤5 per 100,000, mortality ≤2 per 100,000) and assesses their timeframes and cost-effectiveness.</div></div><div><h3>Methods</h3><div>A closed cohort model of Koreans aged 30–79 in 2020 projected HCV incidence and mortality over 20 years. Economic evaluations used a dynamic transmission model, considering prevalent and annual incident cases. This approach addresses the limitations of previous models that neglected annual new HCV infections. Nine scenarios with varying screening intervals were created considering health checkup uptake, treatment rates, and HCV incidence reduction. Economic evaluations from the healthcare system's perspective employed cost-utility and cost-benefit analyses.</div></div><div><h3>Results</h3><div>Without national HCV screening, incidence slightly decreases, whereas mortality triples over 20 years. Introducing HCV screening offers five scenarios to meet WHO targets in 20 years. The quickest, involving biennial screening, high uptake, and a 30% incidence reduction, meets the incidence target at 6 years and mortality target at 14 years. For the most cost-efficient scenario, screening every 4 years with moderate uptake and a 20% incidence reduction meets the incidence target at 17 years and mortality target at 18 years. The Incremental Cost-Effectiveness Ratio (ICER) is $8,867 per quality-adjusted life-year (QALY), with a Benefit-Cost Ratio (BCR) of 1.60.</div></div><div><h3>Conclusion</h3><div>The absence of HCV screening impedes elimination goals and increases mortality. Biennial screening, with high participation and treatment rates, rapidly achieves targets but is less economically efficient. Screening every 4 years with moderate uptake and treatment rates is economically feasible and meets elimination goals within 20 years. Rapid screening implementation is crucial for effective HCV elimination.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102662"},"PeriodicalIF":4.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Epidemiology and clinical outcomes in skin and soft tissue nontuberculous mycobacteria infections: A retrospective study 皮肤和软组织非结核分枝杆菌感染的流行病学和临床结果:一项回顾性研究。
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-10 DOI: 10.1016/j.jiph.2025.102655
Jia Zhou , Qiannan Jia , Lingli Liu , Luling Liang , Hanlin Zhang , Chunxia He , Jun Li , Hongli Sun

Background

Nontuberculous mycobacteria (NTM) are emerging pathogens responsible for increasing skin and soft tissue infections (SSTIs) globally. However, the diagnosis and treatment of NTM SSTIs face significant challenges due to the lack of standardized guidelines. This study reviewed the clinical characteristics, diagnostic challenges, and treatment outcomes of NTM SSTIs in a large cohort from a tertiary referral center in Beijing, China.

Methods

We retrospectively reviewed 142 patients diagnosed with NTM SSTIs at a tertiary hospital from 2014 to 2023. Data collected included clinical presentation, microbiologic and histopathologic findings, diagnostic methods, treatment regimens, and outcomes. The patients were categorized based on NTM species, and immunocompromised status.

Results

The cohort included patients with various NTM species, with M. marinum, M. avium complex (MAC), and M. abscessus complex (MABC) being the most common. The number of patients with NTM infections increased annually (p < 0.01). Fifty-four patients (38.0 %) were immunocompromised. The likelihood of immunosuppression was significantly higher in the MAC group (90.0 %, p = 0.02) and M. kansasii group (80.0 %). The highest proportion of sporotrichosis-pattern lesions was observed in M. marinum infections (p = 0.03). MAC primarily caused extracutaneous disseminated infections (p = 0.05), and immunosuppressed patients were more likely to have extracutaneous infections (79.6 %, p = 0.01). Of the 41 disseminated infection cases, 17.1 % had prior pulmonary NTM infections later disseminated to the skin and had a significantly worse prognosis (p < 0.01). Most misdiagnosed cases (82.6 %) were initially considered skin tuberculosis and bacterial infections. Amikacin was the most consistently effective antibiotic, while resistance to cefoxitin and imipenem was common in MABC and M. chelonae. The MABC strains exhibited 40 % resistance to clarithromycin. Drug side effects occurred in 30.3 % of patients, with 8.5 % switching medications due to adverse impacts. The longest treatment duration was in M. kansasii cases (371.4 days, p = 0.03). Immunosuppressed patients received more drugs (Mean ± SD: 3.0 ± 0.9 vs 2.8 ± 0.7, p = 0.02), whereas showed a nonsignificant trend toward longer treatment durations.

Conclusions

The study highlighted significant challenges in differentiating NTM infections from other conditions and managing their diverse clinical manifestations. Enhanced diagnostic tools and standardized treatment guidelines are essential to improve patient outcomes and manage the increasing burden of NTM SSTIs.
背景:非结核分枝杆菌(NTM)是全球皮肤和软组织感染(SSTIs)增加的新兴病原体。然而,由于缺乏标准化的指南,NTM ssti的诊断和治疗面临着重大挑战。本研究回顾了来自中国北京某三级转诊中心的大型队列NTM ssti的临床特征、诊断挑战和治疗结果。方法:回顾性分析某三级医院2014年至2023年诊断为NTM SSTIs的142例患者。收集的资料包括临床表现、微生物学和组织病理学结果、诊断方法、治疗方案和结果。根据NTM的种类和免疫功能低下情况对患者进行分类。结果:该队列包括不同种类的NTM患者,以海洋分枝杆菌、鸟分枝杆菌复合体(MAC)和脓肿分枝杆菌复合体(MABC)最为常见。NTM感染患者的数量每年都在增加(p )结论:该研究强调了在区分NTM感染与其他疾病以及管理其多样化临床表现方面的重大挑战。改进的诊断工具和标准化的治疗指南对于改善患者预后和管理NTM性传播感染日益增加的负担至关重要。
{"title":"Epidemiology and clinical outcomes in skin and soft tissue nontuberculous mycobacteria infections: A retrospective study","authors":"Jia Zhou ,&nbsp;Qiannan Jia ,&nbsp;Lingli Liu ,&nbsp;Luling Liang ,&nbsp;Hanlin Zhang ,&nbsp;Chunxia He ,&nbsp;Jun Li ,&nbsp;Hongli Sun","doi":"10.1016/j.jiph.2025.102655","DOIUrl":"10.1016/j.jiph.2025.102655","url":null,"abstract":"<div><h3>Background</h3><div>Nontuberculous mycobacteria (NTM) are emerging pathogens responsible for increasing skin and soft tissue infections (SSTIs) globally. However, the diagnosis and treatment of NTM SSTIs face significant challenges due to the lack of standardized guidelines. This study reviewed the clinical characteristics, diagnostic challenges, and treatment outcomes of NTM SSTIs in a large cohort from a tertiary referral center in Beijing, China.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 142 patients diagnosed with NTM SSTIs at a tertiary hospital from 2014 to 2023. Data collected included clinical presentation, microbiologic and histopathologic findings, diagnostic methods, treatment regimens, and outcomes. The patients were categorized based on NTM species, and immunocompromised status.</div></div><div><h3>Results</h3><div>The cohort included patients with various NTM species, with <em>M. marinum</em>, <em>M. avium</em> complex (MAC), and <em>M. abscessus</em> complex (MABC) being the most common. The number of patients with NTM infections increased annually (<em>p</em> &lt; 0.01). Fifty-four patients (38.0 %) were immunocompromised. The likelihood of immunosuppression was significantly higher in the MAC group (90.0 %, <em>p</em> = 0.02) and <em>M. kansasii</em> group (80.0 %). The highest proportion of sporotrichosis-pattern lesions was observed in <em>M. marinum</em> infections (<em>p</em> = 0.03). MAC primarily caused extracutaneous disseminated infections (<em>p</em> = 0.05), and immunosuppressed patients were more likely to have extracutaneous infections (79.6 %, <em>p</em> = 0.01). Of the 41 disseminated infection cases, 17.1 % had prior pulmonary NTM infections later disseminated to the skin and had a significantly worse prognosis (<em>p</em> &lt; 0.01). Most misdiagnosed cases (82.6 %) were initially considered skin tuberculosis and bacterial infections. Amikacin was the most consistently effective antibiotic, while resistance to cefoxitin and imipenem was common in <em>MABC</em> and <em>M. chelonae</em>. The <em>MABC</em> strains exhibited 40 % resistance to clarithromycin. Drug side effects occurred in 30.3 % of patients, with 8.5 % switching medications due to adverse impacts. The longest treatment duration was in <em>M. kansasii</em> cases (371.4 days, <em>p</em> = 0.03). Immunosuppressed patients received more drugs (Mean ± SD: 3.0 ± 0.9 vs 2.8 ± 0.7, <em>p</em> = 0.02), whereas showed a nonsignificant trend toward longer treatment durations.</div></div><div><h3>Conclusions</h3><div>The study highlighted significant challenges in differentiating NTM infections from other conditions and managing their diverse clinical manifestations. Enhanced diagnostic tools and standardized treatment guidelines are essential to improve patient outcomes and manage the increasing burden of NTM SSTIs.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102655"},"PeriodicalIF":4.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Enhancing public health outcomes with AI-powered clinical surveillance: Precise detection of COVID-19 variants using qPCR and nanopore sequencing
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-10 DOI: 10.1016/j.jiph.2025.102663
Hsing-Yi Chung , Ming-Jr Jian , Chih-Kai Chang , Cherng-Lih Perng , Kuo-Sheng Hung , Chun-Hsiang Chiu , Hung-Sheng Shang

Background

We aimed to evaluate the efficacy of integrating the Varia5 multiplex assay (qPCR) and whole genome sequencing (WGS) for monitoring SARS-CoV-2, focusing on their overall performance in identifying various virus variants.

Methods

This study included 140 naso-pharyngeal swab samples from individuals with suspected COVID-19. We utilized our self-developed Varia5 multiplex assay, which targets five viral genes linked to COVID-19 mutations, in conjunction with comprehensive genomic analysis performed through whole genome sequencing (WGS) using the Oxford Nanopore system. Machine learning was integrated to optimize the qPCR conditions and enhance the detection efficiency.

Results

The Varia5 assay identified the prevalent BA.2.75 variant in 92 samples compared to that in 81 samples detected via WGS. The BA.5.2 variant, indicative of higher viral loads, was identified in 15 samples via Varia5 and in 14 samples via WGS.Furthermore, rare variants, such as BA.2.10, were identified. The mean Ct value was 18.36, with significant viral load differences noted between specific variants.

Conclusion

Our findings demonstrate that while WGS offers enhanced sensitivity and specificity for variant detection, qPCR remains crucial for large-scale testing because of its cost and time efficiency. The integrated approach, which combines both techniques, represents a more comprehensive monitoring algorithm that can improve public health strategies against pandemics such as COVID-19.
{"title":"Enhancing public health outcomes with AI-powered clinical surveillance: Precise detection of COVID-19 variants using qPCR and nanopore sequencing","authors":"Hsing-Yi Chung ,&nbsp;Ming-Jr Jian ,&nbsp;Chih-Kai Chang ,&nbsp;Cherng-Lih Perng ,&nbsp;Kuo-Sheng Hung ,&nbsp;Chun-Hsiang Chiu ,&nbsp;Hung-Sheng Shang","doi":"10.1016/j.jiph.2025.102663","DOIUrl":"10.1016/j.jiph.2025.102663","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to evaluate the efficacy of integrating the Varia5 multiplex assay (qPCR) and whole genome sequencing (WGS) for monitoring SARS-CoV-2, focusing on their overall performance in identifying various virus variants.</div></div><div><h3>Methods</h3><div>This study included 140 naso-pharyngeal swab samples from individuals with suspected COVID-19. We utilized our self-developed Varia5 multiplex assay, which targets five viral genes linked to COVID-19 mutations, in conjunction with comprehensive genomic analysis performed through whole genome sequencing (WGS) using the Oxford Nanopore system. Machine learning was integrated to optimize the qPCR conditions and enhance the detection efficiency.</div></div><div><h3>Results</h3><div>The Varia5 assay identified the prevalent BA.2.75 variant in 92 samples compared to that in 81 samples detected via WGS. The BA.5.2 variant, indicative of higher viral loads, was identified in 15 samples via Varia5 and in 14 samples via WGS.Furthermore, rare variants, such as BA.2.10, were identified. The mean Ct value was 18.36, with significant viral load differences noted between specific variants.</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate that while WGS offers enhanced sensitivity and specificity for variant detection, qPCR remains crucial for large-scale testing because of its cost and time efficiency. The integrated approach, which combines both techniques, represents a more comprehensive monitoring algorithm that can improve public health strategies against pandemics such as COVID-19.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102663"},"PeriodicalIF":4.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates 阿拉伯联合酋长国重症监护病房入院时的耳念珠菌筛查。
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-08 DOI: 10.1016/j.jiph.2025.102659
Sungsoo Park , Heesuk Kim , Kilchae Hwang , Duckjin Hong , Estephanie Padua , Eunjung Kim , Hyeyoung Oh

Background

Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine C. auris screening upon admission to the intensive care unit (ICU).

Methods

This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for C. auris screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of C. auris during the pre- and post-screening period.

Results

Of the 1698 patients who underwent C. auris screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results.

Conclusions

Universal C. auris screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for C. auris screening.
背景:耳念珠菌筛查是遏制耳念珠菌传播的感染防控措施的重要组成部分之一。然而,先前的研究已经根据不同地区、医疗机构类型和不同流行程度的患者群体,对金黄色葡萄球菌筛查的有效性产生了不同的结果。我们的目的是评估在重症监护病房(ICU)入院时常规耳念珠菌筛查的临床效果。方法:回顾性研究纳入3356例ICU患者筛查前(N = 1658,2020年6月至2021年11月)和筛查后(N = 1698,2022年6月至2023年11月)。从腋窝和腹股沟采集耳球菌筛选拭子,进行培养,并使用基质辅助激光解吸/电离飞行时间(MALDI-TOF)质谱法或VITEK 2 YST识别卡进行鉴定。我们比较了筛查前后的金黄色葡萄球菌阳性率。结果:在1698例接受耳球菌筛查的患者中,只有4例(0.2 %)检测呈阳性。筛查方案实施前后的阳性率分别为2.92例/ 1000患者日(36/12333)和2.36例/ 1000患者日(21/8909),差异无统计学意义(P = 0.435)。中断时间序列分析显示筛选程序没有立即(P = 0.775)或持续(P = 0.484)的影响。对内科ICU患者的亚组分析也显示了类似的结果。结论:ICU入院时通用的C. auris筛查发现了少数病例。相反,可以采用有针对性的筛查和定期的点流行率调查,以及其他感染预防和控制措施。需要在不同的环境下采用不同的检测策略进行进一步的研究,以建立最有效的金黄色葡萄球菌筛查方法。
{"title":"Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates","authors":"Sungsoo Park ,&nbsp;Heesuk Kim ,&nbsp;Kilchae Hwang ,&nbsp;Duckjin Hong ,&nbsp;Estephanie Padua ,&nbsp;Eunjung Kim ,&nbsp;Hyeyoung Oh","doi":"10.1016/j.jiph.2025.102659","DOIUrl":"10.1016/j.jiph.2025.102659","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida auris</em> screening is one of the crucial components of infection prevention and control measures to curb the spread of <em>C. auris</em>. However, previous research has yielded various results on the effectiveness of <em>C. auris</em> screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine <em>C. auris</em> screening upon admission to the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for <em>C. auris</em> screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of <em>C. auris</em> during the pre- and post-screening period.</div></div><div><h3>Results</h3><div>Of the 1698 patients who underwent <em>C. auris</em> screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results.</div></div><div><h3>Conclusions</h3><div>Universal <em>C. auris</em> screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for <em>C. auris</em> screening.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102659"},"PeriodicalIF":4.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Delays in chemotherapy and radiotherapy of breast cancer during COVID-19 pandemic COVID-19大流行期间乳腺癌化疗和放疗延迟
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-08 DOI: 10.1016/j.jiph.2025.102657
Moein Rast , Arash Tehrani-Banihashemi , Pedram Fadavi , Marzieh Nojomi , Donya Hatami , Kiarash Ansari , Seyyed Amir Yasin Ahmadi

Background

During the COVID-19 pandemic, hospitals were overwhelmed with infected patients, leading to a disruption in the delivery of services. Patients with cancer, including breast cancer, rely on timely treatment, as delays can reduce survival rates. In this study, we investigated delays in treatment and the factors contributing to delays in chemotherapy and radiotherapy for these patients.

Method

All women with breast cancer who received chemotherapy or radiotherapy at academic hospitals of Iran University of Medical Sciences from February 20, 2020, to March 20, 2022, were included in our study. Age and metastasis status, including the presence of any metastasis, were also recorded. Delays were calculated for each chemotherapy session, as well as the total number of delays for each patient. For patients who received radiotherapy, delays in the whole course of radiotherapy were calculated. Logistic and Poisson regression with Incidence Rate Ratio (IRR) was used to analyze the number of delays and the impact of pandemic waves.

Results

The results of the study showed an association between metastasis and delays in chemotherapy for breast cancer. Having metastatic breast cancer before the start of treatment was also associated with the increasing number of delays in the entire course of chemotherapy (IRR=1.44). Delays among radiotherapy patients weren’t associated with age or metastasis of the disease. The first (IRR=2.74), second (IRR=2.64), third (IRR=1.26), and fourth (IRR=1.44) pandemic waves in chemotherapy and first (IRR=2.56), second (IRR=6.45), fifth (IRR=2.36), and sixth (IRR=2.13) waves in radiotherapy were associated with longer delays compared to plateau times of pandemic.

Conclusion

In this study, having metastatic breast cancer before the start of treatment was associated with higher rates of delays in chemotherapy. Also, COVID-19 pandemic waves, specifically the early waves, were associated with longer delays in both chemotherapy and radiotherapy. However, the impact of these delays on patient survival requires further study.
背景:在2019冠状病毒病大流行期间,医院因感染患者而不堪重负,导致服务中断。包括乳腺癌在内的癌症患者依赖于及时治疗,因为延误会降低生存率。在本研究中,我们调查了这些患者的治疗延迟以及导致化疗和放疗延迟的因素。方法:选取2020年2月20日至2022年3月20日在伊朗医科大学附属学术医院接受化疗或放疗的女性乳腺癌患者为研究对象。年龄和转移状态,包括任何转移的存在,也被记录。计算每个化疗疗程的延迟,以及每个患者的延迟总数。对于接受放疗的患者,计算整个放疗过程的延迟时间。采用Logistic回归和泊松回归(IRR)分析延误次数和大流行波的影响。结果:研究结果显示乳腺癌转移与延迟化疗之间存在关联。在治疗开始前患有转移性乳腺癌也与整个化疗过程中延迟的数量增加有关(IRR=1.44)。放疗患者的延迟与年龄或疾病转移无关。化疗中的第1波(IRR=2.74)、第2波(IRR=2.64)、第3波(IRR=1.26)和第4波(IRR=1.44)和放疗中的第1波(IRR=2.56)、第2波(IRR=6.45)、第5波(IRR=2.36)和第6波(IRR=2.13)与大流行的平台时间相比,延迟时间更长。结论:在这项研究中,在治疗开始前患有转移性乳腺癌与化疗延迟率较高相关。此外,COVID-19大流行波,特别是早期波,与化疗和放疗延迟时间较长有关。然而,这些延迟对患者生存的影响需要进一步研究。
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引用次数: 0
Science tells us that portable air filters reduce infection risk. It's time for public health authorities to make this clear 科学告诉我们,便携式空气过滤器可以降低感染风险。现在是公共卫生当局明确这一点的时候了。
IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-08 DOI: 10.1016/j.jiph.2024.102650
Tianyuan Li , Amy Katz , Jo-Ann Osei-Twum , LLana James , Victor Leung , Paul Bozek , Nav Persaud , Patricia O’Campo , Jeffrey A. Siegel
Throughout the COVID-19 pandemic, Canadian public health advisors and politicians have shared mixed messages about the utility of portable air filters (PAFs) for mitigating the transmission of airborne infectious diseases. Some public health advisors and decision-makers have also suggested that PAFs are cumbersome or require expert advice. We take this opportunity to review evidence and address myths about PAFs. In short, PAFs are an important tool to help reduce the risk of transmission of airborne infectious diseases. Moreover, PAFs are relatively simple to use, and there is a variety of high-quality guidance available for their deployment. We share this science here with the expectation that, going forward, public health authorities will position PAFs appropriately in infection prevention and control plans for both health care and community settings.
在2019冠状病毒病大流行期间,加拿大公共卫生顾问和政界人士就便携式空气过滤器(paf)在减轻空气传播传染病方面的作用分享了不同的信息。一些公共卫生顾问和决策者也表示,paf很麻烦,或者需要专家建议。我们借此机会回顾证据并澄清关于paf的误解。简而言之,paf是帮助减少空气传播传染病风险的重要工具。此外,paf使用起来相对简单,并且有各种高质量的可用于部署的指导。我们在这里分享这一科学成果,并期望今后公共卫生当局将在卫生保健和社区环境的感染预防和控制计划中适当地定位paf。
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Journal of Infection and Public Health
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