Organizing pneumonia can be idiopathic or caused by multi- ple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst forma- tion and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year- old male who contracted COVID-19 with subsequent develop-ment of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID- 19 should be screened for organizing pneumonia upon dis-charge. This case also illustrates the importance of follow- ing such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.
{"title":"COVID-19 Case Complicated with Organizing Pneumonia and Pneumothorax: A Case Report","authors":"T. Phillips, Hammad A. Bhatti, Minh Q Ho","doi":"10.55504/2473-2869.1237","DOIUrl":"https://doi.org/10.55504/2473-2869.1237","url":null,"abstract":"Organizing pneumonia can be idiopathic or caused by multi- ple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst forma- tion and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year- old male who contracted COVID-19 with subsequent develop-ment of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID- 19 should be screened for organizing pneumonia upon dis-charge. This case also illustrates the importance of follow- ing such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46263261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sotrovimab is a new therapeutic agent to attenuate COVID-19. It is considered a welcome pharmaceutical preparation in light of SARS-CoV-2 variants, such as Omicron. Some other monoclonal antibody medications have low effectiveness at blocking Omicron’s SARS-CoV-2 cell access. Sotrovimab fills an important therapeutic niche for victims of Omicron infection and is indicated for anyone with medical contraindications to vaccines, persons with serious comorbidities, and immunocompromised persons with suboptimal response to vaccines, and it may be especially helpful with the emergence of variant viral infections that evade vaccineor illness-derived immunity.[1, 2] Sotrovimab reduces the risk of disease progression among high-risk patients with mild-tomoderate COVID-19.[3] Sotrovimab may also reduce the percentage of patients who require oxygen.[4] It seems that sotrovimab is a better choice for dealing with severe or non-severe COVID-19 patients.[5] Hopefully, it will provide high efficacy to patients with early COVID-19, minimizing hospitalizations, morbidity, mortality, and/or healthcare system overload.
{"title":"Sotrovimab: Neutralizing Antibody to Combat COVID-19","authors":"A. Allam, S. Lippmann","doi":"10.55504/2473-2869.1240","DOIUrl":"https://doi.org/10.55504/2473-2869.1240","url":null,"abstract":"Sotrovimab is a new therapeutic agent to attenuate COVID-19. It is considered a welcome pharmaceutical preparation in light of SARS-CoV-2 variants, such as Omicron. Some other monoclonal antibody medications have low effectiveness at blocking Omicron’s SARS-CoV-2 cell access. Sotrovimab fills an important therapeutic niche for victims of Omicron infection and is indicated for anyone with medical contraindications to vaccines, persons with serious comorbidities, and immunocompromised persons with suboptimal response to vaccines, and it may be especially helpful with the emergence of variant viral infections that evade vaccineor illness-derived immunity.[1, 2] Sotrovimab reduces the risk of disease progression among high-risk patients with mild-tomoderate COVID-19.[3] Sotrovimab may also reduce the percentage of patients who require oxygen.[4] It seems that sotrovimab is a better choice for dealing with severe or non-severe COVID-19 patients.[5] Hopefully, it will provide high efficacy to patients with early COVID-19, minimizing hospitalizations, morbidity, mortality, and/or healthcare system overload.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43656152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sharanya S E Santhi, Niguma Rayamajhi, S. Lippmann
Vaccine hesitancy is an issue that should be addressed to maximize protection from serious COVID-19. SARSCoV-2 vaccination hesitancy in the United States ranges from 21 to 42%.[1] Fear of adverse effects and concerns about safety are some of the main reasons for refusing to be immunized.[2, 3] Vaccinations can induce adverse reactions, such as injection site tenderness, headache, myalgia, and arthralgia. Fever is occasionally a systemic side effect.[4] People often self-treat these problems with antipyretic and/or analgesic drugs; physicians sometimes recommend these as well.
{"title":"Are Antipyretic Medications Compatible with SARS-CoV-2 Vaccines?","authors":"Sharanya S E Santhi, Niguma Rayamajhi, S. Lippmann","doi":"10.55504/2473-2869.1242","DOIUrl":"https://doi.org/10.55504/2473-2869.1242","url":null,"abstract":"Vaccine hesitancy is an issue that should be addressed to maximize protection from serious COVID-19. SARSCoV-2 vaccination hesitancy in the United States ranges from 21 to 42%.[1] Fear of adverse effects and concerns about safety are some of the main reasons for refusing to be immunized.[2, 3] Vaccinations can induce adverse reactions, such as injection site tenderness, headache, myalgia, and arthralgia. Fever is occasionally a systemic side effect.[4] People often self-treat these problems with antipyretic and/or analgesic drugs; physicians sometimes recommend these as well.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41579537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandra González, P. Alvarez, Mariano Fielli, A. Santos, Neil Gomez Querales, Elkin Rodriguez Arzuaga
Diffuse alveolar hemorrhage (DAH) syndrome has a mortality rate of 30 to 60%. A 15-year-old male patient presented with a seven-day abdominal pain, vomiting, non-dysenteric diarrhea, conjunctival injection, and fever. Chest radiography revealed bilateral interstitial infiltrates predominating in the lower left lobe. The patient’s condition worsened within hours, with the development of massive hemoptysis, acute respiratory dis- tress syndrome (ARDS), arterial hypotension, and hematocrit decline requiring mechanical ventilation. A chest computed tomography (CT) showed ground-glass opacities with consolidation areas in lower lobes, diffuse tree-in-bud opacities, and centrilobular nodules. A bronchoscopy was conducted without endoluminal lesions and bronchoalveolar lavage (BAL) consistent with alveolar hemorrhage. DAH was diagnosed, and the patient received therapy with intravenous methylpred- nisolone. The outcome of treatment was successful after eight days of mechanical ventilation. Leptospirosis was di- agnosed by serology after discharge. The laboratory findings were normal, and a chest CT scan showed the resolution of the infiltrates. Early recognition of severe hemorrhagic pulmonary syndrome, which has a high mortality rate, is crucial. Therefore, leptospirosis should be suspected as a differential diagnosis in every patient with alveolar hemorrhage, ARDS manifestations, and epidemiological factors.
{"title":"Leptospirosis Presenting as Diffuse Alveolar Hemorrhage","authors":"Alejandra González, P. Alvarez, Mariano Fielli, A. Santos, Neil Gomez Querales, Elkin Rodriguez Arzuaga","doi":"10.55504/2473-2869.1211","DOIUrl":"https://doi.org/10.55504/2473-2869.1211","url":null,"abstract":"Diffuse alveolar hemorrhage (DAH) syndrome has a mortality rate of 30 to 60%. A 15-year-old male patient presented with a seven-day abdominal pain, vomiting, non-dysenteric diarrhea, conjunctival injection, and fever. Chest radiography revealed bilateral interstitial infiltrates predominating in the lower left lobe. The patient’s condition worsened within hours, with the development of massive hemoptysis, acute respiratory dis- tress syndrome (ARDS), arterial hypotension, and hematocrit decline requiring mechanical ventilation. A chest computed tomography (CT) showed ground-glass opacities with consolidation areas in lower lobes, diffuse tree-in-bud opacities, and centrilobular nodules. A bronchoscopy was conducted without endoluminal lesions and bronchoalveolar lavage (BAL) consistent with alveolar hemorrhage. DAH was diagnosed, and the patient received therapy with intravenous methylpred- nisolone. The outcome of treatment was successful after eight days of mechanical ventilation. Leptospirosis was di- agnosed by serology after discharge. The laboratory findings were normal, and a chest CT scan showed the resolution of the infiltrates. Early recognition of severe hemorrhagic pulmonary syndrome, which has a high mortality rate, is crucial. Therefore, leptospirosis should be suspected as a differential diagnosis in every patient with alveolar hemorrhage, ARDS manifestations, and epidemiological factors.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47875018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mucormycosis: COVID-19 and Corticosteroids","authors":"Mittal Savaliya, N. Jha, S. Lippmann","doi":"10.55504/2473-2869.1233","DOIUrl":"https://doi.org/10.55504/2473-2869.1233","url":null,"abstract":"","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47871783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.18297/jri/vol6/iss1/6
Usman Akbar
Introduction: Persistent symptoms have been observed in a substantial proportion of survivors of COVID-19 since relatively early in the pandemic. Among these post-acute sequelae of COVID-19 (PASC), respiratory symptoms appear to be the most prevalent. Methods: We conducted a literature review of peer-reviewed publications in English on the clinical and epidemiological features of respiratory PASC in cohorts of 100 or more patients with a follow-up of four weeks or more after acute infection. Included studies reported the prevalence of persistent respiratory symptoms and/or the results of follow-up pulmonary function tests. Results: On our review included 14 studies across eight countries with a total of 2,380 patients. Subacute PASC was reported in 876 patients, and chronic PASC in 1,504 patients. The median age ranged from 44 to 67 years. The most common symptoms observed were fatigue (44%), dyspnea (40%), and cough (22%). Lung disease as a comorbidity was found in 13% of patients on average. Predominance of males was seen in all studies of subacute PASC and six out of eight studies of chronic PASC. The rates of comorbidities for subacute vs. chronic PASC were: hypertension 32% vs. 31%, cardiovascular disease 10% vs. 7%, diabetes mellitus 15% vs. 12%, kidney disease 7% vs. 4%, and lung disease 19% vs. 10%. Conclusion: Respiratory PASC seems to be more predominant as a chronic presentation, more common in male adults, and less common in older persons. Respiratory PASC is most often associated with fatigue, dyspnea, and cough. There was no strong correlation of severity of illness, acute respiratory distress syndrome, or intensive care unit admission with respiratory PASC.
{"title":"Pulmonary Post-Acute Sequelae of COVID-19","authors":"Usman Akbar","doi":"10.18297/jri/vol6/iss1/6","DOIUrl":"https://doi.org/10.18297/jri/vol6/iss1/6","url":null,"abstract":"Introduction: Persistent symptoms have been observed in a substantial proportion of survivors of COVID-19 since relatively early in the pandemic. Among these post-acute sequelae of COVID-19 (PASC), respiratory symptoms appear to be the most prevalent. Methods: We conducted a literature review of peer-reviewed publications in English on the clinical and epidemiological features of respiratory PASC in cohorts of 100 or more patients with a follow-up of four weeks or more after acute infection. Included studies reported the prevalence of persistent respiratory symptoms and/or the results of follow-up pulmonary function tests. Results: On our review included 14 studies across eight countries with a total of 2,380 patients. Subacute PASC was reported in 876 patients, and chronic PASC in 1,504 patients. The median age ranged from 44 to 67 years. The most common symptoms observed were fatigue (44%), dyspnea (40%), and cough (22%). Lung disease as a comorbidity was found in 13% of patients on average. Predominance of males was seen in all studies of subacute PASC and six out of eight studies of chronic PASC. The rates of comorbidities for subacute vs. chronic PASC were: hypertension 32% vs. 31%, cardiovascular disease 10% vs. 7%, diabetes mellitus 15% vs. 12%, kidney disease 7% vs. 4%, and lung disease 19% vs. 10%. Conclusion: Respiratory PASC seems to be more predominant as a chronic presentation, more common in male adults, and less common in older persons. Respiratory PASC is most often associated with fatigue, dyspnea, and cough. There was no strong correlation of severity of illness, acute respiratory distress syndrome, or intensive care unit admission with respiratory PASC.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73193464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.18297/jri/vol6/iss1/4
Pradeepthi Badugu
Background: Stroke is one of the most prevalent neurological diseases in the United States. Community-acquired pneumonia (CAP) is the leading cause of infections in survivors of stroke. There is limited research evaluating the clinical outcomes of CAP in patients with stroke. The objective of this study was to evaluate the clinical characteristics and outcomes of hospitalized patients with CAP and a history of stroke. Methods: This was a secondary analysis of the University of Louisville Pneumonia Study database. Patients were divided into two groups based on the presence or absence of a history of stroke. Clinical outcomes were length of stay, time to clinical stability, and one-year mortality, which were assessed via stratified Cox proportional hazards regression. Differences in risk of clinical outcomes were reported as adjusted hazard ratios. Results: We found no significant differences in time to clinical stability between the two groups. The median length of stay for patients with a history of stroke hospitalized with CAP was six days and for patients without stroke was five days (P=0.01). We observed a 16% higher risk of mortality in stroke patients with CAP than in the non-stroke population (P=0.001). Conclusions: This study indicates that hospitalized patients with CAP have a longer hospital stay and higher mortality than those without stroke.
{"title":"Clinical Outcomes for Patients with Community-Acquired Pneumonia are Worse in Those with a History of Stroke","authors":"Pradeepthi Badugu","doi":"10.18297/jri/vol6/iss1/4","DOIUrl":"https://doi.org/10.18297/jri/vol6/iss1/4","url":null,"abstract":"Background: Stroke is one of the most prevalent neurological diseases in the United States. Community-acquired pneumonia (CAP) is the leading cause of infections in survivors of stroke. There is limited research evaluating the clinical outcomes of CAP in patients with stroke. The objective of this study was to evaluate the clinical characteristics and outcomes of hospitalized patients with CAP and a history of stroke. Methods: This was a secondary analysis of the University of Louisville Pneumonia Study database. Patients were divided into two groups based on the presence or absence of a history of stroke. Clinical outcomes were length of stay, time to clinical stability, and one-year mortality, which were assessed via stratified Cox proportional hazards regression. Differences in risk of clinical outcomes were reported as adjusted hazard ratios. Results: We found no significant differences in time to clinical stability between the two groups. The median length of stay for patients with a history of stroke hospitalized with CAP was six days and for patients without stroke was five days (P=0.01). We observed a 16% higher risk of mortality in stroke patients with CAP than in the non-stroke population (P=0.001). Conclusions: This study indicates that hospitalized patients with CAP have a longer hospital stay and higher mortality than those without stroke.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88985152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.18297/jri/vol6/iss1/1
Subathra Marimuthu, S. Furmanek, H. Aliesky, L. Wolf
During the COVID-19 pandemic, laboratories experienced periods of shortages for certain critical materials required to meet the high demand for SARS-CoV-2 testing. The U.S. Food & Drug Administration provided a template for molecular diagnostic testing, including guidance for a specimen pooling process in order to evaluate performance of the SARS-CoV-2 nucleic acid amplification assay. This study aimed to evaluate the testing of pooled specimens consisting of four nasopharyngeal swab specimens using the Luminex ARIES ® nucleic acid amplification platform. Results indicated that there was a loss of analytic sensitivity with pooled nasopharyngeal swab samples, demonstrating that this approach should be bal- anced against material shortages and the clinical utility of a less sensitive assay.
{"title":"Impact of Pooling Samples on Analytic Sensitivity of a Real-Time Reverse Transcriptase PCR Assay for SARS CoV-2","authors":"Subathra Marimuthu, S. Furmanek, H. Aliesky, L. Wolf","doi":"10.18297/jri/vol6/iss1/1","DOIUrl":"https://doi.org/10.18297/jri/vol6/iss1/1","url":null,"abstract":"During the COVID-19 pandemic, laboratories experienced periods of shortages for certain critical materials required to meet the high demand for SARS-CoV-2 testing. The U.S. Food & Drug Administration provided a template for molecular diagnostic testing, including guidance for a specimen pooling process in order to evaluate performance of the SARS-CoV-2 nucleic acid amplification assay. This study aimed to evaluate the testing of pooled specimens consisting of four nasopharyngeal swab specimens using the Luminex ARIES ® nucleic acid amplification platform. Results indicated that there was a loss of analytic sensitivity with pooled nasopharyngeal swab samples, demonstrating that this approach should be bal- anced against material shortages and the clinical utility of a less sensitive assay.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87303525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.18297/jri/vol6/iss1/5
Leslie A Beavin
Introduction: Staphylococcus aureus bacteremia has a minimum treatment duration of two weeks, while S. aureus community-acquired pneumonia (CAP) treatment is at least five days. Treatment failure, persistent bacteremia, and recurrence are common among patients with community-acquired S. aureus bacteremia. There is conflicting information in the current Infectious Diseases Society of America (IDSA) guidelines for the treatment of S.aureus bacteremia patients with CAP. Therefore, the appropriate treatment duration and modality for S. aureus CAP with bacteremia is unclear. The objective of this study was to compare outcomes among patients with S. aureus CAP and bacteremia treated in compliance versus non-compliance with IDSA S. aureus bacteremia guidelines. Methods: This was a secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) study database. Logistic regression was used to compare outcomes. Results: A total of 117 patients with S. aureus CAP and bacteremia were included in the study. Compliance with S. aureus bacteremia guidelines was documented in 67 patients, and non-compliance was documented in 50 patients. Compliance with IDSA S. aureus bacteremia guidelines resulted in a decrease in odds of re-hospitalization of 30% after adjusting for confounding variables between the compliant and non-compliant groups (adjusted odds ratio (aOR) 0.70 [95% CI 0.29–1.70]; P=0.42). The 30-day mortality for the compliant group was 6% and for the non-compliant group was 10%; P=0.576. The 1-year mortality for the compliant group was 19% and for the non-compliant group was 44%; P=0.011. Conclusion: The present study demonstrated that when treated in compliance with IDSA guidelines for S. aureus bacteremia, there was decreased 1-year mortality for patients hospitalized for S. aureus CAP with bacteremia. In this case, the IDSA S. aureus bacteremia guidelines recommend treating uncomplicated S. aureus bacteremia with CAP for at least two weeks of antimicrobials and at least four weeks of antimicrobials for complicated S. aureus bacteremia with CAP.
{"title":"Compliance with Guidelines for Treatment of Staphylococcus aureus Bacteremia is Associated with Decreased Mortality in Patients Hospitalized for Community-Acquired Pneumonia with Staphylococcus aureus Bacteremia","authors":"Leslie A Beavin","doi":"10.18297/jri/vol6/iss1/5","DOIUrl":"https://doi.org/10.18297/jri/vol6/iss1/5","url":null,"abstract":"Introduction: Staphylococcus aureus bacteremia has a minimum treatment duration of two weeks, while S. aureus community-acquired pneumonia (CAP) treatment is at least five days. Treatment failure, persistent bacteremia, and recurrence are common among patients with community-acquired S. aureus bacteremia. There is conflicting information in the current Infectious Diseases Society of America (IDSA) guidelines for the treatment of S.aureus bacteremia patients with CAP. Therefore, the appropriate treatment duration and modality for S. aureus CAP with bacteremia is unclear. The objective of this study was to compare outcomes among patients with S. aureus CAP and bacteremia treated in compliance versus non-compliance with IDSA S. aureus bacteremia guidelines. Methods: This was a secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) study database. Logistic regression was used to compare outcomes. Results: A total of 117 patients with S. aureus CAP and bacteremia were included in the study. Compliance with S. aureus bacteremia guidelines was documented in 67 patients, and non-compliance was documented in 50 patients. Compliance with IDSA S. aureus bacteremia guidelines resulted in a decrease in odds of re-hospitalization of 30% after adjusting for confounding variables between the compliant and non-compliant groups (adjusted odds ratio (aOR) 0.70 [95% CI 0.29–1.70]; P=0.42). The 30-day mortality for the compliant group was 6% and for the non-compliant group was 10%; P=0.576. The 1-year mortality for the compliant group was 19% and for the non-compliant group was 44%; P=0.011. Conclusion: The present study demonstrated that when treated in compliance with IDSA guidelines for S. aureus bacteremia, there was decreased 1-year mortality for patients hospitalized for S. aureus CAP with bacteremia. In this case, the IDSA S. aureus bacteremia guidelines recommend treating uncomplicated S. aureus bacteremia with CAP for at least two weeks of antimicrobials and at least four weeks of antimicrobials for complicated S. aureus bacteremia with CAP.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79561052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.18297/jri/vol6/iss1/3
R. Carrico
Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination. Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked four-hour shifts, and training sessions were held at the beginning of every shift. Training included three overarching goals with associated procedures: to protect the vaccine supply, protect the individuals being vaccinated, and protect the healthcare workforce during a 17-week large-scale community drive-through vaccination campaign. Results: Between January 4, 2021, and April 28, 2021, LouVax–Broadbent was open for operation for 82 days. A total of 109,529 doses of COVID-19 vaccine were administered at LouVax–Broadbent; 2,561 volunteers served the community at LouVax–Broadbent, yielding approximately 81,200 volunteer hours. Three needlestick injuries were reported, all of which occurred during safety device activation. Procedures that served to protect the vaccine resulted in a waste of 132 (0.12%) of the 109,529 prepared doses. Conclusions: Vaccination rate outcomes at LouVax–Broadbent demonstrated an ability to engage, train, and safely implement a large and dedicated group of volunteer healthcare and non-healthcare workers as part of a large-scale community mass COVID-19 drive-through vaccination event.
{"title":"Implementation of a Drive-Through COVID-19 Mass Vaccination Site: Experiences from LouVax–Broadbent in Louisville, Kentucky","authors":"R. Carrico","doi":"10.18297/jri/vol6/iss1/3","DOIUrl":"https://doi.org/10.18297/jri/vol6/iss1/3","url":null,"abstract":"Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination. Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked four-hour shifts, and training sessions were held at the beginning of every shift. Training included three overarching goals with associated procedures: to protect the vaccine supply, protect the individuals being vaccinated, and protect the healthcare workforce during a 17-week large-scale community drive-through vaccination campaign. Results: Between January 4, 2021, and April 28, 2021, LouVax–Broadbent was open for operation for 82 days. A total of 109,529 doses of COVID-19 vaccine were administered at LouVax–Broadbent; 2,561 volunteers served the community at LouVax–Broadbent, yielding approximately 81,200 volunteer hours. Three needlestick injuries were reported, all of which occurred during safety device activation. Procedures that served to protect the vaccine resulted in a waste of 132 (0.12%) of the 109,529 prepared doses. Conclusions: Vaccination rate outcomes at LouVax–Broadbent demonstrated an ability to engage, train, and safely implement a large and dedicated group of volunteer healthcare and non-healthcare workers as part of a large-scale community mass COVID-19 drive-through vaccination event.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87967854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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