Pub Date : 2025-01-20DOI: 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.
{"title":"Fatal acute liver failure following norovirus gastroenteritis in a child: A case report","authors":"Rabab Taha , Noura Elazhary , Sarah Alqhtani , Walaa Almansouri","doi":"10.1016/j.jiph.2025.102675","DOIUrl":"10.1016/j.jiph.2025.102675","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 4","pages":"Article 102675"},"PeriodicalIF":4.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074448","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}
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 , 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","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}
Pub Date : 2025-01-17DOI: 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 () of each region was then calculated using the estimated parameters and predicted malaria dynamics.
Results
In the hotspots, the value of rose along with the number of long-latency patients, followed by an increase in short-latency patients. The points where exceeded and fell below one varied by region. Ganghwa-gun exhibited the longest period (), whereas Deokyang-gu had the shortest. Maximum values ranged from 1.1 in Deokyang-gu to 2.7 in Ganghwa-gun. A criterion was established to estimate the timing of 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 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 , Jung Ho Kim , Jeehyun Lee , 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>></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>></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}
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 , 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","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% < 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}
Pub Date : 2025-01-13DOI: 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 , Kyung-Ah Kim , Bo Young Park , Bo Youl Choi , 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}
Pub Date : 2025-01-10DOI: 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.
{"title":"Epidemiology and clinical outcomes in skin and soft tissue nontuberculous mycobacteria infections: A retrospective study","authors":"Jia Zhou , Qiannan Jia , Lingli Liu , Luling Liang , Hanlin Zhang , Chunxia He , Jun Li , 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> < 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> < 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}
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 , Ming-Jr Jian , Chih-Kai Chang , Cherng-Lih Perng , Kuo-Sheng Hung , Chun-Hsiang Chiu , 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}
Pub Date : 2025-01-08DOI: 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.
{"title":"Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates","authors":"Sungsoo Park , Heesuk Kim , Kilchae Hwang , Duckjin Hong , Estephanie Padua , Eunjung Kim , 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}
Pub Date : 2025-01-08DOI: 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.
{"title":"Delays in chemotherapy and radiotherapy of breast cancer during COVID-19 pandemic","authors":"Moein Rast , Arash Tehrani-Banihashemi , Pedram Fadavi , Marzieh Nojomi , Donya Hatami , Kiarash Ansari , Seyyed Amir Yasin Ahmadi","doi":"10.1016/j.jiph.2025.102657","DOIUrl":"10.1016/j.jiph.2025.102657","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102657"},"PeriodicalIF":4.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006253","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}
Pub Date : 2025-01-08DOI: 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.
{"title":"Science tells us that portable air filters reduce infection risk. It's time for public health authorities to make this clear","authors":"Tianyuan Li , Amy Katz , Jo-Ann Osei-Twum , LLana James , Victor Leung , Paul Bozek , Nav Persaud , Patricia O’Campo , Jeffrey A. Siegel","doi":"10.1016/j.jiph.2024.102650","DOIUrl":"10.1016/j.jiph.2024.102650","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102650"},"PeriodicalIF":4.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006644","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}