IJID regions最新文献_第3页

Understanding the change of in-hospital mortality and respiratory failure between Delta and Omicron waves from a tertiary hospital in Southern Thailand: A retrospective cohort study 了解泰国南部一家三甲医院德尔塔波和欧米茄波之间院内死亡率和呼吸衰竭的变化：回顾性队列研究

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-12 DOI: 10.1016/j.ijregi.2024.100446

Objectives

This retrospective cohort study aims to assess the incidence and associated factors of in-hospital mortality and respiratory failure among patients with COVID-19 during the Omicron and Delta epidemics.

Methods

We reviewed medical records from a regional hospital in Southern Thailand of patients with COVID-19 during the Delta wave (August 2021 to December 2021) and the Omicron wave (February 2022 to June 2022). A computer-generated random sampling approach was used to select patients for analysis. Logistic regression identified factors associated with respiratory failure, while Cox proportional hazard models were used for in-hospital mortality associations.

Results

Among 5729 hospitalized patients with COVID-19 (Delta: 1229; Omicron: 4500), 1164 were randomly sampled (Delta: 295; Omicron: 869). Patients during the Delta wave were older (median: 52.0; interquartile range: 31.5-70.0) compared with those during the Omicron wave (median: 37.0; interquartile range: 8.0-65.0), with lower rates of completed two doses of vaccination (Delta: 18.3%; Omicron: 51.8%). The Delta variant exhibited higher rates of respiratory failure (46.8% vs Omicron: 22.3%) and in-hospital mortality (12.5% vs Omicron: 6.9%). Increased age (adjusted odds ratio [aOR] 1.04, 95% confidence interval [CI] 1.03-1.04), severity at admission (aOR 12.48, 95% CI 7.21-22.22), and delayed time to admission (aOR 1.07, 95% CI 1.02-1.12) increased the risk of respiratory failure, while receiving two-dose vaccination reduced this risk (aOR 0.36, 95% CI 0.24-0.53). Similarly, increased age (adjusted hazard ratio [aHR] 1.05, 95% CI 1.03-1.06), severity at admission (aHR 7.20, 95% CI 4.09-12.60), and delayed time to admission (aHR 1.05, 95% CI 1.00-1.11) were associated with higher in-hospital mortality, with two-dose vaccination decreasing this risk (aHR 0.45, 95% CI 0.27-0.75).

Conclusions

The Delta variant exhibited higher in-hospital mortality and respiratory failure rates compared with Omicron. The identification of high-risk groups emphasizes the critical need for timely care for vulnerable patients. Timely access to care and vaccination coverage are crucial in reducing respiratory failure and mortality due to COVID-19, highlighting the necessity for tailored interventions to mitigate the impact of emerging variants.

本回顾性队列研究旨在评估Omicron和Delta流行期间COVID-19患者的院内死亡率和呼吸衰竭的发生率及相关因素。方法我们查阅了泰国南部一家地区医院在Delta波（2021年8月至2021年12月）和Omicron波（2022年2月至2022年6月）期间COVID-19患者的医疗记录。采用计算机生成的随机抽样方法选取患者进行分析。结果在 5729 例 COVID-19 住院患者中（Delta：1229 例；Omicron：4500 例），随机抽取了 1164 例（Delta：295 例；Omicron：869 例）。与 Omicron 波段的患者（中位数：37.0；四分位间距：8.0-65.0）相比，Delta 波段的患者年龄较大（中位数：52.0；四分位间距：31.5-70.0），完成两剂疫苗接种的比例较低（Delta：18.3%；Omicron：51.8%）。德尔塔变异株的呼吸衰竭率（46.8% vs Omicron：22.3%）和院内死亡率（12.5% vs Omicron：6.9%）较高。年龄增加（调整赔率 [aOR] 1.04，95% 置信区间 [CI] 1.03-1.04）、入院时病情严重（aOR 12.48，95% CI 7.21-22.22）和入院时间延迟（aOR 1.07，95% CI 1.02-1.12）会增加呼吸衰竭的风险，而接种两剂疫苗会降低这一风险（aOR 0.36，95% CI 0.24-0.53）。同样，年龄增大（调整后危险比 [aHR] 1.05，95% CI 1.03-1.06）、入院时病情严重（aHR 7.20，95% CI 4.09-12.60）和入院时间延迟（aHR 1.05，95% CI 1.00-1.11）与较高的住院风险相关。结论与 Omicron 相比，Delta 变异型的院内死亡率和呼吸衰竭发生率更高。高危人群的确定强调了及时护理易感患者的重要性。及时获得护理和疫苗接种覆盖率对于减少 COVID-19 导致的呼吸衰竭和死亡率至关重要，这突出表明有必要采取有针对性的干预措施，以减轻新变异株的影响。

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引用次数: 0

HIV and body mass index are associated with prolonged corrected QT interval among people with drug-resistant tuberculosis on bedaquiline-containing regimen in Uganda 乌干达接受含贝达喹治疗的耐药结核病患者中，艾滋病毒和体重指数与校正 QT 间期延长有关

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-10 DOI: 10.1016/j.ijregi.2024.100438

Objectives

People with drug-resistant tuberculosis (DR-TB) on bedaquiline-containing regimens are at risk for a prolonged corrected QT (QTc) interval but this problem is understudied in low-resource countries. We determined the magnitude and risk factors for QTc interval prolongation among people with DR-TB on bedaquiline-containing regimens at three referral hospitals in Uganda.

Methods

Using retrospectively collected data, we designed a matched case-control study, with cases as participants with prolonged QTc interval and controls as those with normal QTc interval in 1:1. QTc interval prolongation was defined as an increase in QTc interval by 60 milliseconds in electrocardiogram from the baseline or ≥500 milliseconds during follow-up for men and women. Factors associated with cases compared with controls were identified using a multivariable conditional regression analysis at a 5% significance level, reported using odds ratio (OR) and the 95% confidence interval (CI).

Results

Of 153 participants, 39 (25.5%) had a prolonged QTc interval. We matched 30 participants with prolonged QTc interval (cases) with 30 participants with normal QTc interval (controls). Cases and controls were similar in several sociodemographic and clinical characteristics but different regarding the baseline body mass index (BMI), baseline weight, and HIV infection. Increasing BMI (adjusted OR 1.29, 95% CI 1.02-1.63) and HIV infection (adjusted OR 0.27, 95% CI 0.08-0.96) were associated with the cases compared with the controls.

Conclusions

We found a relatively high prevalence of QTc interval prolongation among people with DR-TB on a bedaquiline-containing regimen compared with the prevalence in healthy individuals, with a higher likelihood in those with increasing BMI and a lower likelihood in those with HIV. We recommend routine anthropometric measurements to identify individuals with DR-TB at a high risk for QTc interval prolongation. In addition, tuberculosis/HIV treatment guidelines for people with DR-TB on bedaquiline-containing regimens should include risk assessment for prolonged QTc intervals.

目的使用含有贝达喹啉的治疗方案的耐药结核病（DR-TB）患者有可能出现校正 QT（QTc）间期延长，但在资源匮乏的国家对这一问题的研究还很不够。我们在乌干达的三家转诊医院确定了接受含贝达喹疗法的 DR-TB 患者 QTc 间期延长的程度和风险因素。方法利用回顾性收集的数据，我们设计了一项配对病例对照研究，病例为 QTc 间期延长的参与者，对照为 QTc 间期正常的参与者，两者比例为 1:1。QTc间期延长的定义是：男性和女性的QTc间期在心电图上比基线延长60毫秒或在随访期间延长≥500毫秒。在 5%的显著性水平下，通过多变量条件回归分析确定了与病例和对照组相比的相关因素，并使用几率比（OR）和 95% 的置信区间（CI）进行报告。我们将 QTc 间期延长的 30 名参与者（病例）与 QTc 间期正常的 30 名参与者（对照组）进行了配对。病例和对照组在一些社会人口学和临床特征方面相似，但在基线体重指数（BMI）、基线体重和艾滋病毒感染方面不同。与对照组相比，BMI（调整后 OR 1.29，95% CI 1.02-1.63）和 HIV 感染（调整后 OR 0.27，95% CI 0.08-0.96）的增加与病例有关。结论我们发现，与健康人的患病率相比，接受含贝达喹治疗的 DR-TB 患者 QTc 间期延长的患病率相对较高，BMI 增加的人患病率较高，而 HIV 感染者患病率较低。我们建议进行常规人体测量，以识别 QTc 间期延长风险较高的 DR-TB 患者。此外，针对使用含贝达喹啉治疗方案的 DR-TB 患者的结核病/艾滋病毒治疗指南应包括 QTc 间期延长的风险评估。

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引用次数: 0

Triple burden of hepatitis B, hepatitis Delta viruses, and Plasmodium falciparum to pregnant women 乙型肝炎、三角型肝炎病毒和恶性疟原虫对孕妇造成的三重负担

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-10 DOI: 10.1016/j.ijregi.2024.100447

Objectives

Chronic hepatitis B virus (HBV) infection remains a major health problem worldwide. This infection is more severe when combined with hepatitis Delta virus (HDV). Moreover, Plasmodium falciparum (Pf) malaria infection during pregnancy can have severe consequences for the mother and the newborn. Importantly, the manifestation of these three infections has never been described to date.

Methods

Thus, we conducted a prospective study, between May 27, 2022, and April 15, 2023, and we investigated these three infections in 260 pregnant women aged 24 to 46 years, in Gabon and evaluated the impact on newborns. The sera were used to screen hepatitis B surface antigen (HBsAg) and Pf by determining HBsAg® ALERE rapid diagnostic test and malaria rapid diagnostic test kits. The positive sample was confirmed using MINI VIDAS® for HBV and Lambaréné method for “Pf”. The real-time-polymerase chain reaction assay was used to amplify HBV DNA and HDV RNA on Roche instrument.

Results

Our results showed that the prevalences of HBV and (Pf) infection were 4.23% (n = 11) and 34.62% (n = 90), respectively. Moreover, we found that 3.46 % (n = 9) of pregnant women infected with HBV were coinfected with HDV. The prevalence of triple infection was 1.15% (n = 3). In addition, the leukocytes and lymphocytes absolute count were significantly lower for the triple-infected pregnant women.

Conclusions

We describe for the first time the triple coinfection by HBV, HDV, and Pf, which could induce a great inflammatory reaction and high liver disorder in newborns.

目的慢性乙型肝炎病毒（HBV）感染仍然是全球范围内的一个主要健康问题。如果合并感染三角型肝炎病毒（HDV），这种感染会更加严重。此外，孕期感染恶性疟原虫（Pf）疟疾也会对母亲和新生儿造成严重后果。因此，我们在 2022 年 5 月 27 日至 2023 年 4 月 15 日期间开展了一项前瞻性研究，调查了加蓬 260 名 24 至 46 岁孕妇的这三种感染情况，并评估了对新生儿的影响。血清用于通过确定 HBsAg® ALERE 快速诊断检测试剂盒和疟疾快速诊断检测试剂盒筛查乙型肝炎表面抗原（HBsAg）和 Pf。阳性样本使用 MINI VIDAS® 检测 HBV，使用 Lambaréné 方法检测 "Pf"。结果显示，HBV 和（Pf）感染率分别为 4.23%（11 人）和 34.62%（90 人）。此外，我们还发现，在感染 HBV 的孕妇中，有 3.46%（9 人）同时感染了 HDV。三重感染的发生率为 1.15%（n = 3）。结论我们首次描述了 HBV、HDV 和 Pf 三重合并感染，这可能会诱发新生儿出现严重的炎症反应和肝功能紊乱。

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引用次数: 0

Predictors and outcomes of patients with COVID-19 admitted to intensive care units in Pakistan and the development of nosocomial fungal infections: Findings and implications 巴基斯坦重症监护病房收治的 COVID-19 患者的预后因素和结果以及真菌感染的发生：研究结果和意义

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-07 DOI: 10.1016/j.ijregi.2024.100445

Objectives

Patients with COVID-19 admitted to intensive care units (ICUs) typically have many complications and co-morbidities, including secondary bacterial and fungal infections, which increase morbidity and mortality. The first step to address this is to measure the prevalence rates, predictors of fungal infections, and outcomes of patients with COVID-19 admitted to ICUs in Pakistan.

Methods

Retrospective review of medical records of patients admitted with COVID-19 to the ICUs of six tertiary care hospitals in Pakistan between March 2020 and June 2023.

Results

A total of 636 patients were included; 68.9% were aged ≥50 years and 62.6% were male. Diabetes mellitus was the commonest co-morbidity (23.7%). A total of 67.8% of patients had severe COVID-19, with 23% critical cases. Antibiotics and antipyretics (all patients) were the most frequently prescribed medicines, along with corticosteroids (72.5%). A total of 63 nosocomial fungal infections developed in 53 patients, with mechanical ventilation and tracheal intubation being significant predictors of secondary fungal infections among patients with COVID-19. The mortality rate was 4.9%, with secondary fungal infections significantly associated with higher mortality.

Conclusions

Approximately 8% of patients with COVID-19 admitted to the ICUs of tertiary developed secondary fungal infections associated with greater mortality. The key factors associated with secondary fungal infections need to be carefully monitored to reduce future mortality in these patients. We will continue to monitor the situation.

目的重症监护病房（ICU）收治的 COVID-19 患者通常会出现多种并发症和合并症，包括继发细菌和真菌感染，从而增加发病率和死亡率。要解决这一问题，首先要测量巴基斯坦重症监护室收治的 COVID-19 患者的患病率、真菌感染的预测因素和预后。方法回顾性分析 2020 年 3 月至 2023 年 6 月期间巴基斯坦 6 家三级医院重症监护室收治的 COVID-19 患者的病历。糖尿病是最常见的并发症（23.7%）。共有67.8%的患者患有严重的COVID-19，其中23%为危重病例。抗生素和退烧药（所有患者）以及皮质类固醇（72.5%）是最常用的处方药。53 名患者共发生了 63 例医院内真菌感染，机械通气和气管插管是 COVID-19 患者继发真菌感染的重要预测因素。死亡率为4.9%，继发性真菌感染与较高的死亡率显著相关。结论在三级医院重症监护室收治的COVID-19患者中，约有8%发生了与较高死亡率相关的继发性真菌感染。需要仔细监测与继发性真菌感染相关的关键因素，以降低这些患者未来的死亡率。我们将继续关注这一情况。

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引用次数: 0

Prevalence of antibiotic self-medication and knowledge of antimicrobial resistance among community members in Neno District rural Malawi: A cross-sectional study 马拉维农村地区内诺县社区成员的抗生素自我治疗流行率和抗菌药耐药性知识：横断面研究

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-07 DOI: 10.1016/j.ijregi.2024.100444

Objectives

Despite global efforts to address antibiotic self-medication, it is still significantly prevalent. This study aimed to investigate the prevalence of antibiotic self-medication and assess knowledge of antibiotic resistance among community members in Neno District, rural Malawi.

Methods

A cross-sectional, community-based study was conducted from September to November 2023, using simple random sampling across 169 villages. Participants from two households per village were surveyed using a “drug bag” method, focusing on those who had taken antibiotics within the preceding 6 months. In addition, drug retailers were selected via snowball sampling for interviews.

Results

Of the 531 participants and 39 drug retailers, 71.1% reported antibiotic use, with 69.5% self-medicating in the past 6 months, with convenience (31.5%) and confidence (26.7%) being the reasons. Common symptoms prompting self-medication included cough (29.9%), sore throat (28.6%), and aches and pain (28.6%). Amoxicillin (61.1%) and cotrimoxazole (29.6%) were the most used antibiotics. More than half (53.1%) reused leftover antibiotics from health facilities, with employed participants significantly more likely to self-medicate. Awareness of antibiotic resistance was low (16.1%), mainly learned from hospitals. Unlawful antibiotic sales by drug retailers (46.2%) were noted.

Conclusions

The study highlights the urgent need for government-led efforts to regulate antibiotic use and increase public awareness to mitigate the impact on public health.

尽管全球都在努力解决抗生素自我药疗问题，但这一现象仍然十分普遍。本研究旨在调查马拉维农村地区内诺区社区成员自行使用抗生素的普遍程度，并评估他们对抗生素耐药性的了解程度。方法 2023 年 9 月至 11 月，研究人员在 169 个村庄中采用简单随机抽样的方式，开展了一项横断面社区研究。采用 "药袋 "法对每个村庄两户家庭的参与者进行了调查，重点调查在过去 6 个月内服用过抗生素的人。结果在 531 名参与者和 39 名药品零售商中，71.1% 的人报告使用过抗生素，69.5% 的人在过去 6 个月中自行用药，原因主要是方便（31.5%）和自信（26.7%）。导致自行用药的常见症状包括咳嗽（29.9%）、喉咙痛（28.6%）和疼痛（28.6%）。阿莫西林（61.1%）和复方新诺明（29.6%）是最常用的抗生素。半数以上（53.1%）的人重复使用医疗机构剩余的抗生素，其中有工作的参与者更有可能自行用药。对抗生素耐药性的认识不足（16.1%），主要是从医院了解到的。该研究强调，迫切需要由政府牵头，规范抗生素的使用并提高公众意识，以减轻抗生素对公众健康的影响。

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引用次数: 0

Sexually transmitted and blood-borne infections by sex, methamphetamine use, and houselessness before, at, and after HIV diagnosis in Manitoba, Canada 加拿大马尼托巴省艾滋病毒确诊前、确诊时和确诊后按性别、甲基苯丙胺使用情况和无家可归情况分列的性传播和血液传播感染情况

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-07 DOI: 10.1016/j.ijregi.2024.100433

Objectives

Describe the proportion of people newly living with HIV with sexually transmitted and blood-borne infections (STBBIs) before, at, and after HIV diagnosis in Manitoba, Canada.

Methods

A retrospective cohort study reviewed clinical charts of all 404 people ≥18 years old newly diagnosed with HIV in Manitoba, Canada between 2018 and 2021. Syphilis, hepatitis C and B, gonorrhea, and chlamydia infections before, at, and after HIV diagnosis were recorded and analyzed by sex at birth, injection drug use status, use of methamphetamines, and housing status.

Results

A total of 53% of people were diagnosed with syphilis, 44.1% with gonorrhea, 42.8% with chlamydia, and 40.6% with hepatitis C at least once. Among females, 64.1% had at least one or more STBBIs diagnoses before HIV diagnosis compared with 44.8% of males. Over 70% of people experiencing houselessness had at least one STBBI diagnosis before their HIV diagnosis compared with 43.9% of people not houseless. Among people who used methamphetamines, 68.3% had one or more STBBIs before HIV diagnosis compared with 28.9% of people who do not use methamphetamines. In a multivariable analysis houselessness, methamphetamine use, and younger age were associated with increased risk of any STBBIs.

Conclusions

In our Manitoba cohort of people living with HIV, disproportionately more females, people experiencing houselessness, and those who use methamphetamine were diagnosed with STBBIs. The proportion of new infections before HIV diagnoses highlights a missed opportunity to provide prevention modalities, including pre-exposure prophylaxis, and the proportion after HIV diagnosis emphasizes the importance of enhancing engagement, repeated testing, and educational strategies to ameliorate ongoing exposures.

目的描述加拿大马尼托巴省新发现的 HIV 感染者在 HIV 诊断前、诊断时和诊断后感染性传播和血液传播疾病（STBBIs）的比例。方法回顾性队列研究审查了 2018 年至 2021 年期间加拿大马尼托巴省所有 404 名年龄≥18 岁的新诊断 HIV 感染者的临床病历。研究记录了艾滋病毒确诊前、确诊时和确诊后的梅毒、丙型肝炎和乙型肝炎、淋病和衣原体感染情况，并根据出生时的性别、注射毒品使用情况、甲基苯丙胺使用情况和住房情况进行了分析。结果共有53%的人至少确诊过一次梅毒，44.1%的人至少确诊过一次淋病，42.8%的人至少确诊过一次衣原体感染，40.6%的人至少确诊过一次丙型肝炎。在女性中，64.1% 的人在确诊感染艾滋病毒之前至少诊断过一次或多次 STBBIs，而男性的这一比例为 44.8%。超过 70% 的无家可归者在确诊感染艾滋病毒之前至少有过一次 STBBIs 诊断，而非无家可归者的这一比例为 43.9%。在吸食甲基苯丙胺的人群中，68.3%的人在确诊感染艾滋病毒前曾有过一次或多次 STBBI，而在不吸食甲基苯丙胺的人群中，这一比例仅为 28.9%。在一项多变量分析中，无家可归、使用甲基苯丙胺和年龄较小与任何 STBBIs 的风险增加有关。结论在我们马尼托巴省的艾滋病毒感染者队列中，女性、无家可归者和使用甲基苯丙胺者被诊断为 STBBIs 的比例过高。艾滋病毒诊断前的新感染比例突出表明，我们错失了提供包括暴露前预防在内的预防方式的良机，而艾滋病毒诊断后的新感染比例则强调了加强参与、重复检测和教育策略以改善持续暴露的重要性。

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引用次数: 0

Dynamics of anti-SARS-CoV-2 antibodies in the Albanian population: Impact of infection- and vaccine-induced immunity during the COVID-19 pandemic 阿尔巴尼亚人口中抗 SARS-CoV-2 抗体的动态变化：COVID-19 大流行期间感染和疫苗诱导免疫的影响

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-05 DOI: 10.1016/j.ijregi.2024.100440

Objectives

Understanding immune response dynamics during the COVID-19 pandemic is crucial for optimizing future vaccine strategies. This study investigated the infection- and vaccine-induced SARS-CoV-2 antibody responses in the Albanian population from August 2021 to August 2022.

Methods

This used a cross-sectional approach, analyzing two independent, randomly selected population samples over 1 year. Participants’ demographic, health, vaccination, and COVID-19 data were collected, with blood samples assessed via enzyme linked immunosorbent assay for immunoglobulin G class anti-spike and anti-nucleocapsid antibodies.

Results

By August 2022, all individuals receiving one vaccine dose achieved antibody levels comparable to those receiving two doses (median 7.71 index ratio [IR] vs 7.00 IR). In August 2021, those with previous COVID-19 infection receiving one vaccine dose showed median anti-spike immunoglobulin G levels of 7.22 IR compared with 4.84 IR in those without previous infection receiving two doses. However, individuals aged ≥61 years required two vaccine doses to achieve similar immune responses as younger individuals with one dose.

Conclusions

These findings underscore the importance of hybrid immunity, suggesting one vaccine dose may suffice for individuals with previous COVID-19 infection, whereas older adults require additional doses for optimal protection. This study provides insights into humoral immune response dynamics, which is crucial for refining COVID-19 vaccination strategies in middle-income countries with low vaccination coverage and high infection rates.

目的了解 COVID-19 大流行期间的免疫反应动态对于优化未来的疫苗策略至关重要。本研究调查了 2021 年 8 月至 2022 年 8 月期间阿尔巴尼亚人口的感染和疫苗诱导的 SARS-CoV-2 抗体反应。结果到2022年8月，所有接种一剂疫苗的人都达到了与接种两剂疫苗的人相当的抗体水平（中位数指数比[IR]7.71 vs 7.00 IR）。2021年8月，接种一剂疫苗的既往感染过COVID-19的人的抗尖峰免疫球蛋白G水平中位数为7.22 IR，而接种两剂疫苗的既往未感染过COVID-19的人的抗尖峰免疫球蛋白G水平中位数为4.84 IR。然而，年龄≥61 岁的个体需要接种两剂疫苗才能获得与接种一剂疫苗的年轻人相似的免疫反应。结论这些发现强调了混合免疫的重要性，表明对于既往感染过 COVID-19 的个体来说，接种一剂疫苗就足够了，而老年人则需要额外接种疫苗才能获得最佳保护。这项研究为体液免疫反应动态提供了见解，这对于在疫苗接种覆盖率低、感染率高的中等收入国家完善 COVID-19 疫苗接种策略至关重要。

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引用次数: 0

Irregular seasonality of respiratory syncytial virus infection persists in 2023 in Osaka, Japan 2023 年日本大阪呼吸道合胞病毒感染的不规则季节性持续存在

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-05 DOI: 10.1016/j.ijregi.2024.100442

Objectives

Owing to the nonpharmaceutical interventions against COVID-19, respiratory syncytial virus (RSV) infection was nearly absent in 2020. An unusual epidemic size and irregular seasonal pattern were observed worldwide in 2021. In Osaka, Japan, after disrupting the regular pattern of RSV infection dynamics (before the COVID-19 pandemic, RSV epidemics typically start in summer and peak around fall), the epidemic size of RSV infection returned to normal in 2022. However, the epidemic onset timing remained irregular in 2022 and 2023. This study investigated whether the onset of the RSV infection epidemic in 2023 was predictable using previous seasonal patterns.

Methods

The weekly number of RSV infection cases obtained from sentinel pediatric sites between 2007 and the 15th week of 2023 was modeled using the time series susceptible-infected-recovered model. Forecasting of the remainder of 2023 was conducted based on estimated transmission parameters.

Results

None of the estimated transmission rates from previous years successfully forecast the epidemic onset in 2023. Only the transmission rate estimated in the early part of 2023 captured the trend for that year, indicating irregular seasonal transmission rates.

Conclusions

It is still hard to forecast RSV epidemics because of the changed landscape due to the COVID-19 pandemic. The seasonality of RSV infection dynamics has not returned to pre-pandemic level in 2023. Cautious attention to future RSV dynamics in Japan is warranted because further changes may occur in the near future.

目标由于采取了针对 COVID-19 的非药物干预措施，2020 年几乎没有出现呼吸道合胞病毒（RSV）感染。2021 年，全球范围内出现了不寻常的流行规模和不规则的季节性模式。在日本大阪，在破坏了 RSV 感染动态的常规模式后（在 COVID-19 大流行之前，RSV 流行通常在夏季开始，在秋季左右达到高峰），RSV 感染的流行规模在 2022 年恢复正常。然而，2022 年和 2023 年的流行开始时间仍然不规则。本研究利用以往的季节性模式调查了 2023 年 RSV 感染流行的开始时间是否可以预测。方法利用时间序列易感-感染-恢复模型对 2007 年至 2023 年第 15 周期间从儿科哨点获得的每周 RSV 感染病例数进行建模。结果往年估计的传播率均未能成功预测 2023 年疫情的爆发。只有 2023 年初估计的传播率捕捉到了该年的趋势，这表明传播率具有不规则的季节性。到 2023 年，RSV 感染动态的季节性仍未恢复到大流行前的水平。由于在不久的将来可能会发生进一步的变化，因此有必要谨慎关注日本未来的 RSV 动态。

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引用次数: 0

Successful treatment of Staphylococcus argenteus sequence type 2198 uncomplicated bacteremia with a 2-week antibiotic course 用 2 周抗生素疗程成功治疗阿根廷葡萄球菌序列 2198 型无并发症菌血症

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-05 DOI: 10.1016/j.ijregi.2024.100443

There is a paucity of data on the clinical course and treatment of Staphylococcus argenteus. Herein, we describe a successfully treated case of S. argenteus bacteremia. A 76-year-old man with lung adenocarcinoma developed bacteremia caused by penicillin-resistant, oxacillin-susceptible S. argenteus, which was identified through mass spectrometry and nuc gene sequencing. He was diagnosed with a peripheral line–associated bloodstream infection and successfully treated with a 2-week course of cefepime, followed by cefazolin, concurrent with intravenous catheter removal. The isolate was positive for blaZ and negative for mecA. It was assigned to sequence type 2198 using multilocus sequence typing. Formerly classified as Staphylococcus aureus clonal complex 75, S. argenteus became a distinct species in 2015. Its identification has increased owing to widespread mass spectrometer use. Most East and Southeast Asian S. argenteus isolates reported to date are methicillin-susceptible, consistent with the susceptibility pattern of the isolate in our study. Given the potential equivalence in virulence between S. argenteus and S. aureus, we recommend treating S. argenteus with the same rigor as S. aureus until further clinical data becomes available.

有关阿根廷葡萄球菌的临床病程和治疗方法的数据很少。在此，我们描述了一例成功治愈的银葡萄球菌菌血症病例。一名 76 岁的肺腺癌患者因耐受青霉素、对奥沙西林敏感的阿根廷葡萄球菌引起菌血症，通过质谱分析和 nuc 基因测序确定了阿根廷葡萄球菌。他被诊断为外周管路相关性血流感染，并在拔除静脉导管的同时接受了为期两周的头孢吡肟和头孢唑啉治疗。该分离株 blaZ 阳性，mecA 阴性。使用多焦点序列分型法将其归入序列类型 2198。S. argenteus 以前被归类为金黄色葡萄球菌克隆复合体 75，2015 年成为一个独立的物种。由于质谱仪的广泛使用，其鉴定率有所提高。迄今报道的大多数东亚和东南亚 S. argenteus 分离物对甲氧西林敏感，这与我们研究中分离物的敏感性模式一致。鉴于阿根廷痢疾杆菌与金黄色葡萄球菌的毒性可能相当，我们建议在获得更多临床数据之前，以对待金黄色葡萄球菌的同样严格态度对待阿根廷痢疾杆菌。

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引用次数: 0

Elimination of endemic measles and rubella transmission in Oman 在阿曼消除麻疹和风疹的地方性传播

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2024-09-05 DOI: 10.1016/j.ijregi.2024.100437

Objectives

The main objective of the study is to describe the five lines of evidence of measles and rubella elimination in Oman.

Methods

A descriptive record review of the national surveillance database of fever and rash illnesses (measles and rubella surveillance) to demonstrate elimination status.

Results

A total of 532 and 73 cases of measles and rubella cases were reported during 2000-2022, respectively. Of the reported measles cases during 2000-2022, 106 were sporadic cases and 36 outbreaks (426 cases) were reported. The size of the outbreaks was largely small and the largest and the longest outbreak was in 2016-2017 involving the Dhofar-South Sharqiyah governorates with 90 cases due to genotype B3, which lasted for 32 weeks. Of the reported rubella cases during 2000-2022; all 73 were sporadic cases with no outbreaks. The vaccination coverage of Measles Mumps Rubella 2 is high (>98.0%) at the national and sub-national levels since 2008, thus maintaining the high population immunity. The absence of endemic genotype was proven through genetic sequencing of all the reported cases and outbreaks of measles and rubella. The high-performance indicators showed quality surveillance system.

Conclusions

Oman fulfills the criteria for measles and rubella elimination. All the five lines of evidence were verified and Oman was certified to have eliminated measles and rubella in 2019. After 3 years of post-elimination, Oman has continued to maintain its elimination status successfully. High population immunity and quality surveillance resulted in sustaining the elimination during the post-elimination period.

研究的主要目的是描述阿曼消除麻疹和风疹的五大证据。方法对国家发烧和出疹疾病监测数据库（麻疹和风疹监测）进行描述性记录审查，以证明消除状况。结果 2000-2022 年间报告的麻疹和风疹病例分别为 532 例和 73 例。在 2000-2022 年期间报告的麻疹病例中，106 例为散发性病例，36 例为爆发性病例（426 例）。疫情规模大多较小，规模最大、持续时间最长的一次疫情发生在 2016-2017 年，涉及佐法尔-南沙尔基耶省，因基因型 B3 导致 90 例病例，疫情持续了 32 周。在 2000-2022 年期间报告的风疹病例中，所有 73 例均为零星病例，未爆发疫情。自 2008 年以来，麻疹腮腺炎风疹 2 型疫苗在国家和国家以下各级的接种率很高（98.0%），从而保持了较高的人群免疫力。通过对所有报告的麻疹和风疹病例和疫情进行基因测序，证明不存在流行基因型。高绩效指标显示了监测系统的质量。所有五项证据均已核实，阿曼被证明已于 2019 年消除麻疹和风疹。在消除麻疹和风疹 3 年后，阿曼继续成功保持其消除麻疹和风疹的状态。高人口免疫力和高质量的监测使消除麻疹和风疹工作在消除后期间得以持续。

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引用次数: 0