Alexandra Savinkina, Daniel M Weinberger, Cristiana M Toscano, Lucia H De Oliveira
Background The COVID-19 pandemic has had a significant impact on global health, with millions of lives lost worldwide. Vaccination has emerged as a crucial strategy in mitigating the impact of the disease. This study aims to estimate the number of deaths averted through vaccination in Latin America and the Caribbean region (LAC) during the first year and a half of vaccination rollout (January 2021 - May 2022). Methods Publicly available data on COVID-19 deaths and vaccination rates were used to estimate the total number of deaths averted via vaccination in LAC. Using estimates for number of deaths, number of vaccinated, and vaccine effectiveness, a counterfactual estimated number of deaths observed without vaccination was calculated. Vaccine effectiveness estimates were obtained from published studies. The analysis focused on 17 countries in LAC and considered adults aged 18 years and above. Findings After accounting for underreporting, the analysis estimated that over 1.49 million deaths were caused by COVID-19 in the selected countries during the study period. Without vaccination, the model estimated that between 2.10 and 4.11 million COVID-19 deaths would have occurred. Consequently, vaccination efforts resulted in approximately 610,000 to 2.61 million deaths averted. Interpretation This study represents the first large-scale, multi-center estimate of population-level vaccine impact on COVID-19 mortality in LAC. The findings underscore the substantial impact of timely and widespread vaccination in averting COVID-19 deaths. These results provide crucial support for vaccination programs aimed at combating epidemic infectious diseases in the region and future pandemics.
{"title":"Estimated deaths averted in adults by COVID-19 vaccination in select Latin American and Caribbean Countries","authors":"Alexandra Savinkina, Daniel M Weinberger, Cristiana M Toscano, Lucia H De Oliveira","doi":"10.1093/ofid/ofae528","DOIUrl":"https://doi.org/10.1093/ofid/ofae528","url":null,"abstract":"Background The COVID-19 pandemic has had a significant impact on global health, with millions of lives lost worldwide. Vaccination has emerged as a crucial strategy in mitigating the impact of the disease. This study aims to estimate the number of deaths averted through vaccination in Latin America and the Caribbean region (LAC) during the first year and a half of vaccination rollout (January 2021 - May 2022). Methods Publicly available data on COVID-19 deaths and vaccination rates were used to estimate the total number of deaths averted via vaccination in LAC. Using estimates for number of deaths, number of vaccinated, and vaccine effectiveness, a counterfactual estimated number of deaths observed without vaccination was calculated. Vaccine effectiveness estimates were obtained from published studies. The analysis focused on 17 countries in LAC and considered adults aged 18 years and above. Findings After accounting for underreporting, the analysis estimated that over 1.49 million deaths were caused by COVID-19 in the selected countries during the study period. Without vaccination, the model estimated that between 2.10 and 4.11 million COVID-19 deaths would have occurred. Consequently, vaccination efforts resulted in approximately 610,000 to 2.61 million deaths averted. Interpretation This study represents the first large-scale, multi-center estimate of population-level vaccine impact on COVID-19 mortality in LAC. The findings underscore the substantial impact of timely and widespread vaccination in averting COVID-19 deaths. These results provide crucial support for vaccination programs aimed at combating epidemic infectious diseases in the region and future pandemics.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimberly A Stanford, Joseph Mason, Eleanor Friedman, Aniruddha Hazra, Erin Augustine, John Schneider
Background With rising rates of syphilis in the U.S., novel strategies are needed to improve early diagnosis, particularly among priority populations such as pregnant people. As the primary source of healthcare for many communities with limited access to care, the emergency department (ED) visit represents a crucial opportunity for syphilis detection and congenital syphilis prevention. Methods This pre-post design study examined all ED encounters for two-year periods before and after implementation of an opt-out ED syphilis screening intervention in May 2019 at a large, urban, academic ED. Data on laboratory testing, syphilis status, and demographics were extracted from the medical record. Descriptive statistics and logistic regression were used to examine trends in syphilis screening and diagnosis. Results Syphilis screening increased from 5209 (3.6%) to 37,289 (24.4%) encounters. Presumed active syphilis infection (PAI) increased 288%, from 161 patients (3.1% of those screened) to 624 (1.7%). The proportion of female PAI increased from 25.6% to 42.5%, despite no change in proportion of females screened. Post-intervention, 23.6% of PAI were tested for a urogenital sexually transmitted infection (STI) in the ED and 9.0% presented with symptoms of an STI by diagnosis code. Among pregnant people, screening increased from 5.9% to 49.9% of encounters, and syphilis diagnosis increased 750%, from 2 cases to 15. Conclusions Opt-out ED syphilis screening led to a dramatic increase in screening and diagnosis, especially among pregnant individuals, a priority population for congenital syphilis prevention. Most individuals with syphilis did not have STI symptoms. Opt-out screening will be an important strategy in the effort to address the syphilis epidemic.
背景随着美国梅毒发病率的不断上升，需要采取新的策略来提高早期诊断率，尤其是在孕妇等重点人群中。急诊科（ED）是许多医疗条件有限的社区的主要医疗渠道，是梅毒检测和先天性梅毒预防的重要机会。方法 本研究采用前后对比的设计方法，对一家大型城市学术性急诊科在2019年5月实施选择不接受急诊科梅毒筛查干预措施前后两年内的所有急诊科就诊情况进行了调查。从病历中提取了有关实验室检测、梅毒状态和人口统计学的数据。使用描述性统计和逻辑回归来研究梅毒筛查和诊断的趋势。结果 梅毒筛查从 5209 例（3.6%）增加到 37289 例（24.4%）。推定梅毒感染（PAI）增加了288%，从161人（占筛查人数的3.1%）增加到624人（占1.7%）。尽管女性接受筛查的比例没有变化，但女性 PAI 的比例从 25.6% 上升到 42.5%。干预后，23.6% 的 PAI 在急诊室接受了泌尿生殖系统性传播感染 (STI) 检测，9.0% 的 PAI 出现了 STI 诊断代码症状。在孕妇中，筛查比例从 5.9% 增加到 49.9%，梅毒诊断从 2 例增加到 15 例，增幅达 750%。结论 选择性退出 ED 梅毒筛查使筛查和诊断率大幅提高，尤其是在先天性梅毒预防的重点人群--孕妇中。大多数梅毒患者没有性传播感染症状。退出式筛查将成为应对梅毒流行的重要策略。
{"title":"An Opt-out Emergency Department Screening Intervention Leads to Major Increases in Diagnosis of Syphilis","authors":"Kimberly A Stanford, Joseph Mason, Eleanor Friedman, Aniruddha Hazra, Erin Augustine, John Schneider","doi":"10.1093/ofid/ofae490","DOIUrl":"https://doi.org/10.1093/ofid/ofae490","url":null,"abstract":"Background With rising rates of syphilis in the U.S., novel strategies are needed to improve early diagnosis, particularly among priority populations such as pregnant people. As the primary source of healthcare for many communities with limited access to care, the emergency department (ED) visit represents a crucial opportunity for syphilis detection and congenital syphilis prevention. Methods This pre-post design study examined all ED encounters for two-year periods before and after implementation of an opt-out ED syphilis screening intervention in May 2019 at a large, urban, academic ED. Data on laboratory testing, syphilis status, and demographics were extracted from the medical record. Descriptive statistics and logistic regression were used to examine trends in syphilis screening and diagnosis. Results Syphilis screening increased from 5209 (3.6%) to 37,289 (24.4%) encounters. Presumed active syphilis infection (PAI) increased 288%, from 161 patients (3.1% of those screened) to 624 (1.7%). The proportion of female PAI increased from 25.6% to 42.5%, despite no change in proportion of females screened. Post-intervention, 23.6% of PAI were tested for a urogenital sexually transmitted infection (STI) in the ED and 9.0% presented with symptoms of an STI by diagnosis code. Among pregnant people, screening increased from 5.9% to 49.9% of encounters, and syphilis diagnosis increased 750%, from 2 cases to 15. Conclusions Opt-out ED syphilis screening led to a dramatic increase in screening and diagnosis, especially among pregnant individuals, a priority population for congenital syphilis prevention. Most individuals with syphilis did not have STI symptoms. Opt-out screening will be an important strategy in the effort to address the syphilis epidemic.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Hauser, Lorena Urda, Christopher Lang, Christian Mittelholzer, Fabian Otte, Enja Kipfer, Yuepeng Zhang, Martin Lett, Christiane Schebitz, Roman-Ulrich Müller, Wilfried Klimkait, Thomas Klimkait
Background Current COVID-19 vaccines primarily target the Spike protein of defined virus variants, offering limited protection against emerging variants in immunocompetent individuals. Similarly, protective immunity following natural SARS-CoV-2 infection is variable and of short duration, raising concerns about immunocompromised individuals’ vaccination strategies. Methods This prospective multi-center study examined 66 sera from 59 immunocompromised and 451 sera from 215 immunocompetent individuals from different pandemic periods. We establish and validate a live virus-based neutralization assay (VNA) to determine the virus-inactivating potential against ancestral and current SARS-CoV-2 isolates. Results Our VNA demonstrated superior performance over surrogate neutralization assays. We found strong but transient immunity after complete vaccination schemes, with single doses providing minimum neutralization, regardless of vaccine type. Combining vaccination-induced immunity with SARS-CoV-2 infection before or after vaccination yielded higher neutralizing titers than vaccination or infection alone, consistent across both study groups. Additional doses after a full vaccination course restore neutralization levels. Conclusions Potentially protective SARS-CoV-2 neutralization is reliably induced in immunocompromised individuals by prior attenuation of immunosuppression. First-generation vaccines protect against various SARS-CoV-2 variants in immunocompetent individuals, with effective cross-neutralization demonstrated up to the Delta variant but largely absent for later Omicron variants. Continuous vaccine updates are necessary to address emerging SARS-CoV-2 variants.
{"title":"Benefits of repeated SARS-CoV-2 vaccination and virus-induced cross-neutralization potential in immunocompromised transplant patients and healthy individuals","authors":"David Hauser, Lorena Urda, Christopher Lang, Christian Mittelholzer, Fabian Otte, Enja Kipfer, Yuepeng Zhang, Martin Lett, Christiane Schebitz, Roman-Ulrich Müller, Wilfried Klimkait, Thomas Klimkait","doi":"10.1093/ofid/ofae527","DOIUrl":"https://doi.org/10.1093/ofid/ofae527","url":null,"abstract":"Background Current COVID-19 vaccines primarily target the Spike protein of defined virus variants, offering limited protection against emerging variants in immunocompetent individuals. Similarly, protective immunity following natural SARS-CoV-2 infection is variable and of short duration, raising concerns about immunocompromised individuals’ vaccination strategies. Methods This prospective multi-center study examined 66 sera from 59 immunocompromised and 451 sera from 215 immunocompetent individuals from different pandemic periods. We establish and validate a live virus-based neutralization assay (VNA) to determine the virus-inactivating potential against ancestral and current SARS-CoV-2 isolates. Results Our VNA demonstrated superior performance over surrogate neutralization assays. We found strong but transient immunity after complete vaccination schemes, with single doses providing minimum neutralization, regardless of vaccine type. Combining vaccination-induced immunity with SARS-CoV-2 infection before or after vaccination yielded higher neutralizing titers than vaccination or infection alone, consistent across both study groups. Additional doses after a full vaccination course restore neutralization levels. Conclusions Potentially protective SARS-CoV-2 neutralization is reliably induced in immunocompromised individuals by prior attenuation of immunosuppression. First-generation vaccines protect against various SARS-CoV-2 variants in immunocompetent individuals, with effective cross-neutralization demonstrated up to the Delta variant but largely absent for later Omicron variants. Continuous vaccine updates are necessary to address emerging SARS-CoV-2 variants.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kasper Høtoft Bengtsen, Alexander Christian Falkentoft, Melanie Vuong Le, Ketil Haugan, Berit Thornvig Philbert, Jens Brock Johansen, Christian Torp-Pedersen, Sam Riahi, Jens Cosedis Nielsen, Charlotte Larroudé, Andreas Petersen, Anders Rhod Larsen, Lauge Østergaard, Emil Fosbøl, Niels Eske Bruun, Anne-Christine Ruwald
Background and aims Staphylococcus aureus bacteraemia (SAB) is a high-risk condition associated with high morbidity and mortality. In the presence of cardiac implantable electronic devices (CIEDs) SAB may cause or clinically indicate device infection. We aimed to estimate the 10-year absolute risk of SAB in adult Danish first-time CIED carriers. Secondary aims included identification of risk factors associated with SAB. Methods A registry-based study utilizing Danish nationwide registers and including consecutive Danish patients undergoing first CIED implantation between 2000 and 2020 was conducted. The primary outcome was first-time SAB after CIED-implantation. Results 87,257 patients with first CIED implantation in the study period were identified (median age 75 years, 62.6% males, median follow-up 3.8 years). Patients with pacemakers (PM) were older and with more non-cardiovascular comorbidities compared to patients with implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy devices w/wo defibrillator capacity (CRT). In total 1,366 patients (1.6%) developed SAB. The 10-year absolute risk of SAB was 2.0% (1.9-2.1) for PM-, 2.6% (2.2-3.1) for ICD- and 3.7% (3.0-4.5) for CRT-patients. A multivariable Cox analysis identified haemodialysis (Hazard Ratio [HR] 8.51), SAB before CIED (HR 2.76), liver disease (HR 2.35), and carrying a CRT device (HR 1.68) among the covariates associated with increased risk of SAB. Conclusions The absolute risk of SAB in Danish CIED carriers increased with more advanced CIED-systems. The risk was highest within the first 3 months after CIED implantation and increased with the presence of certain covariates including renal dialysis, SAB before CIED, male sex and advancing age.
{"title":"Incidence of Staphylococcus aureus bacteraemia in patients following implantation of cardiac implantable electronic devices: a Danish nationwide cohort study","authors":"Kasper Høtoft Bengtsen, Alexander Christian Falkentoft, Melanie Vuong Le, Ketil Haugan, Berit Thornvig Philbert, Jens Brock Johansen, Christian Torp-Pedersen, Sam Riahi, Jens Cosedis Nielsen, Charlotte Larroudé, Andreas Petersen, Anders Rhod Larsen, Lauge Østergaard, Emil Fosbøl, Niels Eske Bruun, Anne-Christine Ruwald","doi":"10.1093/ofid/ofae515","DOIUrl":"https://doi.org/10.1093/ofid/ofae515","url":null,"abstract":"Background and aims Staphylococcus aureus bacteraemia (SAB) is a high-risk condition associated with high morbidity and mortality. In the presence of cardiac implantable electronic devices (CIEDs) SAB may cause or clinically indicate device infection. We aimed to estimate the 10-year absolute risk of SAB in adult Danish first-time CIED carriers. Secondary aims included identification of risk factors associated with SAB. Methods A registry-based study utilizing Danish nationwide registers and including consecutive Danish patients undergoing first CIED implantation between 2000 and 2020 was conducted. The primary outcome was first-time SAB after CIED-implantation. Results 87,257 patients with first CIED implantation in the study period were identified (median age 75 years, 62.6% males, median follow-up 3.8 years). Patients with pacemakers (PM) were older and with more non-cardiovascular comorbidities compared to patients with implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy devices w/wo defibrillator capacity (CRT). In total 1,366 patients (1.6%) developed SAB. The 10-year absolute risk of SAB was 2.0% (1.9-2.1) for PM-, 2.6% (2.2-3.1) for ICD- and 3.7% (3.0-4.5) for CRT-patients. A multivariable Cox analysis identified haemodialysis (Hazard Ratio [HR] 8.51), SAB before CIED (HR 2.76), liver disease (HR 2.35), and carrying a CRT device (HR 1.68) among the covariates associated with increased risk of SAB. Conclusions The absolute risk of SAB in Danish CIED carriers increased with more advanced CIED-systems. The risk was highest within the first 3 months after CIED implantation and increased with the presence of certain covariates including renal dialysis, SAB before CIED, male sex and advancing age.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irene A Abela,Frédérique Chammartin,Alain Amstutz,Bernard Surial,Marie Ballif,Catia Marzolini,Karoline Aebi-Popp,Julia Notter,Olivier Segeral,Marcel Stoeckle,Matthias Cavassini,Enos Bernasconi,Huldrych F Günthard,Roger D Kouyos,Chloé Pasin,
The REPRIEVE trial suggests that primary cardiovascular disease (CVD) prevention could be considered among people with HIV at low CVD risk. We found cisgender women with low/moderate and high CVD risk are less likely to receive statins than cisgender men. Efforts are needed to guarantee equal access to statin-based CVD prevention.
{"title":"Gender Disparities in Statin Prescriptions in People With HIV With Low/Moderate to High Cardiovascular Risk.","authors":"Irene A Abela,Frédérique Chammartin,Alain Amstutz,Bernard Surial,Marie Ballif,Catia Marzolini,Karoline Aebi-Popp,Julia Notter,Olivier Segeral,Marcel Stoeckle,Matthias Cavassini,Enos Bernasconi,Huldrych F Günthard,Roger D Kouyos,Chloé Pasin,","doi":"10.1093/ofid/ofae502","DOIUrl":"https://doi.org/10.1093/ofid/ofae502","url":null,"abstract":"The REPRIEVE trial suggests that primary cardiovascular disease (CVD) prevention could be considered among people with HIV at low CVD risk. We found cisgender women with low/moderate and high CVD risk are less likely to receive statins than cisgender men. Efforts are needed to guarantee equal access to statin-based CVD prevention.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background To address the need for treatments for patients with COVID-19, three therapies have been given either full approval or Emergency Use Authorization. These were based on randomized data showing a reduction in deaths/hospitalization, but since then, circulating viral strains and population immunity has changed. Methods We identified all trials testing nirmatrelvir/ritonavir and molnupiravir in patients with COVID-19 and assessed the pooled efficacy in a meta-analysis. We searched PubMed, Web of Science, Embase, and clinicaltrials.gov for clinical trials testing nirmatrelvir/ritonavir and molnupiravir for COVID-19. We calculated pooled estimates of hospitalization and death in patients with COVID-19 and the number of studies with published/reported data. Results Of the 23 studies found, 11 tested nirmatrelvir/ritonavir, 10 tested molnupiravir, and two tested both agents. The pooled estimate in reducing deaths and hospitalization for molnupiravir was 0.62 (95% CI: 0.15 to 2.53), and the pooled estimate for nirmatrelvir/ritonavir was 0.33 (95%CI: 0.03 to 3.35). The one nirmatrelvir/ritonavir trial that reported significant improvements tested people who were predominantly infected with earlier COVID-19 variants, whereas the two null trials were tested in people infected with more recent variants. The two positive molnupiravir trials included participants primarily with the delta variant, whereas the null trials were tested later, against more recent variants. Conclusions While early trial data show effectiveness of these therapies, the overall pooled effects are non-significant, suggesting that recommendations and use of approved oral COVID-19 treatment therapies need to be re-evaluated in the context of current viral strains and population immunity.
{"title":"A systematic review of nirmatrelvir/ritonavir and molnupiravir for the treatment of COVID-19","authors":"Alyson Haslam, Vinay Prasad","doi":"10.1093/ofid/ofae497","DOIUrl":"https://doi.org/10.1093/ofid/ofae497","url":null,"abstract":"Background To address the need for treatments for patients with COVID-19, three therapies have been given either full approval or Emergency Use Authorization. These were based on randomized data showing a reduction in deaths/hospitalization, but since then, circulating viral strains and population immunity has changed. Methods We identified all trials testing nirmatrelvir/ritonavir and molnupiravir in patients with COVID-19 and assessed the pooled efficacy in a meta-analysis. We searched PubMed, Web of Science, Embase, and clinicaltrials.gov for clinical trials testing nirmatrelvir/ritonavir and molnupiravir for COVID-19. We calculated pooled estimates of hospitalization and death in patients with COVID-19 and the number of studies with published/reported data. Results Of the 23 studies found, 11 tested nirmatrelvir/ritonavir, 10 tested molnupiravir, and two tested both agents. The pooled estimate in reducing deaths and hospitalization for molnupiravir was 0.62 (95% CI: 0.15 to 2.53), and the pooled estimate for nirmatrelvir/ritonavir was 0.33 (95%CI: 0.03 to 3.35). The one nirmatrelvir/ritonavir trial that reported significant improvements tested people who were predominantly infected with earlier COVID-19 variants, whereas the two null trials were tested in people infected with more recent variants. The two positive molnupiravir trials included participants primarily with the delta variant, whereas the null trials were tested later, against more recent variants. Conclusions While early trial data show effectiveness of these therapies, the overall pooled effects are non-significant, suggesting that recommendations and use of approved oral COVID-19 treatment therapies need to be re-evaluated in the context of current viral strains and population immunity.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Data are limited on the protective role of the Omicron BA bivalent vaccine, previous infection, and their induced neutralizing antibodies against Omicron XBB.1.16 and EG.5.1 infection. Methods We conducted a nested case-control analysis among tertiary hospital staff in Tokyo who had received three or more doses of COVID-19 vaccines and donated blood samples in June 2023 (1 month before Omicron XBB.1.16 and EG.5.1 wave). We identified 206 symptomatic cases between June and September 2023 and selected their controls with 1:1 propensity-score matching. We examined the association of vaccination, previous infection, and preinfection live-virus neutralizing antibody titers against Omicron XBB.1.16 and EG.5.1 with the risk of COVID-19 infection. Results Previous infection during Omicron BA- or XBB-dominant phases was associated with a significantly lower infection risk during the XBB.1.16 and EG.5.1 dominant phase than infection-naïve with 70% and 100% protection, respectively, whereas Omicron BA bivalent vaccination showed no association. Preinfection-neutralizing titers against XBB.1.16 and EG.5.1 were 39% (95%CI: 8–60) and 28% (95%CI: 8–44), respectively, lower in cases than in matched controls. Neutralizing activity against XBB.1.16 and EG.5.1. were somewhat detectable in the sera of individuals with previous infection but barely detectable in those who were infection-naïve and received the Omicron bivalent vaccine. Conclusions In the era when the Omicron XBB vaccine was unavailable, the Omicron BA bivalent vaccine did not confer the neutralizing activity and protection against Omicron XBB.1.16 and EG.5.1 symptomatic infection. The previous infection afforded neutralizing titers and protection against symptomatic infection with these variants.
{"title":"Protection of Omicron bivalent vaccine, previous infection, and their induced neutralizing antibodies against symptomatic infection with Omicron XBB.1.16 and EG.5.1","authors":"Shohei Yamamoto, Kouki Matsuda, Kenji Maeda, Tetsuya Mizoue, Kumi Horii, Kaori Okudera, Tomofumi Tan, Yusuke Oshiro, Natsumi Inamura, Takashi Nemoto, Junko S Takeuchi, Maki Konishi, Haruhito Sugiyama, Nobuyoshi Aoyanagi, Wataru Sugiura, Norio Ohmagari","doi":"10.1093/ofid/ofae519","DOIUrl":"https://doi.org/10.1093/ofid/ofae519","url":null,"abstract":"Background Data are limited on the protective role of the Omicron BA bivalent vaccine, previous infection, and their induced neutralizing antibodies against Omicron XBB.1.16 and EG.5.1 infection. Methods We conducted a nested case-control analysis among tertiary hospital staff in Tokyo who had received three or more doses of COVID-19 vaccines and donated blood samples in June 2023 (1 month before Omicron XBB.1.16 and EG.5.1 wave). We identified 206 symptomatic cases between June and September 2023 and selected their controls with 1:1 propensity-score matching. We examined the association of vaccination, previous infection, and preinfection live-virus neutralizing antibody titers against Omicron XBB.1.16 and EG.5.1 with the risk of COVID-19 infection. Results Previous infection during Omicron BA- or XBB-dominant phases was associated with a significantly lower infection risk during the XBB.1.16 and EG.5.1 dominant phase than infection-naïve with 70% and 100% protection, respectively, whereas Omicron BA bivalent vaccination showed no association. Preinfection-neutralizing titers against XBB.1.16 and EG.5.1 were 39% (95%CI: 8–60) and 28% (95%CI: 8–44), respectively, lower in cases than in matched controls. Neutralizing activity against XBB.1.16 and EG.5.1. were somewhat detectable in the sera of individuals with previous infection but barely detectable in those who were infection-naïve and received the Omicron bivalent vaccine. Conclusions In the era when the Omicron XBB vaccine was unavailable, the Omicron BA bivalent vaccine did not confer the neutralizing activity and protection against Omicron XBB.1.16 and EG.5.1 symptomatic infection. The previous infection afforded neutralizing titers and protection against symptomatic infection with these variants.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhi Jie Goh, Ruiqi Li, Min Xian Wang, Po Ying Chia, Jue Tao Lim
Introduction This systematic review and meta-analysis aimed to analyse the impacts of transfusing ‘non packed red blood cell’ blood products on patients with dengue and evaluate the effectiveness in reducing hospital stay, bleeding, mortality, and intensive care unit requirements. Methods Four databases were searched for relevant articles. Inclusion criteria were prospective or retrospective randomised or non-randomised studies which investigated the impacts of transfusion of blood products in patients with dengue. Results Nine studies were included in the final meta-analysis. Transfusion of blood products was associated with significantly higher mortality (9 studies, OR: 3.59, 95% CI: 1.07–15.98, I2 = 0%, p=0.04) and significantly longer length of hospital stay (6 studies, 0.56 days, 95% CI: 0.03–1.08, I2 = 95%, p=0.04). There was no significant difference in the incidence of clinical bleeding (7 studies, OR: 1.13, 95% CI: 0.77–1.65, I2 = 39%, p=0.54) or intensive care unit requirement (3 studies, OR: 1.59, 95% CI: 0.40–6.39, I2 = 0%, p=0.51). Conclusions Transfusing blood products for patients with dengue showed no benefit and may even be harmful.
{"title":"Transfusion of blood products and clinical outcomes for dengue fever patients: a systematic review and meta-analysis","authors":"Zhi Jie Goh, Ruiqi Li, Min Xian Wang, Po Ying Chia, Jue Tao Lim","doi":"10.1093/ofid/ofae507","DOIUrl":"https://doi.org/10.1093/ofid/ofae507","url":null,"abstract":"Introduction This systematic review and meta-analysis aimed to analyse the impacts of transfusing ‘non packed red blood cell’ blood products on patients with dengue and evaluate the effectiveness in reducing hospital stay, bleeding, mortality, and intensive care unit requirements. Methods Four databases were searched for relevant articles. Inclusion criteria were prospective or retrospective randomised or non-randomised studies which investigated the impacts of transfusion of blood products in patients with dengue. Results Nine studies were included in the final meta-analysis. Transfusion of blood products was associated with significantly higher mortality (9 studies, OR: 3.59, 95% CI: 1.07–15.98, I2 = 0%, p=0.04) and significantly longer length of hospital stay (6 studies, 0.56 days, 95% CI: 0.03–1.08, I2 = 95%, p=0.04). There was no significant difference in the incidence of clinical bleeding (7 studies, OR: 1.13, 95% CI: 0.77–1.65, I2 = 39%, p=0.54) or intensive care unit requirement (3 studies, OR: 1.59, 95% CI: 0.40–6.39, I2 = 0%, p=0.51). Conclusions Transfusing blood products for patients with dengue showed no benefit and may even be harmful.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report two cases of infection by fungi unprecedented in Rwanda. One patient with emergomycosis presented with disseminated disease and prominent cutaneous involvement and one patient with African blastomycosis had cutaneous and osseous disease. These cases illustrate the clinicopathologic and molecular traits of novel dimorphic onygenalean species in Rwanda.
{"title":"Systemic mycoses by novel Onygenalean fungal pathogens Emergomyces spp. and Blastomyces percursus in Rwanda","authors":"Alvaro C Laga, Deogratias Ruhangaza, Annie Isabelle Izimukwiye, Raquel Vilela, Leonel Mendoza","doi":"10.1093/ofid/ofae511","DOIUrl":"https://doi.org/10.1093/ofid/ofae511","url":null,"abstract":"We report two cases of infection by fungi unprecedented in Rwanda. One patient with emergomycosis presented with disseminated disease and prominent cutaneous involvement and one patient with African blastomycosis had cutaneous and osseous disease. These cases illustrate the clinicopathologic and molecular traits of novel dimorphic onygenalean species in Rwanda.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula M Krzos, Cynthia T Nguyen, Brenna Kane, Sambhavi Krishnamoorthy, Tanya W Kristof, Luke F Reynolds, Jennifer Pisano, Michelle A Josephson, Rolf Barth, Derek Owen
Existing literature on best practices to reduce the risk of infectious complications associated with ureteral stent removal in kidney transplant recipients is limited. Prior to 2021, a formal process surrounding stent removal was not in place at our institution. In June 2021, a stent removal protocol was established. This protocol included: obtaining a pre-procedure urine culture, prescribing universal culture-directed antimicrobial prophylaxis, earlier stent removal post-transplant, and patient education. We performed a retrospective, quasi-experimental study of kidney transplant recipients who had their stent removed between July 2020 and June 2022. The primary outcome was the incidence of infectious complications within 30 days. Infectious complications were defined as urinary tract infection (UTI), bacteremia due to urinary source, or hospitalization, emergency department visit, or outpatient encounter for possible UTI. Secondary objectives included infectious and immunologic complications within 30 days to one year from transplant. During this study period, 239 adult kidney transplant recipients were included, 88 patients in the pre-protocol group and 151 patients in the protocol group. The median time to stent removal was shorter in the protocol group (25 versus 36 days, p<0.001). More patients in the protocol group received pre-procedure antibiotics (99% versus 36%, p<0.001). Infectious complications were higher in the pre-protocol group (9% versus 3%, p=0.035). Overall, the stent removal protocol was associated with fewer infectious complications [OR (95% CI): 0.18 (0.05, 0.73]. Further investigation is necessary to determine which individual interventions (if any), drive this benefit.
{"title":"Evaluation of a ureteral stent removal protocol in adult kidney transplant recipients","authors":"Paula M Krzos, Cynthia T Nguyen, Brenna Kane, Sambhavi Krishnamoorthy, Tanya W Kristof, Luke F Reynolds, Jennifer Pisano, Michelle A Josephson, Rolf Barth, Derek Owen","doi":"10.1093/ofid/ofae510","DOIUrl":"https://doi.org/10.1093/ofid/ofae510","url":null,"abstract":"Existing literature on best practices to reduce the risk of infectious complications associated with ureteral stent removal in kidney transplant recipients is limited. Prior to 2021, a formal process surrounding stent removal was not in place at our institution. In June 2021, a stent removal protocol was established. This protocol included: obtaining a pre-procedure urine culture, prescribing universal culture-directed antimicrobial prophylaxis, earlier stent removal post-transplant, and patient education. We performed a retrospective, quasi-experimental study of kidney transplant recipients who had their stent removed between July 2020 and June 2022. The primary outcome was the incidence of infectious complications within 30 days. Infectious complications were defined as urinary tract infection (UTI), bacteremia due to urinary source, or hospitalization, emergency department visit, or outpatient encounter for possible UTI. Secondary objectives included infectious and immunologic complications within 30 days to one year from transplant. During this study period, 239 adult kidney transplant recipients were included, 88 patients in the pre-protocol group and 151 patients in the protocol group. The median time to stent removal was shorter in the protocol group (25 versus 36 days, p&lt;0.001). More patients in the protocol group received pre-procedure antibiotics (99% versus 36%, p&lt;0.001). Infectious complications were higher in the pre-protocol group (9% versus 3%, p=0.035). Overall, the stent removal protocol was associated with fewer infectious complications [OR (95% CI): 0.18 (0.05, 0.73]. Further investigation is necessary to determine which individual interventions (if any), drive this benefit.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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