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Zembsch T, Jansen D, Lee X, Oberle E, Philip R, Bartholomay L, Paskewitz S. Tick spotting: using mannequins to evaluate individual efficacy at detecting Ixodes scapularis (Acari: Ixodidae). JOURNAL OF MEDICAL ENTOMOLOGY 2025:tjaf053. [PMID: 40384496 DOI: 10.1093/jme/tjaf053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Revised: 02/24/2025] [Accepted: 03/24/2025] [Indexed: 05/20/2025]
Abstract
Tick checks are a free and accessible personal protection measure used to prevent tick bites and are frequently recommended by public health institutions and vector-borne disease researchers. However, little is known about how successful people are at detecting ticks on themselves or others when using this method. We developed a tool for evaluating factors affecting the efficacy of tick checks using mannequins. In 2022 and 2023, we recruited 207 participants to complete a brief survey and perform a tick check on a mannequin, where dead Ixodes scapularis Say larvae, nymphs, and adults had been glued at various locations. None of the survey results (demographics, knowledge, attitude, and concerns about ticks and tick-borne disease) were associated with likelihood of tick detection. On average, participants detected 42% of nymphs on the mannequin. Adult females were 3 to 4 times more likely to be detected than nymphs. Ticks above the waistline were detected 3 times more frequently than ticks below. Ticks that were on white-colored clothing were 3 times more likely to be detected than those on dark-colored clothing. Ticks that were not covered by hair or clothing were 2 times more likely to be detected than covered ticks. These findings show that there are multiple factors that may limit tick detection during a tick check. Outreach should emphasize the importance of awareness of size variation between stages, completing a thorough whole-body examination including the lower limbs and covered locations, and wearing light-colored clothing.
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Affiliation(s)
- Tela Zembsch
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- Department of Pathobiological Science, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - David Jansen
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- Department of Pathobiological Science, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Xia Lee
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Division of Public Health, Wisconsin Department of Health Services, Madison, WI, USA
| | - Emily Oberle
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Rosemary Philip
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Lyric Bartholomay
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- Department of Pathobiological Science, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Susan Paskewitz
- Midwest Center of Excellence for Vector-Borne Disease, Madison, WI, USA
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Kerek Á, Román I, Szabó Á, Kovács D, Kardos G, Kovács L, Jerzsele Á. Antibiotic resistance genes in Escherichia coli - literature review. Crit Rev Microbiol 2025:1-35. [PMID: 40249005 DOI: 10.1080/1040841x.2025.2492156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 03/25/2025] [Accepted: 04/07/2025] [Indexed: 04/19/2025]
Abstract
Antimicrobial resistance threatens humans and animals worldwide and is recognized as one of the leading global public health issues. Escherichia coli (E. coli) has an unquestionable role in carrying and transmitting antibiotic resistance genes (ARGs), which in many cases are encoded on plasmids or phage, thus creating the potential for horizontal gene transfer. In this literature review, the authors summarize the major antibiotic resistance genes occurring in E. coli bacteria, through the major antibiotic classes. The aim was not only listing the resistance genes against the clinically relevant antibiotics, used in the treatment of E. coli infections, but also to cover the entire resistance gene carriage in E. coli, providing a more complete picture. We started with the long-standing antibiotic groups (beta-lactams, aminoglycosides, tetracyclines, sulfonamides and diaminopyrimidines), then moved toward the newer groups (phenicols, peptides, fluoroquinolones, nitrofurans and nitroimidazoles), and in every group we summarized the resistance genes grouped by the mechanism of their action (enzymatic inactivation, antibiotic efflux, reduced permeability, etc.). We observed that the frequency of antibiotic resistance mechanisms changes in the different groups.
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Affiliation(s)
- Ádám Kerek
- Department of Pharmacology and Toxicology, University of Veterinary Medicine Budapest, Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - István Román
- Department of Pharmacology and Toxicology, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Ábel Szabó
- Department of Pharmacology and Toxicology, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Dóra Kovács
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Gábor Kardos
- One Health Institute, University of Debrecen, Debrecen, Hungary
- National Public Health Center, Budapest, Hungary
- Department of Gerontology, Faculty of Health Sciences, University of Debrecen, Nyíregyháza, Hungary
| | - László Kovács
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, Budapest, Hungary
- Department of Animal Hygiene, Herd Health and Mobile Clinic, University of Veterinary Medicine, Budapest, Hungary
| | - Ákos Jerzsele
- Department of Pharmacology and Toxicology, University of Veterinary Medicine Budapest, Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, Budapest, Hungary
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Shome R, Patil S, Skariah S, Maharana SM, Shanmugam G, Suresh KP, Nanditha TR, Mohandoss N. Bovine brucellosis sero-prevalence trend during 2011-14 and 2015-18 in Indian sub-continent. Vet Res Commun 2025; 49:164. [PMID: 40214828 DOI: 10.1007/s11259-025-10731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2025] [Accepted: 04/05/2025] [Indexed: 05/09/2025]
Abstract
Brucellosis, a significant zoonotic disease impacting livestock and human health poses substantial economic and public health challenges in endemic regions. This study analyses and compares the sero-prevalence of bovine brucellosis across 14 states in India over two distinct periods: 2011-14 and 2015-18. A stratified random sampling approach and a protein G-based indirect Enzyme Linked Immunosorbent Assay (iELISA) were employed to evaluate 6408 bovine serum samples during 2015-18 (cattle- 4495; buffaloes- 1913) and results were compared to published data of 2011-14. Chi-square test and analysis of variance (ANOVA) were carried out to know the significance among the states and also between the two time periods. Bovine brucellosis sero-prevalence across Indian states showed a significant decline from 2011 to 14 to 2015-18. In cattle, sero-prevalence reduced from 9.60 to 1.76% (p < 0.0001) with notable reductions in seven states (Gujarat, Madhya Pradesh, Karnataka, Kerala, Maharashtra, Tamil Nadu, and Rajasthan). Except in the state of Punjab, highest sero-prevalence was noted despite a significant decrease (p = 0.002). Whereas, in buffaloes, prevalence declined from 5.35 to 2.67% (p < 0.0001), with significant reduction in two out of ten states tested with modest decreases in other states. The study revealed that only 2 out of 10 states showed reduced brucellosis sero-prevalence in buffaloes indicating the need for aggressive control efforts and continued investment in surveillance, vaccination, and public health education.
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Affiliation(s)
- Rajeswari Shome
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India.
| | - Sharangauda Patil
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
| | - Somy Skariah
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
| | - Snigdha Madhaba Maharana
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
| | - G Shanmugam
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
| | - Kuralayanapalya Puttahonnappa Suresh
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
| | - Thimmappa Rajeshwari Nanditha
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
| | - Nagalingam Mohandoss
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Yelahanka, Bengaluru, 560 064, India
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Szczepański A, Klesiewicz K, Drożdż K, Ankiersztejn-Bartczak M, Olechowska-Jarząb A, Brzychczy-Włoch M. Assessment of the Impact of Gender, Age, Sexual Orientation and PrEP on HIV Infection: Analysis of Anonymous HIV Tests of People in Voluntary Counselling and Testing Points (VCTs) in Poland in 2015-2023. AIDS Behav 2025:10.1007/s10461-025-04701-2. [PMID: 40185968 DOI: 10.1007/s10461-025-04701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2025] [Indexed: 04/07/2025]
Abstract
Human immunodeficiency virus (HIV) is still an important global health burden and remains a common sexually transmitted infection (STI). Voluntary Counselling and Testing points (VCTs) in Poland allow free and anonymous access to HIV testing among the adult population. The aim of the study was to investigate whether there is an increased occurrence of HIV infection among individuals who identify as homosexual and to profile three distinct groups among VCTs clients: the most common patient coming for testing, the most frequent HIV-positive individual, and the most typical Pre-Exposure Prophylaxis (PrEP) user. Data obtained from 29 VCT points in Poland between 2015 and 2023 were retrospectively analyzed. The prevalence of HIV infection in this cohort was calculated and a model for HIV infection risk among various populations was built. 295,556 patient reports revealed that heterosexual men aged 25-34 years (13.43%) tested most frequently. In total, the average prevalence of HIV-positive patients amounted to 1.36%. Among the tested population, HIV infection was the most prevalent among homosexual men aged 25-34 (0.34%). Moreover, we showed that the risk of receiving a positive HIV result was almost five times higher among homosexual and bisexual patients than among heterosexual individuals. The findings highlight the urgent need for targeted HIV prevention efforts, particularly among homosexual and bisexual men. Ongoing monitoring and education are necessary even among PrEP users to prevent new infections.
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Affiliation(s)
- Adrian Szczepański
- Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18, 31-121, Krakow, Poland
- Association of Health Prevention "One World", Miłkowskiego 5, 30-349, Krakow, Poland
| | - Karolina Klesiewicz
- Department of Pharmaceutical Microbiology, Jagiellonian University Medical College, Medyczna 9, 30-688, Krakow, Poland
| | - Kamil Drożdż
- Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18, 31-121, Krakow, Poland
| | | | - Aldona Olechowska-Jarząb
- Department of Pharmaceutical Microbiology, Jagiellonian University Medical College, Medyczna 9, 30-688, Krakow, Poland
| | - Monika Brzychczy-Włoch
- Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18, 31-121, Krakow, Poland.
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Menezes Pinto N, das Chagas Mendonça MR, da Silva Santos J, Dos Santos Ferraz CM, Santos Oliveira D, Dos Santos LVB, de Souza Araújo AA, José Quintans Júnior L, Lyra Júnior DP, de Oliveira Filho AD, Lira AAM, Russo Serafini M, de Souza Nunes R. Lessons learned from the COVID-19 pandemic: the intranasal administration as a route for treatment - a patent review. Pharm Dev Technol 2025; 30:400-416. [PMID: 40186505 DOI: 10.1080/10837450.2025.2487575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 03/26/2025] [Accepted: 03/28/2025] [Indexed: 04/07/2025]
Abstract
The COVID-19 pandemic exposed the fragility of today's marketed treatments for respiratory infections. As a primary site of infection, the upper airways may represent a key access route for the control and treatment for these conditions. The present study aims to explore and identify, through a patent review, the novelty of therapies for COVID-19 that use the intranasal route for drug administration. A search was carried out in Wipo and Espacenet, using the descriptors 'COVID-19 OR SARS-CoV 2' AND 'treatment OR therapy' AND NOT 'vaccine OR immunizing' and the classification 'A61K9/0043'. Of the 151 patents identified, we excluded 73 duplicates, and 36 documents that meet the criteria adopted for exclusion (not nasally administered formulations, vaccines, post COVID-19 treatments, uncertain route of administration or form). We identified 78 unique patents on patent databases, of which 42 were selected for this review. The documents revealed the use of the intranasal pathway not only for drug repositioning but also for using plant-derived and biological molecules. Overall, the new formulations explore a variety of known drugs and natural products incorporated in drug carrier systems and devices for drug delivery and administration. Thus, the intranasal route remains a promising strategy for drug delivery, offering direct access to the primary infection site and warranting further exploration.
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Kochanek M, Berek M, Gibb S, Hermes C, Hilgarth H, Janssens U, Kessel J, Kitz V, Kreutziger J, Krone M, Mager D, Michels G, Möller S, Ochmann T, Scheithauer S, Wagenhäuser I, Weeverink N, Weismann D, Wengenmayer T, Wilkens FM, König V. [S1 guideline on sustainability in intensive care and emergency medicine]. Med Klin Intensivmed Notfmed 2025:10.1007/s00063-025-01261-0. [PMID: 40128386 DOI: 10.1007/s00063-025-01261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2025] [Indexed: 03/26/2025]
Affiliation(s)
- M Kochanek
- Klinik I für Innere Medizin (Hämatologie und Onkologie), Schwerpunkt Internistische Intensivmedizin, Universitätsklinikum, Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - M Berek
- Klinik für Anästhesiologie, Intensivmedizin und perioperative Schmerztherapie, Städtisches Klinikum Dessau, Dessau-Roßlau, Deutschland
| | - S Gibb
- Universitätsmedizin, Klinik für Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universität Greifswald, Greifswald, Deutschland
| | - C Hermes
- Hochschule für Angewandte Wissenschaften, Hamburg (HAW Hamburg), Alexanderstr. 1, 20099, Hamburg, Deutschland
- Studiengang "Erweiterte Klinische Pflege M.Sc und B.Sc.", Akkon Hochschule für Humanwissenschaften, Berlin, Deutschland
| | - H Hilgarth
- Bundesverband Deutscher Krankenhausapotheker e. V. (ADKA) Berlin, Berlin, Deutschland
| | - U Janssens
- Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital, Eschweiler, Deutschland
| | - J Kessel
- Medizinische Klinik 2, Infektiologie, Universitätsklinikum Frankfurt, Goethe-Universität Frankfurt am Main, Theodor Stern Kai 7, Frankfurt am Main, Deutschland
| | - V Kitz
- Interdisziplinäre Intensivstation, Pflegeentwicklung, Agaplesion Diakonieklinikum Hamburg, Hamburg, Deutschland
| | - J Kreutziger
- Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - M Krone
- Zentrale Einrichtung Krankenhaushygiene und Antimicrobial Stewardship, Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg, Würzburg, Deutschland
| | - D Mager
- Anästhesiologisch-neurochirurgische Intensivstation 1D, Krankenhaus der Barmherzigen Brüder Trier, Trier, Deutschland
| | - G Michels
- Medizincampus Trier der Universitätsmedizin Mainz, Notfallzentrum, Krankenhaus der Barmherzigen Brüder Trier, Trier, Deutschland
| | - S Möller
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Internistische konservative Intensivstation, Universität zu Lübeck, Lübeck, Deutschland
| | - T Ochmann
- Hochschule für Angewandte Wissenschaften, Hamburg (HAW Hamburg), Alexanderstr. 1, 20099, Hamburg, Deutschland
- Klinik für Kardiologie, Internistische Intensivmedizin und Angiologie, Medizinische Intensivstation, Kath. Marienkrankenhaus gGmbH, Hamburg, Deutschland
| | - S Scheithauer
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland
| | - I Wagenhäuser
- Zentrale Einrichtung Krankenhaushygiene und Antimicrobial Stewardship, Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg, Würzburg, Deutschland
| | - N Weeverink
- Fächerverbund für Infektiologie, Pneumologie und Intensivmedizin, Klinik für Infektiologie und Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - D Weismann
- Internistische Notfall- und Intensivmedizin, Medizinische Klinik und Poliklinik I, Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg, Würzburg, Deutschland
| | - T Wengenmayer
- Interdisziplinäre Medizinische Intensivtherapie (IMIT), Universitätsklinikum Freiburg, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
| | - F M Wilkens
- Klinik für Pneumologie und Beatmungsmedizin, Thoraxklinik Heidelberg GmbH, Universitätsklinikum Heidelberg, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - V König
- Viszeralmedizinisches und Viszeralonkologisches Zentrum, Interdisziplinäre Intensivstation, Israelitisches Krankenhaus Hamburg, Hamburg, Deutschland
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Corral-Liria I, Losa-Iglesias M, Becerro-De-Bengoa-Vallejo R, Herraiz-Soria E, Calvo-Lobo C, San-Antolín-Gil M, González-Martín S, Jimenez-Fernández R. Second victim syndrome among nursing professionals as a result of COVID-19: qualitative research. BMC Nurs 2025; 24:298. [PMID: 40121495 PMCID: PMC11929328 DOI: 10.1186/s12912-025-02974-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/13/2025] [Indexed: 03/25/2025] Open
Abstract
INTRODUCTION The infection caused by the COVID-19 virus, with its high capacity for spread and transmission, reached the level of an international pandemic, affecting many people and resulting in a large number of deaths. AIM To analyse the experiences of nursing professionals caring for patients with COVID-19 during the early stages of the pandemic and the skills or coping strategies that they employed. METHODS A qualitative study was carried out with an interpretative phenological design. Semistructured interviews were conducted with 20 nursing professionals working in emergency and critical care units, which were adapted to care for patients with symptoms of the disease, in public hospitals in Madrid, Spain. The data were analysed following, the Interpretive Phenomenological Analysis (IPA) of Smith et al. FINDINGS: Five themes were identified: "emotional brain training (EBT) to cope with great emotional stress", "material and sequential difficulties"; "an experience similar to a war that can cause burnout"; "Second Victim Syndrome (SVS), the emotional impact of witnessing trauma"; and "Surviving COVID-19 with overloads of energy and positivity". CONCLUSION Nursing professionals who cared for patients with Covid-19 during the first wave of the pandemic lived an experience in which they experienced a brain training of feelings, including sadness, impotence, fear, anger, pain and much worry. They also experienced a great feeling of suffering and guilt as in Second Victim Syndrome, in a situation similar to a war, due to the number of deaths caused by the virus, with all this resulting in a great overload of work. It is essential that these situations do not affect the mental health of these professionals in the dimensions that they did, and it is necessary to regain enthusiasm and motivation to provide comprehensive care for patients with COVID-19. Nursing professionals are not alone and need to be taken care of to respond to the chaos that can cause a pandemic, without ignoring the risks that it entails. They require specific training, which is necessary to provide them with proper security, and it is necessary to develop health and welfare policies, which will not be possible without first understanding their experiences.
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Tebben K, Eng V, Seng D, Tat B, Feufack Donfack LB, Orban A, Yeat R, Salvador J, Sin S, Ko K, Khim N, Flamand C, Sommen C, Lek D, Serre D, Popovici J. Cambodian Plasmodium vivax parasites with reduced hemoglobin digestion display delayed clearance upon artesunate treatment. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2025:2025.03.09.25323469. [PMID: 40162245 PMCID: PMC11952599 DOI: 10.1101/2025.03.09.25323469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
Artemisinin-based combination therapies are the frontline drugs for the treatment of malaria infections but, for Plasmodium falciparum, the efficacy of artemisinin is threatened by the spread of resistance . P. vivax is the second most common cause of human malaria but we have little information on its susceptibility to artemisinin due to the lack of in vitro cultures. Here, we analyze 161 P. vivax infections from Cambodian patients treated with 2 mg/kg/day of artesunate for seven days. All infections were successfully cleared by day 3. However, one third of the infections displayed a slow clearance after treatment, with nine infections (5.7%) with a parasite clearance time greater than 5 hours, meeting the WHO definition of artemisinin resistance. We observed no significant association between slow clearance and either patient- or infection characteristics (including stage composition). We used RNA-seq to characterize the gene expression of parasites from 15 fast- and 16 slow-clearing infections at baseline and 1, 2 and 4 hours after treatment. While fast-clearing parasites showed significant changes in gene expression immediately upon treatment, slow-clearing parasites displayed a significantly delayed gene expression response, with a downregulation of many genes associated with hemoglobin endocytosis and digestion. Overall, our results indicate that some Cambodian P. vivax parasites clear slowly after artesunate treatment, possibly due to a downregulation of hemoglobin metabolism that may reduce the efficiency of the artesunate. Research in context Evidence before this study: The WHO treatment guidelines recommend artemisinin-combination therapy (ACT) for treatment of blood-stage infections caused by Plasmodium vivax in all areas (with chloroquine recommended only in areas where P. vivax are still chloroquine-sensitive). In P. falciparum , partial resistance to artemisinin derivatives is defined in vivo as either detected parasitemia on day 3 post treatment or as a half-life of the parasite clearance slope of ≥ 5 hours. We searched Pubmed for studies containing the terms "vivax" AND "clearance" AND ("artesunate" OR "dihydroartemisinin" OR "artemether" OR "artemisinin") published between 1990 and February 2025, with no language restrictions. Our search retrieved 102 studies for which title and abstracts were screened to identify 21 studies reporting outcomes of P. vivax treatment with an artemisinin derivative. While all these studies concluded that artemisinin derivatives provided rapid clearance of P. vivax parasites, two studies reported a low frequency of day 3 positivity following artesunate-amodiaquine treatment (2.6% in Brazil) or dihydroartemisinin-piperaquine (0.6% in Indonesia). No study reported clearance slope half-life ≥ 5 hours. Added value of this study: This study used a cohort of Cambodian patients infected by P. vivax to rigorously examine the efficacy of artesunate monotherapy at clearing blood stage infections. Our study showed significant variations in clearance rates among infections, with 5.7% of the infections with a clearance slope half-life ≥ 5 hours, meeting the criteria for artemisinin partial resistance used for P. falciparum . Variations in clearance rate upon artesunate treatment were not associated with patient or infection characteristics. Gene expression analyses revealed that the slow-clearing parasites down-regulated upon treatment many genes involved in hemoglobin endocytosis and digestion, possibly resulting in a lesser activation of artesunate. Implications of all the available evidence: Our results confirm that 2 mg/kg of artesunate per day for seven days is effective at clearing P. vivax blood stage infections. However, a subset of the P. vivax parasites displayed a slow clearance following artesunate treatment meeting artemisinin partial resistance definition in P. falciparum . Gene expression analyses suggest that metabolic variations may underlie slow clearance. Increased monitoring of treatment efficacy and drug resistance in P. vivax is therefore recommended.
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Jiao X, Zhu J, Ding Y, Xiao M, Zhai Z. Effect of herpes zoster vaccine on patients after hematopoietic stem cell transplantation: a systematic review and meta-analysis. Virol J 2025; 22:54. [PMID: 40025586 PMCID: PMC11874116 DOI: 10.1186/s12985-025-02670-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Accepted: 02/13/2025] [Indexed: 03/04/2025] Open
Abstract
BACKGROUND Herpes zoster(HZ), a severe complication following hematopoietic stem cell transplantation (HSCT), is associated with significant morbidity. The effect of herpes zoster vaccine(HZV) for preventing HZ on patients after HSCT is unclear. We conducted a systematic review and meta-analysis investigating the efficacy and safety of HZV in HSCT recipients. METHODS The databases Pubmed, Embase, and Cochrane Library were searched to identify relevant studies. Random-effects models were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs) for HZ infection and related events. RESULTS A total of 3048 individuals from five studies (four randomized controlled trials and one retrospective cohort study) were included. The overall incidence of HZ in the HZV group and control group was 6.4% and 18.3% respectively, resulting in a pooled RR of 0.36 (95%CI, 0.29-0.45; P < 0.001), indicating no heterogeneity (P = 0.88,I2 = 0). HZV demonstrated a reduction in the risk of PHN (RR, 0.40; 95% CI, 0.15-1.11), although statistical significance was not reached (P = 0.08). Furthermore, through two independent RCTs, HZV showed a decrease in the incidence of HZ-related complications compared to placebo administration. The overall incidence of adverse events in the HZV group and control group was found to be 63.6% and 60.2% respectively, with a pooled RR of 1.02 (95% CI, 0.97-1.06, P = 0.51), indicating no heterogeneity (P = 0.66, I2 = 0). CONCLUSION The HZV group demonstrated a significant reduction in the risk of HZ among HSCT recipients, without an increase in adverse events. This highlights the positive impact of HZV on decreasing the incidence of PHN and complications associated with HZ. Furthermore, our findings support the effectiveness and tolerability of HZV as a preventive measure against HZ for HSCT recipients.
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Affiliation(s)
- Xunyi Jiao
- Department of Hematology/Hematological Lab, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jinli Zhu
- Department of Hematology/Hematological Lab, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yangyang Ding
- Department of Hematology/Hematological Lab, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Meng Xiao
- Department of Hematology/Hematological Lab, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Zhimin Zhai
- Department of Hematology/Hematological Lab, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
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10
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Cimen C, Berends MS, Lokate M, Glasner C, Herrmann J, Bathoorn E, Hamprecht A, Voss A. Infection prevention and control without borders: comparison of guidelines on multidrug-resistant organisms in the northern Dutch-German cross-border region. Antimicrob Resist Infect Control 2025; 14:11. [PMID: 39940037 PMCID: PMC11817605 DOI: 10.1186/s13756-025-01528-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Accepted: 01/28/2025] [Indexed: 02/14/2025] Open
Abstract
Infections due to multidrug-resistant organisms (MDROs) are a health threat due to increasing patient morbidity and mortality and the burden on healthcare systems. Robust infection prevention and control (IPC) measures are needed to minimize their emergence in hospitals. Therefore, various international and national IPC guidelines exist, yet the lack of harmonized IPC guidelines complicates the management of patients seeking healthcare across European borders. This study explores the similarities and differences in IPC measures for vancomycin-resistant enterococci (VRE) and multidrug-resistant (MDR) Enterobacterales both on local and national levels within the northern Dutch-German cross-border region. In Germany, IPC efforts are often led by hospital hygiene doctors, whereas in the Netherlands, they involve a collaboration between infection preventionists and clinical microbiologists, with local variations. The local guidelines in both countries, as expected, are based on national recommendations, yet introduce specific regulations in various aspects. The Dutch guidelines are more stringent for VRE management compared to the German guidelines, often imposing additional local measures beyond national requirements. The Dutch and German guidelines largely diverge in definitions of MDR Gram-negative bacteria. Unlike the Dutch guidelines, the German guidelines do not currently recommend screening or isolation for extended-spectrum beta-lactamase-producing Enterobacterales. For carbapenem-resistant and carbapenemase-producing Enterobacterales, there is no notable distinction between the countries' guidelines, with both sharing the objective of maintaining a low prevalence and actively working towards containment. Inconsistencies in guidelines can lead to inefficient information exchange and inconsistent hygienic measures during patient transfers. Despite common commitments, differences in focus may reflect evolving understanding of MDRO transmission and ongoing debates on their management. Our findings highlight the divergence of IPC guidelines for the management of MDROs across two countries and call for collaboration in cross-border regions to increase the effectiveness of MDRO management in these regions and improve patient care.
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Affiliation(s)
- Cansu Cimen
- Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Matthijs S Berends
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Certe Medical Diagnostics and Advice Foundation, Department of Medical Epidemiology, Groningen, the Netherlands
| | - Mariëtte Lokate
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Corinna Glasner
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jörg Herrmann
- Institute for Hospital Hygiene Oldenburg, Klinikum Oldenburg, Oldenburg, Germany
| | - Erik Bathoorn
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Axel Hamprecht
- Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany.
| | - Andreas Voss
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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11
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Guru S, Harish V, Guru N, Ali M, Cortez K. New Delhi Metallo-Beta-Lactamases (NDM)-Carbapenem-Resistant Acinetobacter baumannii Pneumonia: A Case Report. Cureus 2025; 17:e79198. [PMID: 39974295 PMCID: PMC11836519 DOI: 10.7759/cureus.79198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2025] [Indexed: 02/21/2025] Open
Abstract
Acinetobacter baumannii are Gram-negative aerobic bacteria, that are ubiquitous in the environment. They are difficult to treat given their numerous intrinsic resistance and ability to acquire resistance genes. Infections caused by carbapenem-resistant A. baumannii (CRAb) with New Delhi Metallo-beta-lactamases (NDM) are rare in the US but have risen in the past few years. There are limited treatment options available. We present a case of NDM-CRAb pneumonia in a 75-year-old man with a history of penicillin anaphylaxis with severe hypoxia requiring intubation and vasopressor support. In the absence of cefiderocol at the medical facility and the inability to use high-dose ampicillin-sulbactam infusion, a combination of polymyxin B and minocycline was used. Two courses of the combination antibiotic therapy were given, initially four days course then another course of 10 days. After this, he improved clinically and was able to be weaned off the ventilator and vasopressors. However, he experienced acute renal failure from polymyxin B and vancomycin, requiring hemodialysis for four months.
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Affiliation(s)
- Siddartha Guru
- Infectious Diseases, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Vignesh Harish
- Critical Care Medicine, Geisinger Medical Center, Danville, USA
| | - Navami Guru
- Internal Medicine, Greater Baltimore Medical Center, Towson, USA
| | - Maimoona Ali
- Internal Medicine, CHI Good Samaritan Hospital, Kearney, USA
| | - Karoll Cortez
- Infectious Diseases, Greater Baltimore Medical Center, Towson, USA
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12
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Ivanova OE, Mikhailova YM, Kozlovskaya LI, Maleev VV. [Problems of poliomyelitis eradication]. TERAPEVT ARKH 2024; 96:1104-1109. [PMID: 39731773 DOI: 10.26442/00403660.2024.11.202993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Indexed: 12/30/2024]
Abstract
The article is devoted to the problems of implementation of the WHO Global Polio Eradication Initiative. The influence of the features of poliovirus infection and poliovirus vaccines on the course of the program, its successes and difficulties is considered, the issue of possibility of eradication this infection is discussed.
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Affiliation(s)
- O E Ivanova
- Chumakov Federal Center for Research and Development of Immune-and-Biological Products (Institute of Poliomyelitis)
- Sechenov First Moscow State Medical University (Sechenov University)
| | | | - L I Kozlovskaya
- Chumakov Federal Center for Research and Development of Immune-and-Biological Products (Institute of Poliomyelitis)
- Sechenov First Moscow State Medical University (Sechenov University)
| | - V V Maleev
- Central Research Institute of Epidemiology
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13
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Poongavanan J, Lourenço J, Tsui JLH, Colizza V, Ramphal Y, Baxter C, Kraemer MU, Dunaiski M, de Oliveira T, Tegally H. Assessing Dengue Virus Importation Risks in Africa: A Climate and Travel-Based Model. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.07.24306997. [PMID: 39574849 PMCID: PMC11581072 DOI: 10.1101/2024.05.07.24306997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/09/2024]
Abstract
Background Dengue is a significant global public health concern that poses a threat to Africa. Particularly, African countries are at risk of viral introductions through air travel connectivity with areas of South America and Asia that experience frequent explosive outbreaks. Limited reporting and diagnostic capacity hinder a comprehensive assessment of continent-wide transmission dynamics and deployment of surveillance strategies in Africa. This study aimed to identify African airports at high risk of receiving dengue infected passengers from Asia, Latin America and other African countries with high dengue incidence. Methods The risk of dengue introduction into Africa from countries of high incidence in Africa, Latin America and within Africa was estimated based on origin-destination air travel flows and epidemic activity at origin. We produced a novel proxy for local dengue epidemic activity using a composite index of theoretical climate-driven transmission suitability and population density, which we used, along with travel information in a risk flow model, to estimate importation risk. Findings We find that countries in East Africa face higher estimated risk of importation from Asia and other East African countries, whereas for West African countries, larger risk of importation is estimated from within the region. Some countries with high risk of importation experience low local transmission suitability which likely hampers the chances that importations lead to local transmission and establishment. Conversely, Mauritius, Uganda, Ivory Coast, Senegal, and Kenya are identified as countries susceptible to dengue introductions during periods of persistent transmission suitability. Interpretation Our work improves data driven allocation of surveillance resources, in regions of Africa that are at high risk of dengue introduction and establishment, including from regional circulation. This will be critical in detecting and managing imported cases and can improve local response to dengue outbreaks. Funding Rockefeller Foundation, National Institute of Health, EDCTP3 and Horizon Europe Research and Innovation, World Bank Group, Medical Research Foundation, Wellcome Trust, Google.org, Oxford Martin School Pandemic Genomics programme, John Fell Fund.
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Affiliation(s)
- Jenicca Poongavanan
- Centre for Epidemic Response and innovation (CERI), Stellenbosch University, Stellenbosch, South Africa
| | - José Lourenço
- BioISI (Biosystems and Integrative Sciences Institute), University of Lisbon, Lisbon, Portugal
- Universidade Católica Portuguesa, Medical School, Biomedical Research Center, Lisboa, Portugal
| | | | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France
- Department of Biology, Georgetown University, Washington, District of Columbia, USA
| | - Yajna Ramphal
- Centre for Epidemic Response and innovation (CERI), Stellenbosch University, Stellenbosch, South Africa
| | - Cheryl Baxter
- Centre for Epidemic Response and innovation (CERI), Stellenbosch University, Stellenbosch, South Africa
| | - Moritz U.G. Kraemer
- Department of Biology, University of Oxford, Oxford,UK
- Pandemic Sciences Institute, University of Oxford, UK
| | - Marcel Dunaiski
- Computer Science Division, Department of Mathematical Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Tulio de Oliveira
- Centre for Epidemic Response and innovation (CERI), Stellenbosch University, Stellenbosch, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, Durban, South Africa
| | - Houriiyah Tegally
- Centre for Epidemic Response and innovation (CERI), Stellenbosch University, Stellenbosch, South Africa
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14
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Kumaresan V, Kamaraj Y, Subramaniyan S, Punamalai G. Understanding the Dynamics of Human Defensin Antimicrobial Peptides: Pathogen Resistance and Commensal Induction. Appl Biochem Biotechnol 2024; 196:6993-7024. [PMID: 38478321 DOI: 10.1007/s12010-024-04893-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 11/21/2024]
Abstract
Antimicrobial peptides (AMPs), also known as host defense peptides, are petite molecules with inherent microbicidal properties that are synthesized by the host's innate immune response. These peptides serve as an initial barrier against pathogenic microorganisms, effectively eliminating them. Human defensin (HD) AMPs represent a prominent group of peptides involved in the innate immune response of humans. These peptides are primarily produced by neutrophils and epithelial cells, serving as a crucial defense mechanism against invading pathogens. The extensive research conducted has focused on the broad spectrum of antimicrobial activities and multifaceted immunomodulatory functions exhibited by human defensin AMPs. During the process of co-evolution between hosts and bacterial pathogens, bacteria have developed the ability to recognize and develop an adaptive response to AMPs to counterattack their bactericidal activity by different antibiotic-resistant mechanisms. However, numerous non-pathogenic commensal bacteria elicit the upregulation of defensins as a means to surmount the resistance mechanisms implemented by pathogens. The precise mechanism underlying the induction of HD by commensal organisms remains to be fully understood. This review summarizes the most recent research on the expression of human defensin by pathogens and discusses the various defense mechanisms used by pathogens to counter host AMP production. We also mention recent developments in the commensal induction of defensin AMPs. A better knowledge of the pathogens' defensin AMP resistance mechanisms and commensals' induction of AMP expression may shed light on the creation of fresh antibacterial tactics to get rid of bacterial infection.
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Affiliation(s)
- Veenayohini Kumaresan
- Department of Microbiology, Faculty of Science, Annamalai University, Annamalai Nagar, Chidambaram, Tamilnadu, 608002, India
| | - Yoganathan Kamaraj
- Biofuel Institute, School of Environment and Safety Engineering, Jiangsu University, Zhenjiang, 212013, China
| | - Satheeshkumar Subramaniyan
- Department of Microbiology, Faculty of Science, Annamalai University, Annamalai Nagar, Chidambaram, Tamilnadu, 608002, India
| | - Ganesh Punamalai
- Department of Microbiology, Faculty of Science, Annamalai University, Annamalai Nagar, Chidambaram, Tamilnadu, 608002, India.
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15
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Dou ZZ, Li W, Hu HL, Guo X, Hu B, Chen TM, Chen HY, Guo LY, Liu G. Group A Streptococcal meningitis in children: a short case series and systematic review. Eur J Clin Microbiol Infect Dis 2024; 43:1517-1531. [PMID: 38842766 PMCID: PMC11271352 DOI: 10.1007/s10096-024-04863-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Group A streptococcal(GAS) meningitis is a severe disease with a high case fatality rate. In the era of increasing GAS meningitis, our understanding about this disease is limited. PURPOSE To gain a better understanding about GAS meningitis. METHODS Five new cases with GAS meningitis were reported. GAS meningitis related literatures were searched for systematic review in PUBMED and EMBASE. Case reports and case series on paediatric cases were included. Information on demographics, risk factors, symptoms, treatments, outcomes, and emm types of GAS was summarized. RESULTS Totally 263 cases were included. Among 100 individuals, 9.9% (8/81) had prior varicella, 11.1% (9/81) had anatomical factors, and 53.2% (42/79) had extracranial infections. Soft tissue infections were common among infants (10/29, 34.5%), while ear/sinus infections were more prevalent in children ≥ 3 years (21/42, 50.0%). The overall case fatality rate (CFR) was 16.2% (12/74). High risk of death was found in patients with shock or systemic complications, young children(< 3 years) and cases related to hematogenic spread. The predominate cause of death was shock(6/8). Among the 163 patients included in case series studies, ear/sinus infections ranged from 21.4 to 62.5%, while STSS/shock ranged from 12.5 to 35.7%, and the CFR ranged from 5.9 to 42.9%. CONCLUSIONS A history of varicella, soft tissue infections, parameningeal infections and CSF leaks are important clinical clues to GAS in children with meningitis. Young children and hematogenic spread related cases need to be closely monitored for shock due to the high risk of death.
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Affiliation(s)
- Zhen-Zhen Dou
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Wanrong Li
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Hui-Li Hu
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Xin Guo
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Bing Hu
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Tian-Ming Chen
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - He-Ying Chen
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Ling-Yun Guo
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China
| | - Gang Liu
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Ministry of Education, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
- Research Unit of Critical infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China.
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Kamiab Hesari D, Aljadeeah S, Brhlikova P, Hyzam D, Komakech H, Patiño Rueda JS, Ocampo Cañas J, Ching C, Orubu S, Bernal Acevedo O, Basaleem H, Orach CG, Zaman M, Prazeres da Costa C. Access to and utilisation of antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia: a pilot cross-sectional survey. BMJ Open 2024; 14:e084734. [PMID: 39013652 PMCID: PMC11253744 DOI: 10.1136/bmjopen-2024-084734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/13/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVES Identifying key barriers to accessing quality-assured and affordable antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia and investigating their (1) utilisation patterns of antibiotics, (2) knowledge about antimicrobial resistance (AMR) and (3) perception of the quality of antimicrobials received. DESIGN Pilot cross-sectional survey. SETTING Data were collected from five health facilities in the Kiryandongo refugee settlement (Bweyale, Uganda), three camps for internally displaced persons (IDPs) in the Dar Sad district (Aden, Yemen) and a district with a high population of Venezuelan migrants (Kennedy district, Bogotá, Colombia). Data collection took place between February and May 2021. The three countries were selected due to their high number of displaced people in their respective continents. PARTICIPANTS South Sudanese refugees in Uganda, IDPs in Yemen and Venezuelan migrants in Colombia. OUTCOME MEASURE The most common barriers to access to quality-assured and affordable antimicrobials. RESULTS A total of 136 participants were enrolled in this study. Obtaining antimicrobials through informal pathways, either without a doctor's prescription or through family and friends, was common in Yemen (27/50, 54.0%) and Colombia (34/50, 68.0%). In Yemen and Uganda, respondents used antibiotics to treat (58/86, 67.4%) and prevent (39/86, 45.3%) a cold. Knowledge of AMR was generally low (24/136, 17.6%). Barriers to access included financial constraints in Colombia and Uganda, prescription requirements in Yemen and Colombia, and non-availability of drugs in Uganda and Yemen. CONCLUSION Our multicentred research identified common barriers to accessing quality antimicrobials among refugees/IDPs/migrants and common use of informal pathways. The results suggest that knowledge gaps about AMR may lead to potential misuse of antimicrobials. Due to the study's small sample size and use of non-probability sampling, the results should be interpreted with caution, and larger-scale assessments on this topic are needed. Future interventions designed for similar humanitarian settings should consider the interlinked barriers identified.
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Affiliation(s)
- David Kamiab Hesari
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
- Centre for Global Health, Technical University of Munich, Munich, Germany
| | - Saleh Aljadeeah
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Petra Brhlikova
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dalia Hyzam
- Women's Research and Training Centre, University of Aden, Aden, Yemen
| | - Henry Komakech
- Department of Community Health and Behavioral Science, Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Carly Ching
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Samuel Orubu
- Institute for Health System Innovation and Policy, Boston University, Boston, Massachusetts, USA
- Faculty of Pharmacy, Niger Delta University, Amassoma, Bayelsa, Nigeria
| | | | - Huda Basaleem
- Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | | | - Muhammad Zaman
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
- Centre for Global Health, Technical University of Munich, Munich, Germany
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17
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Andijani O, Alsalhi S. The Non-inferiority of Human Papillomavirus Vaccine Immunogenicity Among Women Over 26 Years: A Systematic Review. Cureus 2024; 16:e65157. [PMID: 39176354 PMCID: PMC11339578 DOI: 10.7759/cureus.65157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE Demonstrate the immunogenicity of the human papillomavirus (HPV) vaccine for the older age group (above 26 years) to prevent HPV infection with high-risk types and argue for extending vaccination recommendations for the older age group. METHODS Two authors searched PubMed, Embase, and the Cochrane Library from inception to December 2023 to collect information on clinical trials of HPV vaccine immunogenicity. The database search strategy used a combination of subject terms and free terms. Two authors first identified studies by reading the title, abstract, and full texts and, subsequently, based on the inclusion criteria. Studies eligible to be included are the clinical trials using one of the following types of HPV vaccines: 2vHPV, 4vHPV, and 9vHPV, and measuring the immunogenicity by the geometric mean concentration or titer (GMC/T) and seroconversion rate (SCR) among healthy women aged 9 to 55 years who had never received a prophylactic HPV vaccine, known serostatus for HPV, non-immunocompetence, or non-pregnant. RESULTS This review included nine articles, seven RCTs, and two open-labeled studies. CONCLUSION In summary, we have demonstrated that the immunogenicity of the HPV vaccines is non-inferior in the older age group. Even though the GMT declines with age, the SCR is similar in all age groups regardless of the serostatus. The immunogenicity of the bivalent vaccine is superior to that of the quadrivalent vaccine for the older age group. Additionally, the vaccine is more efficient in women under the age of 26, but older women will benefit from it.
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Affiliation(s)
| | - Sara Alsalhi
- Preventive Medicine, Saudi Ministry of Health, Jeddah, SAU
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18
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Solano N, Herring EC, Hintz CW, Newberry PM, Schatz AM, Walker JW, Osenberg CW, Murdock CC. Mosquito population dynamics is shaped by the interaction among larval density, season, and land use. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.08.598043. [PMID: 38915528 PMCID: PMC11195073 DOI: 10.1101/2024.06.08.598043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Understanding how variation in key abiotic and biotic factors interact at spatial scales relevant for mosquito fitness and population dynamics is crucial for predicting current and future mosquito distributions and abundances, and the transmission potential for human pathogens. However, studies investigating the effects of environmental variation on mosquito traits have investigated environmental factors in isolation or in laboratory experiments that examine constant environmental conditions that often do not occur in the field. To address these limitations, we conducted a semi-field experiment in Athens, Georgia using the invasive Asian tiger mosquito (Aedes albopictus). We selected nine sites that spanned natural variation in impervious surface and vegetation cover to explore effects of the microclimate (temperature and humidity) on mosquitoes. On these sites, we manipulated conspecific larval density at each site. We repeated the experiment in the summer and fall. We then evaluated the effects of land cover, larval density, and time of season, as well as interactive effects, on the mean proportion of females emerging, juvenile development time, size upon emergence, and predicted per capita population growth (i.e., fitness). We found significant effects of larval density, land cover, and season on all response variables. Of most note, we saw strong interactive effects of season and intra-specific density on each response variable, including a non-intuitive decrease in development time with increasing intra-specific competition in the fall. Our study demonstrates that ignoring the interaction between variation in biotic and abiotic variables could reduce the accuracy and precision of models used to predict mosquito population and pathogen transmission dynamics, especially those inferring dynamics at finer-spatial scales across which transmission and control occur.
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Affiliation(s)
- Nicole Solano
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Emily C. Herring
- Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Carl W. Hintz
- Department of Applied Ecology, North Carolina State University, Raleigh, NC, USA
| | - Philip M. Newberry
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Annakate M. Schatz
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Joseph W. Walker
- Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | | | - Courtney C. Murdock
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
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19
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Hendy A, Fé NF, Pedrosa I, Girão A, dos Santos TNF, Mendonça CR, Andes Júnior JT, Assunção FP, Costa ER, Sluydts V, Gordo M, Scarpassa VM, Buenemann M, de Lacerda MVG, Mourão MPG, Vasilakis N, Hanley KA. Forest edge landscape context affects mosquito community composition and risk of pathogen emergence. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.30.591911. [PMID: 38746412 PMCID: PMC11092638 DOI: 10.1101/2024.04.30.591911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Forest edges, where humans, mosquitoes, and wildlife interact, may serve as a nexus for zoonotic arbovirus exchange. Although often treated as uniform interfaces, the landscape context of edge habitats can greatly impact ecological interactions. Here, we investigated how the landscape context of forest edges shapes mosquito community structure in an Amazon rainforest reserve near the city of Manaus, Brazil, using hand-nets to sample mosquitoes at three distinct forest edge types. Sampling sites were situated at edges bordering urban land cover, rural land cover, and natural treefall gaps, while sites in continuous forest served as controls. Community composition differed substantially among edge types, with rural edges supporting the highest species diversity. Rural edges also provided suitable habitat for forest specialists, including key sylvatic vectors, of which Haemagogus janthinomys was the most abundant species sampled overall. Our findings emphasize the importance of landscape context in assessing pathogen emergence risk at forest edges.
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Affiliation(s)
- Adam Hendy
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Biology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Nelson Ferreira Fé
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | - Igor Pedrosa
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | - André Girão
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | | | - Claudia Reis Mendonça
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | | | | | - Edson Rodrigues Costa
- Laboratório de Biologia da Conservação, Projeto Sauim-de-Coleira, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
| | - Vincent Sluydts
- Department of Biology, University of Antwerp, Evolutionary Ecology Group, Wilrijk, Belgium
| | - Marcelo Gordo
- Laboratório de Biologia da Conservação, Projeto Sauim-de-Coleira, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
| | - Vera Margarete Scarpassa
- Coordenação de Biodiversidade, Instituto Nacional de Pesquisas da Amazônia, Manaus, Amazonas, Brazil
| | - Michaela Buenemann
- Department of Geography and Environmental Studies, New Mexico State University, Las Cruces, New Mexico, USA
| | - Marcus Vinícius Guimarães de Lacerda
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Instituto Leônidas & Maria Deane (Fiocruz - Amazônia), Manaus, Amazonas, Brazil
| | | | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
- Center for Vector-Borne and Zoonotic Diseases, University of Texas Medical Branch, Galveston, Texas, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, Texas, USA
| | - Kathryn A. Hanley
- Department of Biology, New Mexico State University, Las Cruces, New Mexico, USA
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20
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Lencina FA, Bertona M, Stegmayer MA, Olivero CR, Frizzo LS, Zimmermann JA, Signorini ML, Soto LP, Zbrun MV. Prevalence of colistin-resistant Escherichia coli in foods and food-producing animals through the food chain: A worldwide systematic review and meta-analysis. Heliyon 2024; 10:e26579. [PMID: 38434325 PMCID: PMC10904249 DOI: 10.1016/j.heliyon.2024.e26579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
The purpose of this systematic review and meta-analysis was to summarize the available scientific evidence on the prevalence of colistin-resistant Escherichia coli strains isolated from foods and food-producing animals, the mobile colistin-resistant genes involved, and the impact of the associated variables. A systematic review was carried out in databases according to selection criteria and search strategies established a priori. Random-effect meta-analysis models were fitted to estimate the prevalence of colistin-resistant Escherichia coli and to identify the factors associated with the outcome. In general, 4.79% (95% CI: 3.98%-5.76%) of the food and food-producing animal samples harbored colistin-resistant Escherichia coli (total number of colistin-resistant Escherichia coli/total number of samples), while 5.70% (95% confidence interval: 4.97%-6.52%) of the E. coli strains isolated from food and food-producing animal samples harbored colistin resistance (total number of colistin-resistant Escherichia coli/total number of Escherichia coli isolated samples). The prevalence of colistin-resistant Escherichia coli increased over time (P < 0.001). On the other hand, 65.30% (95% confidence interval: 57.77%-72.14%) of colistin resistance was mediated by the mobile colistin resistance-1 gene. The mobile colistin resistance-1 gene prevalence did not show increases over time (P = 0.640). According to the findings, other allelic variants (mobile colistin resistance 2-10 genes) seem to have less impact on prevalence. A higher prevalence of colistin resistance was estimated in developing countries (P < 0.001), especially in samples (feces and intestinal content, meat, and viscera) derived from poultry and pigs (P < 0.001). The mobile colistin resistance-1 gene showed a global distribution with a high prevalence in most of the regions analyzed (>50%). The prevalence of colistin-resistant Escherichia coli and the mobile colistin resistance-1 gene has a strong impact on the entire food chain. The high prevalence estimated in the retail market represents a potential risk for consumers' health. There is an urgent need to implement based-evidence risk management measures under the "One Health" approach to guarantee public health, food safety, and a sustainable future.
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Affiliation(s)
- Florencia Aylen Lencina
- Laboratory of Food Analysis, Institute of Veterinary Science (ICiVet Litoral), National University of the Litoral, National Council of Scientific and Technical Research (UNL/CONICET), Esperanza, Argentina
| | - Matías Bertona
- Department of Public Health, Faculty of Veterinary Science – Litoral National University, Esperanza, Argentina
| | - María Angeles Stegmayer
- Laboratory of Food Analysis, Institute of Veterinary Science (ICiVet Litoral), National University of the Litoral, National Council of Scientific and Technical Research (UNL/CONICET), Esperanza, Argentina
| | - Carolina Raquel Olivero
- Laboratory of Food Analysis, Institute of Veterinary Science (ICiVet Litoral), National University of the Litoral, National Council of Scientific and Technical Research (UNL/CONICET), Esperanza, Argentina
| | - Laureano Sebastián Frizzo
- Laboratory of Food Analysis, Institute of Veterinary Science (ICiVet Litoral), National University of the Litoral, National Council of Scientific and Technical Research (UNL/CONICET), Esperanza, Argentina
- Department of Public Health, Faculty of Veterinary Science – Litoral National University, Esperanza, Argentina
| | - Jorge Alberto Zimmermann
- Laboratory of Food Analysis, Institute of Veterinary Science (ICiVet Litoral), National University of the Litoral, National Council of Scientific and Technical Research (UNL/CONICET), Esperanza, Argentina
| | - Marcelo Lisandro Signorini
- Department of Public Health, Faculty of Veterinary Science – Litoral National University, Esperanza, Argentina
- Instituto de Investigación de la Cadena Láctea (INTA-CONICET), Estación Experimental Agropecuaria Rafaela, Ruta 34 Km 227, Rafaela, Santa Fe, Argentina
| | - Lorena Paola Soto
- Laboratory of Food Analysis, Institute of Veterinary Science (ICiVet Litoral), National University of the Litoral, National Council of Scientific and Technical Research (UNL/CONICET), Esperanza, Argentina
- Department of Public Health, Faculty of Veterinary Science – Litoral National University, Esperanza, Argentina
| | - María Virginia Zbrun
- Department of Public Health, Faculty of Veterinary Science – Litoral National University, Esperanza, Argentina
- Instituto de Investigación de la Cadena Láctea (INTA-CONICET), Estación Experimental Agropecuaria Rafaela, Ruta 34 Km 227, Rafaela, Santa Fe, Argentina
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21
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Rivera LF, Lezcano-Coba C, Galué J, Rodriguez X, Juarez Y, de Souza WM, Capitan-Barrios Z, Valderrama A, Abrego L, Cedeño H, Jackman C, Waggoner JJ, Aguilar PV, Guzman H, Weaver SC, Tesh RB, López-Vèrges S, Donnelly CA, Estofolete CF, Nogueira ML, Faria NR, Vasilakis N, Vittor AY, Smith DR, Carrera JP. Clinical and epidemiological characteristics of Madariaga and Venezuelan equine encephalitis virus infections. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.02.24302220. [PMID: 38352566 PMCID: PMC10863014 DOI: 10.1101/2024.02.02.24302220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Madariaga virus (MADV) and Venezuelan equine encephalitis virus (VEEV) are emerging arboviruses affecting rural and remote areas of Latin America. However, there are limited clinical and epidemiological reports available, and outbreaks are occurring at an increasing frequency. We addressed this gap by analyzing all the available clinical and epidemiological data of MADV and VEEV infections recorded since 1961 in Panama. A total of 168 of human alphavirus encephalitis cases were detected in Panama from 1961 to 2023. Here we describe the clinical signs and symptoms and epidemiological characteristics of these cases, and also explored signs and symptoms as potential predictors of encephalitic alphavirus infection when compared to those of other arbovirus infections occurring in the region. Our results highlight the challenges clinical diagnosis of alphavirus disease in endemic regions with overlapping circulation of multiple arboviruses.
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Affiliation(s)
- Luis Felipe Rivera
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Carlos Lezcano-Coba
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Josefrancisco Galué
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Xacdiel Rodriguez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Yelissa Juarez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | | | - Zeuz Capitan-Barrios
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
- Universidad de Panamá, Ciudad de Panamá
| | - Anayansi Valderrama
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Leyda Abrego
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
- Universidad de Panamá, Ciudad de Panamá
| | | | | | | | | | - Hilda Guzman
- The University of Texas Medical Branch, Galveston, TX, USA
| | | | - Robert B. Tesh
- The University of Texas Medical Branch, Galveston, TX, USA
| | | | | | - Cassia F. Estofolete
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo Brazil
| | - Mauricio L. Nogueira
- The University of Texas Medical Branch, Galveston, TX, USA
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo Brazil
| | - Nuno R. Faria
- Imperial College London, London, United Kingdom
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Jean-Paul Carrera
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
- University of Oxford, Oxford, United Kingdom
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22
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Wang Q, Li Z, Guo Y, Mellis IA, Iketani S, Liu M, Yu J, Valdez R, Lauring AS, Sheng Z, Gordon A, Liu L, Ho DD. Evolving antibody evasion and receptor affinity of the Omicron BA.2.75 sublineage of SARS-CoV-2. iScience 2023; 26:108254. [PMID: 38026207 PMCID: PMC10654603 DOI: 10.1016/j.isci.2023.108254] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/20/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
SARS-CoV-2 Omicron BA.2.75 has diversified into multiple subvariants with additional spike mutations and several are expanding in prevalence, particularly CH.1.1 and BN.1. Here, we investigated the viral receptor affinities and neutralization evasion properties of major BA.2.75 subvariants actively circulating in different regions worldwide. We found two distinct evolutionary pathways and three newly identified mutations that shaped the virological features of these subvariants. One phenotypic group exhibited a discernible decrease in viral receptor affinities, but a noteworthy increase in resistance to antibody neutralization, as exemplified by CH.1.1, which is apparently as resistant as XBB.1.5. In contrast, a second group demonstrated a substantial increase in viral receptor affinity but only a moderate increase in antibody evasion, as exemplified by BN.1. We also observed that all prevalent SARS-CoV-2 variants in the circulation presently, except for BN.1, exhibit profound levels of antibody evasion, suggesting this is the dominant determinant of virus transmissibility today.
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Affiliation(s)
- Qian Wang
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Zhiteng Li
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Yicheng Guo
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Ian A. Mellis
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Sho Iketani
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Michael Liu
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Jian Yu
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Riccardo Valdez
- Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Adam S. Lauring
- Division of Infectious Diseases, Department of Internal Medicine, Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Zizhang Sheng
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Lihong Liu
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - David D. Ho
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Department of Microbiology and Immunology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
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23
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Kumar P, Wang M, Kumru OS, Hickey JM, Sanmiguel J, Zabaleta N, Vandenberghe LH, Joshi SB, Volkin DB. Correlating physicochemical and biological properties to define critical quality attributes of a rAAV vaccine candidate. Mol Ther Methods Clin Dev 2023; 30:103-121. [PMID: 37746246 PMCID: PMC10512015 DOI: 10.1016/j.omtm.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/08/2023] [Indexed: 09/26/2023]
Abstract
Recombinant adeno-associated viruses (rAAVs) are a preferred vector system in clinical gene transfer. A fundamental challenge to formulate and deliver rAAVs as stable and efficacious vaccines is to elucidate interrelationships between the vector's physicochemical properties and biological potency. To this end, we evaluated an rAAV-based coronavirus disease 2019 (COVID-19) vaccine candidate that encodes the Spike antigen (AC3) and is produced by a commercially viable process. First, state-of-the-art analytical techniques were employed to determine key structural attributes of AC3, including primary and higher-order structures, particle size, empty/full capsid ratios, aggregates, and multi-step thermal degradation pathway analysis. Next, several quantitative potency measures for AC3 were implemented, and data were correlated with the physicochemical analyses on thermally stressed and control samples. Results demonstrate links between decreasing AC3 physical stability profiles, in vitro transduction efficiency in a cell-based assay, and, importantly, in vivo immunogenicity in a mouse model. These findings are discussed in the general context of future development of rAAV-based vaccine candidates as well as specifically for the rAAV vaccine application under study.
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Affiliation(s)
- Prashant Kumar
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS 66047, USA
| | - Michael Wang
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS 66047, USA
| | - Ozan S. Kumru
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS 66047, USA
| | - John M. Hickey
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS 66047, USA
| | - Julio Sanmiguel
- Grousbeck Gene Therapy Center, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Nerea Zabaleta
- Grousbeck Gene Therapy Center, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Luk H. Vandenberghe
- Grousbeck Gene Therapy Center, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Sangeeta B. Joshi
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS 66047, USA
| | - David B. Volkin
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS 66047, USA
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24
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Ogwuche J, Chang CA, Ige O, Sagay AS, Chaplin B, Kahansim ML, Paul M, Elujoba M, Imade G, Kweashi G, Dai YC, Hsieh SC, Wang WK, Hamel DJ, Kanki PJ. Arbovirus surveillance in pregnant women in north-central Nigeria, 2019-2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.04.23293671. [PMID: 37609234 PMCID: PMC10441490 DOI: 10.1101/2023.08.04.23293671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The adverse impact of Zika (ZIKV), dengue (DENV), and chikungunya (CHIKV) virus infection in pregnancy has been recognized in Latin America and Asia but is not well studied in Africa. In Nigeria, we screened 1006 pregnant women for ZIKV, DENV and CHIKV IgM/IgG by rapid test (2019-2022). Women with acute infection were recruited for prospective study and infants were examined for any abnormalities from delivery through six months. A subset of rapid test-reactive samples were confirmed using virus-specific ELISAs and neutralization assays. Prevalence of acute infection (IgM+) was 3.8%, 9.9% and 11.8% for ZIKV, DENV and CHIKV, respectively; co-infections represented 24.5% of all infections. Prevalence in asymptomatic women was twice the level of symptomatic infection. We found a significant association between acute maternal ZIKV/DENV/CHIKV infection and any gross abnormal birth outcome (p=0.014). Further prospective studies will contribute to our understanding of the clinical significance of these endemic arboviruses in Africa.
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25
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Matthews PC, Ocama P, Wang S, El-Sayed M, Turkova A, Ford D, Torimiro J, Garcia Ferreira AC, Espinosa Miranda A, De La Hoz Restrepo FP, Seremba E, Mbu R, Pan CQ, Razavi H, Dusheiko G, Spearman CW, Hamid S. Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus. JHEP Rep 2023; 5:100777. [PMID: 37554925 PMCID: PMC10405098 DOI: 10.1016/j.jhepr.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 08/10/2023] Open
Abstract
Prevention of mother-to-child transmission of hepatitis B virus (HBV) infection is a cornerstone of efforts to support progress towards elimination of viral hepatitis. Current guidelines recommend maternal screening, antiviral therapy during the third trimester of high-risk pregnancies, universal and timely HBV birth dose vaccination, and post-exposure prophylaxis with hepatitis B immunoglobulin for selected neonates. However, serological and molecular diagnostic testing, treatment and HBV vaccination are not consistently deployed, particularly in many high endemicity settings, and models predict that global targets for reduction in paediatric incidence will not be met by 2030. In this article, we briefly summarise the evidence for current practice and use this as a basis to discuss areas in which prevention of mother-to-child transmission can potentially be enhanced. By reducing health inequities, enhancing pragmatic use of resources, filling data gaps, developing advocacy and education, and seeking consistent investment from multilateral agencies, significant advances can be made to further reduce vertical transmission events, with wide health, societal and economic benefits.
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Affiliation(s)
- Philippa C. Matthews
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, UK
- Department of Infection, University College London Hospitals, 235 Euston Rd, London NW1 2BU, UK
| | - Ponsiano Ocama
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Su Wang
- Cooperman Barnabas Medical Center, Florham Park, NJ, USA
- Hepatitis B Foundation, Doylestown, PA, USA
| | - Manal El-Sayed
- Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Anna Turkova
- Medical Research Council Clinical Trials Unit, University College London, 90 High Holborn, London WC1V 6LJ, UK
| | - Deborah Ford
- Medical Research Council Clinical Trials Unit, University College London, 90 High Holborn, London WC1V 6LJ, UK
| | - Judith Torimiro
- Chantal Biya International Reference Centre for Research on Prevention and Management of HIV/AIDS (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Ana Cristina Garcia Ferreira
- Ministry of Health, Health Surveillance Department, Department of Chronic Diseases and Sexually Transmitted Infections, SRTVN Quadra 701, Lote D, PO700 Building, CEP: 70719-040, Brasília/DF, Brazil
| | - Angélica Espinosa Miranda
- Ministry of Health, Health Surveillance Department, Department of Chronic Diseases and Sexually Transmitted Infections, SRTVN Quadra 701, Lote D, PO700 Building, CEP: 70719-040, Brasília/DF, Brazil
| | | | - Emmanuel Seremba
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robinson Mbu
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Calvin Q. Pan
- Division of Gastroenterology and Hepatology, NYU Langone Health, NYU Grossman School of Medicine, NY, USA
| | - Homie Razavi
- Center for Disease Analysis Foundation, 1120 W South Boulder Rd Suite 102, Lafayette, CO 80026, USA
| | - Geoffrey Dusheiko
- Liver Unit, King’s College Hospital, Denmark Hill, London SE5 9RS, UK
| | - C. Wendy Spearman
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
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26
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Accoti A, Multini LC, Diouf B, Becker M, Vulcan J, Sylla M, Yap DAY, Khanipov K, Weaver SC, Diallo M, Gaye A, Dickson LB. The influence of the larval microbiome on susceptibility to Zika virus is mosquito genotype dependent. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.10.540191. [PMID: 37215022 PMCID: PMC10197687 DOI: 10.1101/2023.05.10.540191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The microbiome of the mosquito Aedes aegypti is largely determined by the environment and influences mosquito susceptibility for arthropod-borne viruses (arboviruses). Larval interactions with different bacteria can influence adult Ae. aegypti replication of arboviruses, but little is known about the role that mosquito host genetics play in determining how larval-bacterial interactions shape Ae aegypti susceptibility to arboviruses. To address this question, we isolated single bacterial isolates and complex microbiomes from Ae. aegypti larvae from various field sites in Senegal. Either single bacterial isolates or complex microbiomes were added to two different genetic backgrounds of Ae. aegypti in a gnotobiotic larval system. Using 16S amplicon sequencing we show that similarities in bacterial community structures when given identical microbiomes between different genetic backgrounds of Ae. aegypti was dependent on the source microbiome, and the abundance of single bacterial taxa differed between Ae. aegypti genotypes. Using single bacterial isolates or the entire preserved complex microbiome, we tested the ability of specific microbiomes to drive differences in infection rates for Zika virus in different genetic backgrounds of Ae. aegypti . We observed that the proportion of Zika virus-infected adults was dependent on the interaction between the larval microbiome and Ae. aegypti host genetics. By using the larval microbiome as a component of the environment, these results demonstrate that interactions between the Ae. aegypti genotype and its environment can influence Zika virus infection. As Ae. aegypti expands and adapts to new environments under climate change, an understanding of how different genotypes interact with the same environment will be crucial for implementing arbovirus transmission control strategies.
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Ayorinde A, Ghosh I, Ali I, Zahair I, Olarewaju O, Singh M, Meehan E, Anjorin SS, Rotheram S, Barr B, McCarthy N, Oyebode O. Health inequalities in infectious diseases: a systematic overview of reviews. BMJ Open 2023; 13:e067429. [PMID: 37015800 PMCID: PMC10083762 DOI: 10.1136/bmjopen-2022-067429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities. METHODS We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis. RESULTS We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews. CONCLUSION We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes.
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Affiliation(s)
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Ifra Ali
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Iram Zahair
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Olajumoke Olarewaju
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megha Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Edward Meehan
- School of Public Health and Prevention Medicine, Monash University, Clayton, Victoria, Australia
| | | | - Suzanne Rotheram
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Ben Barr
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Noel McCarthy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, London, London, UK
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28
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Wang Q, Iketani S, Li Z, Liu L, Guo Y, Huang Y, Bowen AD, Liu M, Wang M, Yu J, Valdez R, Lauring AS, Sheng Z, Wang HH, Gordon A, Liu L, Ho DD. Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants. Cell 2023; 186:279-286.e8. [PMID: 36580913 PMCID: PMC9747694 DOI: 10.1016/j.cell.2022.12.018] [Citation(s) in RCA: 580] [Impact Index Per Article: 290.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
The BQ and XBB subvariants of SARS-CoV-2 Omicron are now rapidly expanding, possibly due to altered antibody evasion properties deriving from their additional spike mutations. Here, we report that neutralization of BQ.1, BQ.1.1, XBB, and XBB.1 by sera from vaccinees and infected persons was markedly impaired, including sera from individuals boosted with a WA1/BA.5 bivalent mRNA vaccine. Titers against BQ and XBB subvariants were lower by 13- to 81-fold and 66- to 155-fold, respectively, far beyond what had been observed to date. Monoclonal antibodies capable of neutralizing the original Omicron variant were largely inactive against these new subvariants, and the responsible individual spike mutations were identified. These subvariants were found to have similar ACE2-binding affinities as their predecessors. Together, our findings indicate that BQ and XBB subvariants present serious threats to current COVID-19 vaccines, render inactive all authorized antibodies, and may have gained dominance in the population because of their advantage in evading antibodies.
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Affiliation(s)
- Qian Wang
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Sho Iketani
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Zhiteng Li
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Liyuan Liu
- Department of Systems Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Yicheng Guo
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Yiming Huang
- Department of Systems Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Anthony D Bowen
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael Liu
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Maple Wang
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jian Yu
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Riccardo Valdez
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Adam S Lauring
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Zizhang Sheng
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Harris H Wang
- Department of Systems Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Lihong Liu
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - David D Ho
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Microbiology and Immunology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
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29
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Bugrov SN, Dvorakovskaya IV, Ariel BM. [Lung pathology in post-covid syndrome]. Arkh Patol 2023; 85:52-59. [PMID: 37814851 DOI: 10.17116/patol20238505152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
The clinic and pathological anatomy of the infection caused by the SARS-CoV-2 virus (coronavirus infection - CI) with the development of Post-Covid syndrome (PS) have not been studied enough. This also applies to morphofunctional changes in the lungs, one of the most important components of PS. We conducted a histological and bacterioscopic study of lung biopsy specimens in 20 patients of both sexes aged 22-75 years. In many patients, PS developed relatively late - not earlier than 1 year - 1 year 4 months after the onset of acute clinical symptoms of CI. Structural changes in the lungs in PS appear as an inflammatory reaction such as interstitial pneumonia. Most patients had nonspecific interstitial pneumonia with elements of organizing interstitial pneumonia, in some cases complicated by the presence of a specific granulomatous reaction, characteristic of pulmonary tuberculosis. Despite this, according to the results of traditional bacterioscopic and bacteriological studies, the tuberculous etiology of pulmonary fibrosis has not yet been confirmed. Perhaps this is due to the fact that we are talking about an inapparent tuberculosis infection, the causative agent of which is the L-form of Mycobacterium tuberculosis. Patients with PS who have pulmonary fibrosis on x-ray should be under the special supervision of a phthisiatrician or pulmonologist.
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Affiliation(s)
- S N Bugrov
- St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia
- First St. Petersburg State Medical University named after academician I.P. Pavlov, St. Petersburg, Russia
| | - I V Dvorakovskaya
- St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia
- First St. Petersburg State Medical University named after academician I.P. Pavlov, St. Petersburg, Russia
| | - B M Ariel
- St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia
- First St. Petersburg State Medical University named after academician I.P. Pavlov, St. Petersburg, Russia
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30
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Bruel T, Stéfic K, Nguyen Y, Toniutti D, Staropoli I, Porrot F, Guivel-Benhassine F, Bolland WH, Planas D, Hadjadj J, Handala L, Planchais C, Prot M, Simon-Lorière E, André E, Baele G, Cuypers L, Mouthon L, Mouquet H, Buchrieser J, Sève A, Prazuck T, Maes P, Terrier B, Hocqueloux L, Schwartz O. Longitudinal analysis of serum neutralization of SARS-CoV-2 Omicron BA.2, BA.4, and BA.5 in patients receiving monoclonal antibodies. Cell Rep Med 2022; 3:100850. [PMID: 36450283 PMCID: PMC9706550 DOI: 10.1016/j.xcrm.2022.100850] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/10/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
The emergence of Omicron sublineages impacts the therapeutic efficacy of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies (mAbs). Here, we evaluate neutralization and antibody-dependent cellular cytotoxicity (ADCC) activities of 6 therapeutic mAbs against Delta, BA.2, BA.4, and BA.5. The Omicron subvariants escape most antibodies but remain sensitive to bebtelovimab and cilgavimab. Consistent with their shared spike sequence, BA.4 and BA.5 display identical neutralization profiles. Sotrovimab is the most efficient at eliciting ADCC. We also analyze 121 sera from 40 immunocompromised individuals up to 6 months after infusion of Ronapreve (imdevimab + casirivimab) or Evusheld (cilgavimab + tixagevimab). Sera from Ronapreve-treated individuals do not neutralize Omicron subvariants. Evusheld-treated individuals neutralize BA.2 and BA.5, but titers are reduced. A longitudinal evaluation of sera from Evusheld-treated patients reveals a slow decay of mAb levels and neutralization, which is faster against BA.5. Our data shed light on antiviral activities of therapeutic mAbs and the duration of effectiveness of Evusheld pre-exposure prophylaxis.
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Affiliation(s)
- Timothée Bruel
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France; Vaccine Research Institute, Créteil, France.
| | - Karl Stéfic
- INSERM U1259, Université de Tours, Tours, France; CHRU de Tours, National Reference Center for HIV-Associated Laboratory, Tours, France
| | - Yann Nguyen
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP.CUP, Hopital Cochin, Paris, France
| | - Donatella Toniutti
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France
| | - Isabelle Staropoli
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France
| | - Françoise Porrot
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France
| | | | - William-Henry Bolland
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France; Université Paris Cité, École doctorale BioSPC 562, Paris, France
| | - Delphine Planas
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France; Vaccine Research Institute, Créteil, France
| | - Jérôme Hadjadj
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP.CUP, Hopital Cochin, Paris, France
| | - Lynda Handala
- INSERM U1259, Université de Tours, Tours, France; CHRU de Tours, National Reference Center for HIV-Associated Laboratory, Tours, France
| | - Cyril Planchais
- Humoral Immunology Laboratory, Institut Pasteur, Université Paris Cité, INSERM U1222, Paris, France
| | - Matthieu Prot
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université Paris Cité, Paris, France
| | - Etienne Simon-Lorière
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université Paris Cité, Paris, France
| | - Emmanuel André
- University Hospitals Leuven, Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, Leuven, Belgium; KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, Leuven, Belgium
| | - Guy Baele
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Lize Cuypers
- University Hospitals Leuven, Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, Leuven, Belgium
| | - Luc Mouthon
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP.CUP, Hopital Cochin, Paris, France
| | - Hugo Mouquet
- Humoral Immunology Laboratory, Institut Pasteur, Université Paris Cité, INSERM U1222, Paris, France
| | - Julian Buchrieser
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France
| | - Aymeric Sève
- CHR d'Orléans, Service de Maladies Infectieuses, Orléans, France
| | - Thierry Prazuck
- CHR d'Orléans, Service de Maladies Infectieuses, Orléans, France
| | - Piet Maes
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Benjamin Terrier
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP.CUP, Hopital Cochin, Paris, France
| | | | - Olivier Schwartz
- Virus and Immunity Unit, Institut Pasteur, Université Paris Cité, CNRS UMR3569, Paris, France; Vaccine Research Institute, Créteil, France.
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31
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Rumpf B, Lickefett B, Baumgartner C, Kauer V, Karolyi M, Pawelka E, Seitz T, Traugott M, Triska P, Bergthaler A, Laferl H, Wenisch C, Zoufaly A. Comparison of clinical characteristics among patients infected with alpha vs. delta SARS-CoV-2 variants. Wien Klin Wochenschr 2022; 134:850-855. [PMID: 36070027 PMCID: PMC9450815 DOI: 10.1007/s00508-022-02084-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has undergone different molecular changes, sprouting genetic variants of the original wildtype. Clinical comparisons between patients infected with alpha versus delta are scarce. METHODS In this retrospective observational study, adult patients hospitalized with coronavirus disease 2019 (COVID-19) due to confirmed SARS-CoV‑2 alpha or delta infection were included. Patient characteristics, virologic and laboratory parameters, as well as the clinical course were compared in patients infected with alpha vs. delta variants. RESULTS A total of 106 patients infected with alpha and 215 patients infected with delta were included. Patients infected with the delta variant were admitted to hospital earlier after symptom onset (6 vs. 7 days, p < 0.001). Blood levels of C‑reactive protein (43.3 vs. 62.9 mg/l, p = 0.02) and neutrophil count (3.81 vs. 4.53 G/l, p = 0.06) were lower in delta patients. Furthermore, at hospital admission cycle threshold (CT) values were significantly lower in patients infected with the delta variant (22.3 vs. 24.9, p < 0.001). Patients infected with the delta variant needed supplemental oxygen less often during disease course (50% vs. 64%, p = 0.02). Furthermore, there was a statistically non-significant trend towards a lower ICU admission rate among delta patients (16% vs. 24%, p = 0.08) CONCLUSION: Patients diagnosed with the delta variant were admitted to the hospital earlier, had a less severe course of disease and a higher viral replication on admission. This may provide a window of opportunity for antivirals in the hospital setting.
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Affiliation(s)
| | | | | | | | - Mario Karolyi
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria
| | - Erich Pawelka
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria
| | - Tamara Seitz
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria
| | - Marianna Traugott
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria
| | - Petr Triska
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Andreas Bergthaler
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Hermann Laferl
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria
| | - Christoph Wenisch
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria
| | - Alexander Zoufaly
- Department of Internal Medicine IV with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Vienna, Austria.
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria.
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32
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Yu T, Zhang X, Wang Q, Zheng F, Wang L. Communication openness and nosocomial infection reporting: the mediating role of team cohesion. BMC Health Serv Res 2022; 22:1416. [PMID: 36434720 PMCID: PMC9701000 DOI: 10.1186/s12913-022-08646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The states of IPC (Infection Prevention and Control) is serious under the COVID-19 pandemic. Nosocomial infection reporting is of great significance to transparent management of IPC in regard to the COVID-19 pandemic. We aimed to explore the relationship between communication openness and nosocomial infection reporting, explore the mediating effect of team cohesion in the two, and provide evidence-based organizational perspective for improving IPC management in the hospitals. METHOD A questionnaire was used to collect data on communication openness, team cohesion and nosocomial infection reporting in 3512 medical staff from 239 hospitals in Hubei, China. Structural Equation Model (SEM) was conducted to examine the hypothetical model. RESULT Communication openness was positively related to nosocomial infection reporting (β = 0.540, p < 0.001), and was positively related to team cohesion (β = 0.887, p < 0.001). Team cohesion was positively related to nosocomial infection reporting (β = 0.328, p < 0.001). The partial mediating effect of team cohesion was significant (β = 0.291, SE = 0.055, 95% CI = [ 0.178,0.392 ]), making up 35.02% of total effect. CONCLUSION Communication openness was not only positively related to nosocomial infection reporting. Team cohesion can be regarded as a mediator between communication openness and nosocomial infection reporting. It implies that strengthening communication openness and team cohesion is the strategy to promote IPC management from the new organizational perspective.
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Affiliation(s)
- Tiantian Yu
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei China
| | - Xinping Zhang
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei China
| | - Qianning Wang
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei China
| | - Feiyang Zheng
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei China
| | - Lu Wang
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei China
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Li JF, Zhang CJ, Li YW, Li C, Zhang SC, Wang SS, Jiang Y, Luo XB, Liao XJ, Wu SX, Lin L. Coxsackievirus A6 was the most common enterovirus serotype causing hand, foot, and mouth disease in Shiyan City, central China. World J Clin Cases 2022; 10:11358-11370. [PMID: 36387823 PMCID: PMC9649535 DOI: 10.12998/wjcc.v10.i31.11358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/04/2022] [Accepted: 09/20/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) has become one of the most common infectious diseases in China. Before 2016, the primary causal serotypes were enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16). Following the introduction of EV-A71 vaccines in China since 2016, the situation could change. CV-A6 has recently replaced EV-A71 and CV-A16 in some areas of China. However, the epidemiological characteristics of central China remain unknown.
AIM To investigate the clinical symptoms and pathogen spectrum of HFMD in Shiyan City, central China, in recent years.
METHODS The epidemiological, clinical, and laboratory data from HFMD cases reported to the Shiyan Center for Disease Control and Prevention between January 2016 and December 2020 were analyzed. 196 throat swab specimens were collected from hospitalized HFMD patients between January 2018 and December 2020. To detect and genotype enteroviruses, real-time reverse transcription-polymerase chain reaction and sequencing of the 5'-untranslated region were used. In Shiyan, 168 laboratory-confirmed HFMD cases were studied using a logistic regression model to determine the effect of predominant enterovirus serotypes. Based on the logistic regression model, the least absolute shrinkage and selection operator model was used to analyze the correlation between CV-A6 infection and various clinical characteristics in HFMD patients in Shiyan.
RESULTS From 2016 to 2020, 35840 HFMD cases were reported in Shiyan. The number of cases decreased by 48.4% from 2016 to 2017. Approximately 1.58-fold increases were found in 2018 and 2019 when compared to the previous year, respectively. In 2020, a decrease of about 85.5% was reported when compared to 2019. The most common serotypes shifted from EV-A71 and CV-A16 (about 60%-80% in 2016 and 2018) to others (more than 80.0% in 2017, 2019, and 2020). EV-A71 lost its dominance in 2017 in Shiyan. Among 196 confirmed HFMD cases, 85.7% tested positive for enterovirus, with CV-A6 being the most common serotype (121/168, 72.0%). The positive rates for CV-A16 and CV-A10 were 4.8% and 3.0%, respectively. There was no EV-A71 discovered. Infection with CV-A6 was linked to fever, myocardial damage, increased creatine kinase MB isoenzyme, and lactate dehydrogenase levels.
CONCLUSION CV-A6 was the most common enterovirus serotype in Shiyan City, replacing EV-A71 and CV-A16 as the HFMD pathogen. Developing vaccines against CV-A6 or multiple pathogens, as well as rising CV-A6 surveillance, will help prevent HFMD in central China.
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Affiliation(s)
- Jing-Feng Li
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Chuan-Jie Zhang
- Department of Children Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430061, Hubei Province, China
| | - Ya-Wei Li
- Department of Health Services, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Chao Li
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Shi-Chao Zhang
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Sha-Sha Wang
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Yong Jiang
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Xin-Bing Luo
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Xing-Juan Liao
- Department of Pediatrics, Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China
| | - Shou-Xin Wu
- Department of Pharmaceuticals, Shanghai Biotecan Pharmaceuticals Co. Ltd., Shanghai 200000, China
- Zhangjiang Center for Translational Medicine, Shanghai Zhangjiang Institute of Medical Innovation, Shanghai 442000, China
| | - Ling Lin
- Department of Pharmaceuticals, Shanghai Biotecan Pharmaceuticals Co. Ltd., Shanghai 200000, China
- Zhangjiang Center for Translational Medicine, Shanghai Zhangjiang Institute of Medical Innovation, Shanghai 442000, China
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Huang Y, Shin JE, Xu AM, Yao C, Joung S, Wu M, Zhang R, Shin B, Foley J, Mahov SB, Modes ME, Ebinger JE, Driver M, Braun JG, Jefferies CA, Parimon T, Hayes C, Sobhani K, Merchant A, Gharib SA, Jordan SC, Cheng S, Goodridge HS, Chen P. Evidence of premature lymphocyte aging in people with low anti-spike antibody levels after BNT162b2 vaccination. iScience 2022; 25:105209. [PMID: 36188190 PMCID: PMC9510055 DOI: 10.1016/j.isci.2022.105209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/22/2022] [Accepted: 09/22/2022] [Indexed: 11/26/2022] Open
Abstract
SARS-CoV-2 vaccines have unquestionably blunted the overall impact of the COVID-19 pandemic, but host factors such as age, sex, obesity, and other co-morbidities can affect vaccine efficacy. We identified individuals in a relatively healthy population of healthcare workers (CORALE study cohort) who had unexpectedly low peak anti-spike receptor binding domain (S-RBD) antibody levels after receiving the BNT162b2 vaccine. Compared to matched controls, "low responders" had fewer spike-specific antibody-producing B cells after the second and third/booster doses. Moreover, their spike-specific T cell receptor (TCR) repertoire had less depth and their CD4+ and CD8+T cell responses to spike peptide stimulation were less robust. Single cell transcriptomic evaluation of peripheral blood mononuclear cells revealed activation of aging pathways in low responder B and CD4+T cells that could underlie their attenuated anti-S-RBD antibody production. Premature lymphocyte aging may therefore contribute to a less effective humoral response and could reduce vaccination efficacy.
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Affiliation(s)
- Yapei Huang
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Juliana E. Shin
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alexander M. Xu
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Changfu Yao
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sandy Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Min Wu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ruan Zhang
- Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Bongha Shin
- Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Joslyn Foley
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Simeon B. Mahov
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Matthew E. Modes
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Joseph E. Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Matthew Driver
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jonathan G. Braun
- Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Caroline A. Jefferies
- Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Tanyalak Parimon
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Chelsea Hayes
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Akil Merchant
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sina A. Gharib
- Computational Medicine Core at Center for Lung Biology, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA 98109, USA
| | - Stanley C. Jordan
- Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Helen S. Goodridge
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Peter Chen
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Sigle A, Michaelis J, Schöb D, Benndorf M, Schimmöller L, Becker B, Pallauf M, Gross AJ, Herrmann TRW, Klein JT, Lusuardi L, Netsch C, Häcker A, Westphal J, Jilg C, Gratzke C, Miernik A. [Image-guided biopsy of the prostate gland]. UROLOGIE (HEIDELBERG, GERMANY) 2022; 61:1137-1148. [PMID: 36040512 DOI: 10.1007/s00120-022-01929-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
The recommendations on carrying out a multiparametric magnetic resonance imaging (mpMRI) for the primary diagnostics and during active surveillance of prostate cancer, include as a consequence an image-guided sampling from conspicuous areas. In doing so, the information on the localization provided by mpMRI is used for a targeted biopsy of the area suspected of being a tumor. The targeted sampling is mainly performed under sonographic control and after fusion of MRI and ultrasound but can also be (mostly in special cases) carried out directly in the MRI scanner. In an ultrasound-guided biopsy, it is vital to coregister the MR images with the ultrasound images (segmentation of the contour of the prostate and registration of suspect findings). This coregistration can either be carried out cognitively (transfer by the person performing the biopsy alone) or software based. Each method shows specific advantages and disadvantages in the prioritization between diagnostic accuracy and resource expenditure.
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Affiliation(s)
- August Sigle
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.
- Berta-Ottenstein-Programm, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland.
| | - Jakob Michaelis
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland
| | - Dominik Schöb
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland
| | - Matthias Benndorf
- Medizinische Fakultät, Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Lars Schimmöller
- Medizinische Fakultät, Institut für Diagnostische und Interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Benedikt Becker
- Abteilung für Urologie, Asklepios Klinik Barmbek, Hamburg, Deutschland
| | - Maximilian Pallauf
- Johns Hopkins University, Baltimore, USA
- Department für Urologie und Onkologie, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
- Department für Urologie, Uniklinikum Salzburg, Salzburg, Österreich
| | - Andreas J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Hamburg, Deutschland
| | - Thomas R W Herrmann
- Urologie, Spital Thurgau AG, Frauenfeld, Schweiz
- Medizinische Hochschule Hannover, Hannover, Deutschland
- Division of Urology, Department of Surgical Sciences, Stellenbosch University, Western Cape, Südafrika
| | - Jan-Thorsten Klein
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Lukas Lusuardi
- Paracelsus Medizinische Universitätsklinik für Urologie, Salzburger Landeskliniken, Salzburg, Österreich
| | | | - Axel Häcker
- Klinik für Urologie, Universitätsklinikum Mannheim, Mannheim, Deutschland
| | - Jens Westphal
- Klinik für Urologie, Kinderurologie und Urogynäkologie, Krankenhaus Maria-Hilf, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf, Krefeld, Deutschland
| | - Cordula Jilg
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland
| | - Christian Gratzke
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland
| | - Arkadiusz Miernik
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland
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36
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Beck J, Fischer J, Kubitz JC. [34/f-Acute loss of consciousness : Preparation course anesthesiological intensive care medicine: case 27]. DIE ANAESTHESIOLOGIE 2022; 71:140-144. [PMID: 35925189 DOI: 10.1007/s00101-022-01165-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Affiliation(s)
- J Beck
- Klinik für Anästhesiologie, Klinikum Nürnberg, Prof. Ernst Nathan Str. 1, 90419, Nürnberg, Deutschland
| | - J Fischer
- Klinik für Anästhesiologie, Klinikum Nürnberg, Prof. Ernst Nathan Str. 1, 90419, Nürnberg, Deutschland
| | - J C Kubitz
- Klinik für Anästhesiologie, Klinikum Nürnberg, Prof. Ernst Nathan Str. 1, 90419, Nürnberg, Deutschland.
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Beatrice SAC, Luiza BP, Bogdan P, Simona BG, Mihnea CC, Ionela CA, Elena DT, Petra TB, Simona-Andreea R, Doinița OI, Gabriel BȘV, Raluca G. Antimicrobial therapy in complicated rhinosinusitis. Front Microbiol 2022; 13:960319. [PMID: 36071977 PMCID: PMC9444058 DOI: 10.3389/fmicb.2022.960319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Complicated rhinosinusitis is a rare but life-threatening pathology that requires both medical and surgical treatment as soon as possible. The spread of the infection from the paranasal sinuses affects, most often, the orbit, patients presenting diplopia, preseptal cellulitis, orbital cellulitis, or even blindness alongside exteriorization of puss from the middle meatus and nasal obstruction. Materials and methods We carried out a retrospective review of 32 patients that were diagnosed in our clinic with complicated rhinosinusitis from 2015 to 2022. All the patients received at least one intravenous antibiotic, and some also received antifungal drugs. All patients underwent surgery, either endoscopically or combined approach. Nasal washout or nasal swabs during surgery were sent for laboratory examination in all patients, and we studied the microbial etiology in these extensive infections. A database with all the information regarding demographic and medical data was established. Results 78% of the patients were male, with a mean age of 50.55. A wide range of antibiotics were used, while some patients, diagnosed with mucormycosis also received antifungal drugs. The mean hospitalization period was 12 days. We correlated the type of antibiotic with the hospitalization period and the outcome but also the degree of involvement of the orbit and the microbial strains identified. Discussion The management of patients with complicated rhinosinusitis is complex and dynamic and it must be tailored to every patient, after an interdisciplinary meeting with the infectious disease specialist, ophthalmologist, and rhinologist. The microbial strains that produce such important infections are sometimes multi-resistant or combined, patients usually already had followed a course of antibiotics at home, and choosing the right treatment is sometimes challenging.
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Affiliation(s)
- Simion-Antonie Catrinel Beatrice
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- *Correspondence: Simion-Antonie Catrinel Beatrice,
| | - Bejenaru Paula Luiza
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Popescu Bogdan
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Berteșteanu Gloria Simona
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of ENT, Head, and Neck Surgery, “Carol Davila” Emergency Central Military Hospital, Bucharest, Romania
| | - Condeescu-Cojocărița Mihnea
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Cîrstea Anca Ionela
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
| | - Diaconu Teodora Elena
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
| | - Taher Bianca Petra
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Rujan Simona-Andreea
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Oașă Irina Doinița
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
| | - Berteșteanu Șerban Vifor Gabriel
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Grigore Raluca
- Department of ENT, Head and Neck Surgery, Colţea Clinical Hospital, Bucharest, Romania
- Department of Ophthalmology & ENT, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Blankenberger J, Kaufmann M, Albanese E, Amati R, Anker D, Camerini AL, Chocano-Bedoya P, Cullati S, Cusini A, Fehr J, Harju E, Kohler P, Kriemler S, Michel G, Rodondi N, Rodondi PY, Speierer A, Tancredi S, Puhan MA, Kahlert CR. Is living in a household with children associated with SARS-CoV-2 seropositivity in adults? Results from the Swiss national seroprevalence study Corona Immunitas. BMC Med 2022; 20:233. [PMID: 35725472 PMCID: PMC9207841 DOI: 10.1186/s12916-022-02431-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to determine whether living in a household with children is associated with SARS-CoV-2 seropositivity in adults and investigated interacting factors that may influence this association. METHODS SARS-CoV-2 serology testing was performed in randomly selected individuals from the general population between end of October 2020 and February 2021 in 11 cantons in Switzerland. Data on sociodemographic and household characteristics, employment status, and health-related history was collected using questionnaires. Multivariable logistic regression was used to examine the association of living with children <18 years of age (number, age group) and SARS-CoV-2 seropositivity. Further, we assessed the influence of reported non-household contacts, employment status, and gender. RESULTS Of 2393 working age participants (18-64 years), 413 (17.2%) were seropositive. Our results suggest that living with children and SARS-CoV-2 seropositivity are likely to be associated (unadjusted odds ratio (OR) 1.22, 95% confidence interval [0.98-1.52], adjusted OR 1.25 [0.99-1.58]). A pattern of a positive association was also found for subgroups of children aged 0-11 years (OR 1.21 [0.90-1.60]) and 12-17 years (OR 1.14 [0.78-1.64]). Odds of seropositivity were higher with more children (OR 1.14 per additional child [1.02-1.27]). Men had higher risk of SARS-CoV-2 infection when living with children than women (interaction: OR 1.74 [1.10-2.76]). CONCLUSIONS In adults from the general population living with children seems associated with SARS-CoV-2 seropositivity. However, child-related infection risk is not the same for every subgroup and depends on factors like gender. Further factors determining child-related infection risk need to be identified and causal links investigated. TRIAL REGISTRATION https://www.isrctn.com/ISRCTN18181860 .
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Affiliation(s)
- Jacob Blankenberger
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Daniela Anker
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Anne-Linda Camerini
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Patricia Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexia Cusini
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- Division of Infectious Disease & Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Erika Harju
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pierre-Yves Rodondi
- Institute of Family Medicine (IMF), University of Fribourg, Fribourg, Switzerland
| | - Alexandre Speierer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Christian R. Kahlert
- Children’s Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006 St. Gallen, Switzerland
| | - on behalf of the Corona Immunitas Research Group
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
- Division of Infectious Disease & Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Family Medicine (IMF), University of Fribourg, Fribourg, Switzerland
- Children’s Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006 St. Gallen, Switzerland
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Omuferen LO, Maseko B, Olowoyo JO. Occurrence of antibiotics in wastewater from hospital and convectional wastewater treatment plants and their impact on the effluent receiving rivers: current knowledge between 2010 and 2019. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:306. [PMID: 35353241 DOI: 10.1007/s10661-022-09846-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
The increased usage of antibiotics over the recent years has been of great concern all over the world. It is estimated that about 100,000 tons to 200,000 tons of antibiotics are being consumed worldwide. This increased consumption of antibiotics is worrisome as this has resulted in their detection in wastewater treatment plants' (WWTPs) effluent due to the inability of WWTP to remove them during treatment processes. The antibiotics may emanate from hospital effluents, surface waters, and sediments around the world. However, the migration of antibiotics to the environment is detrimental to public health since it can lead to antibiotics resistance in both humans and animals which has now been reported to be one of the biggest threats to public health in this twenty-first century. This present review work established from literature the presence, concentrations, and types of antibiotics both in influents and effluents of various waste treatment plants, natural water bodies, and hospital wastewaters from different countries over the past 10 years (2010-2019). A total of 78 published articles containing information on the presence of antibiotics in convectional and hospital wastewater and also in surface water were retrieved from scientific databases such as ScienceDirect, Google Scholar, PubMed, and Web of Science. A total of 39 different types of antibiotics from 10 different classes of antibiotics and others were recorded. Among the articles reviewed, the most frequently detected antibiotics are the classes of sulfonamides (sulfamethoxazole) which were present in almost all the WWTPs at concentrations as high as 10-800 ng/l in influent and 3600-68,700 ng/l in effluent samples. Macrolides (clarithromycin, erythromycin, azithromycin), trimethoprim, quinolones (ofloxacin, ciprofloxacin, norfloxacin), and tetracyclines (tetracycline) were also highly present in all treatment plants. β-Lactam antibiotics were seldom detected which might be due to hydrolysis. Most of the antibiotics present were recorded in Asian countries such as China and Singapore which have occurrence frequency of 6-30% and in European countries such as Greece and Spain with frequencies of about 6-10%. Future researches on the need for development of more reliable and cost-effective technologies for antibiotic removal such as advanced oxidation processes and remediation methods are suggested for more research attention.
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Affiliation(s)
- Loveth Oke Omuferen
- Department of Chemistry, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - B Maseko
- Department of Chemistry, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
| | - J O Olowoyo
- Department of Biology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Fentie AM, Degefaw Y, Asfaw G, Shewarega W, Woldearegay M, Abebe E, Gebretekle GB. Multicentre point-prevalence survey of antibiotic use and healthcare-associated infections in Ethiopian hospitals. BMJ Open 2022; 12:e054541. [PMID: 35149567 PMCID: PMC8845215 DOI: 10.1136/bmjopen-2021-054541] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/31/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Effective antimicrobial containment strategies such as Antimicrobial Stewardship Programs (ASPs) require comprehensive data on antibiotics use which are scarce in Ethiopia. This study sought to assess antibiotics use and healthcare-associated infections (HCAIs) in Ethiopian public hospitals. DESIGN We conducted a cross-sectional study using the WHO point-prevalence survey protocol for systemic antibiotics use and HCAIs for low/middle-income countries. SETTING The study was conducted among 10 public hospitals in 2021. PARTICIPANTS All patients admitted to adult and paediatric inpatient and emergency wards before or at 08:00 on the survey date were enrolled. OUTCOME MEASURE The primary outcome measures were the prevalence of antibiotic use, HCAIs and the hospitals' readiness to implement ASP. RESULTS Data were collected from 1820 patient records. None of the surveyed hospitals had functional ASP. The common indication for antibiotics was for HCAIs (40.3%). Pneumonia was the most common bacterial infection (28.6%) followed by clinical sepsis (17.8%). Most treatments were empiric (96.7%) and the overall prevalence of antibiotic use was 63.8% with antibiotics prescription per patient ratio of 1.77. Ceftriaxone was the most commonly prescribed antibiotic (30.4%) followed by metronidazole (15.4%). Age, having HIV infection, ward type, type of hospital, catheterisation and intubation history had significant association with antibiotic use. Patients who were treated in paediatric surgical wards were about four times more likely to be on antibiotics compared with patients treated at an adult emergency ward. Patients on urinary catheter (adjusted OR (AOR)=2.74, 95% CI: 2.04 to 3.68) and intubation device (AOR=2.62, 95% CI: 1.02 to 6.76) were more likely to be on antibiotics than their non-intubated/non-catheterised counterparts. Patients treated at secondary-level hospitals had 0.34 times lower odds of being on antibiotics compared with those in tertiary hospitals. CONCLUSIONS Antibiotic use across the surveyed hospitals was common and most were empiric which has both practical and policy implications for strengthening ASP and promoting rational antibiotics use.
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Affiliation(s)
- Atalay Mulu Fentie
- School of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - Yidnekachew Degefaw
- Pharmaceuticals and Medical Equipment Directorate, Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | - Getachew Asfaw
- Pharmaceuticals and Medical Equipment Directorate, Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | - Wendosen Shewarega
- Pharmaceuticals and Medical Equipment Directorate, Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | | | - Ephrem Abebe
- College of Pharmacy, Purdue University, West Lafayette, Indiana, USA
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Gebremedhin Beedemariam Gebretekle
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
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A new deep learning pipeline to detect Covid-19 on chest X-ray images using local binary pattern, dual tree complex wavelet transform and convolutional neural networks. APPL INTELL 2021; 51:2740-2763. [PMID: 34764560 PMCID: PMC7609830 DOI: 10.1007/s10489-020-02019-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2020] [Indexed: 12/17/2022]
Abstract
In this study, which aims at early diagnosis of Covid-19 disease using X-ray images, the deep-learning approach, a state-of-the-art artificial intelligence method, was used, and automatic classification of images was performed using convolutional neural networks (CNN). In the first training-test data set used in the study, there were 230 X-ray images, of which 150 were Covid-19 and 80 were non-Covid-19, while in the second training-test data set there were 476 X-ray images, of which 150 were Covid-19 and 326 were non-Covid-19. Thus, classification results have been provided for two data sets, containing predominantly Covid-19 images and predominantly non-Covid-19 images, respectively. In the study, a 23-layer CNN architecture and a 54-layer CNN architecture were developed. Within the scope of the study, the results were obtained using chest X-ray images directly in the training-test procedures and the sub-band images obtained by applying dual tree complex wavelet transform (DT-CWT) to the above-mentioned images. The same experiments were repeated using images obtained by applying local binary pattern (LBP) to the chest X-ray images. Within the scope of the study, four new result generation pipeline algorithms having been put forward additionally, it was ensured that the experimental results were combined and the success of the study was improved. In the experiments carried out in this study, the training sessions were carried out using the k-fold cross validation method. Here the k value was chosen as 23 for the first and second training-test data sets. Considering the average highest results of the experiments performed within the scope of the study, the values of sensitivity, specificity, accuracy, F-1 score, and area under the receiver operating characteristic curve (AUC) for the first training-test data set were 0,9947, 0,9800, 0,9843, 0,9881 and 0,9990 respectively; while for the second training-test data set, they were 0,9920, 0,9939, 0,9891, 0,9828 and 0,9991; respectively. Within the scope of the study, finally, all the images were combined and the training and testing processes were repeated for a total of 556 X-ray images comprising 150 Covid-19 images and 406 non-Covid-19 images, by applying 2-fold cross. In this context, the average highest values of sensitivity, specificity, accuracy, F-1 score, and AUC for this last training-test data set were found to be 0,9760, 1,0000, 0,9906, 0,9823 and 0,9997; respectively.
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Loganathan J, Doumouchtsis SK. Impact of COVID-19 on management of urogynaecology patients: a rapid review of the literature. Int Urogynecol J 2021; 32:2631-2646. [PMID: 33533991 PMCID: PMC7856854 DOI: 10.1007/s00192-021-04704-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The coronavirus (COVID-19) pandemic has impacted health systems worldwide. There is a continuing need for clinicians to adapt practice to facilitate timely provision of medical care, whilst minimising horizontal transmission. Guidance and recommendations are increasingly available, and this rapid review aimed to provide a timely evidence synthesis on the current recommendations surrounding urogynaecological care. METHODS We performed a literature review using PubMed/Medline, Embase and Cochrane and a manual search of national and international societies for management recommendations for urogynaecological patients during the COVID-19 pandemic. RESULTS Nine guidance documents and 17 articles, including 10 reviews, were included. Virtual clinics are recommended for new and follow-up patients, to assess and initiate treatment, as well as triage patients who require face-to-face appointments. Outpatient investigations such as urodynamics and cystoscopy for benign indications can be deferred. Prolapse and continence surgery should be suspended, except in specific circumstances such as procidentia with upper tract complications and failed pessaries. There is no evidence to support a particular route of surgery, but recommendations are made to minimise COVID-19 transmission. CONCLUSIONS Urogynaecological patients face particular challenges owing to inherent vulnerabilities of these populations. Behavioural and medical therapies should be recommended as first line options and initiated via virtual or remote clinics, which are integral to management during the COVID-19 pandemic. Expanding the availability and accessibility of technology will be increasingly required. The majority of outpatient and inpatient procedures can be deferred, but the longer-term effects of such practices are unclear.
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Affiliation(s)
| | - Stergios K Doumouchtsis
- Epsom and St Helier University Hospitals NHS Trust, Dorking Road, Epsom, KT18 7EG, UK.
- St George's University of London, London, UK.
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, Athens, Greece.
- American University of the Caribbean, School of Medicine, Pembroke Pines, FL, USA.
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Dainton C, Hay A. Quantifying the relationship between lockdowns, mobility, and effective reproduction number (Rt) during the COVID-19 pandemic in the Greater Toronto Area. BMC Public Health 2021; 21:1658. [PMID: 34507570 PMCID: PMC8433050 DOI: 10.1186/s12889-021-11684-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The effectiveness of lockdowns in mitigating the spread of COVID-19 has been the subject of intense debate. Data on the relationship between public health restrictions, mobility, and pandemic growth has so far been conflicting. OBJECTIVE We assessed the relationship between public health restriction tiers, mobility, and COVID-19 spread in five contiguous public health units (PHUs) in the Greater Toronto Area (GTA) in Ontario, Canada. METHODS Weekly effective reproduction number (Rt) was calculated based on daily cases in each of the five GTA public health units between March 1, 2020, and March 19, 2021. A global mobility index (GMI) for each PHU was calculated using Google Mobility data. Segmented regressions were used to assess changes in the behaviour of Rt over time. We calculated Pearson correlation coefficients between GMI and Rt for each PHU and mobility regression coefficients for each mobility variable, accounting for time lag of 0, 7, and 14 days. RESULTS In all PHUs except Toronto, the most rapid decline in Rt occurred in the first 2 weeks of the first province-wide lockdown, and this was followed by a slight trend to increased Rt as restrictions decreased. This trend reversed in all PHUs between September 6th and October 10th after which Rt decreased slightly over time without respect to public health restriction tier. GMI began to increase in the first wave even before restrictions were decreased. This secular trend to increased mobility continued into the summer, driven by increased mobility to recreational spaces. The decline in GMI as restrictions were reintroduced coincides with decreasing mobility to parks after September. During the first wave, the correlation coefficients between global mobility and Rt were significant (p < 0.01) in all PHUs 14 days after lockdown, indicating moderate to high correlation between decreased mobility and decreased viral reproduction rates, and reflecting that the incubation period brings in a time-lag effect of human mobility on Rt. In the second wave, this relationship was attenuated, and was only significant in Toronto and Durham at 14 days after lockdown. CONCLUSIONS The association between mobility and COVID-19 spread was stronger in the first wave than the second wave. Public health restriction tiers did not alter the existing secular trend toward decreasing Rt over time.
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Affiliation(s)
- Christopher Dainton
- McMaster University, 1280 Main Street W, Hamilton, Ontario L8S 4L8 Canada
- Grand River Hospital, 835 King St. West, Kitchener, Ontario N2G 1G3 Canada
| | - Alexander Hay
- National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892 USA
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Mzumara GW, Mambiya M, Iroh Tam PY. Antimicrobial stewardship interventions in least developed and low-income countries: a systematic review protocol. BMJ Open 2021; 11:e047312. [PMID: 34385248 PMCID: PMC8362704 DOI: 10.1136/bmjopen-2020-047312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Antimicrobial resistance (AMR) is increasing in low resource settings. It complicates the management of infectious diseases and is an increasing cause of death. This is due to, among other things, lack of health resources for appropriate diagnosis and unregulated access to antimicrobials in the public sphere. Developing context-specific interventions that enable judicious use of antimicrobials is important to curb this problem. METHODS We will conduct a systematic review of antimicrobial stewardship (AMS) approaches in Development Assistance Committee in least developed and low-income countries. The inclusion criteria are antimicrobial stewardship interventions in hospitalised patients of all age groups and exclusion criteria are community-based trials and studies that solely focus on viral, fungal or parasite infections. Antimicrobial stewardship interventions will be classified as structural, enabling, persuasive, restrictive or combined. Outcomes of included studies will be classified as clinical, microbiological or behavioural outcomes. The studies to be included will be randomised controlled trials, controlled before-after studies, interrupted time series trials, cohort and qualitative studies. Data will be extracted using forms adapted from the Cochrane collaboration data collection form. This systematic review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and risk of bias will be done according to the Integrated quality Criteria for Review of Multiple Study Designs. ETHICS AND DISSEMINATION Our findings will be presented to clinicians and policymakers, to support developing AMS protocols for low resource settings. We will publish our results in peer-reviewed journals. TRIAL REGISTRATION NUMBER CRD42020210634.
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Affiliation(s)
- Grace Wezi Mzumara
- Child Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, Blantyre 3 Malawi, Malawi
- Peadiatrics and Child Health, University of Malawi College of Medicine, Chichiri, Blantyre 3 Malawi, Malawi
| | - Michael Mambiya
- Child Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, Blantyre 3 Malawi, Malawi
| | - Pui-Ying Iroh Tam
- Child Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, Blantyre 3 Malawi, Malawi
- Peadiatrics and Child Health, University of Malawi College of Medicine, Chichiri, Blantyre 3 Malawi, Malawi
- Liverpool School of Tropical Medicine, Liverpool, UK
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van Bunnik BAD, Morgan ALK, Bessell PR, Calder-Gerver G, Zhang F, Haynes S, Ashworth J, Zhao S, Cave RNR, Perry MR, Lepper HC, Lu L, Kellam P, Sheikh A, Medley GF, Woolhouse MEJ. Segmentation and shielding of the most vulnerable members of the population as elements of an exit strategy from COVID-19 lockdown. Philos Trans R Soc Lond B Biol Sci 2021. [PMID: 34053266 DOI: 10.1101/2020.05.04.20090597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
This study demonstrates that an adoption of a segmenting and shielding strategy could increase the scope to partially exit COVID-19 lockdown while limiting the risk of an overwhelming second wave of infection. We illustrate this using a mathematical model that segments the vulnerable population and their closest contacts, the 'shielders'. Effects of extending the duration of lockdown and faster or slower transition to post-lockdown conditions and, most importantly, the trade-off between increased protection of the vulnerable segment and fewer restrictions on the general population are explored. Our study shows that the most important determinants of outcome are: (i) post-lockdown transmission rates within the general and between the general and vulnerable segments; (ii) fractions of the population in the vulnerable and shielder segments; (iii) adherence to protective measures; and (iv) build-up of population immunity. Additionally, we found that effective measures in the shielder segment, e.g. intensive routine screening, allow further relaxations in the general population. We find that the outcome of any future policy is strongly influenced by the contact matrix between segments and the relationships between physical distancing measures and transmission rates. This strategy has potential applications for any infectious disease for which there are defined proportions of the population who cannot be treated or who are at risk of severe outcomes. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.
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Affiliation(s)
- Bram A D van Bunnik
- Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - Alex L K Morgan
- School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - Paul R Bessell
- The Roslin Institute, University of Edinburgh, Edinburgh, UK
| | | | - Feifei Zhang
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Samuel Haynes
- School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Meghan R Perry
- Clinical Infection Research Group, Regional Infectious Diseases Unit, Western General Hospital, UK
| | | | - Lu Lu
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Paul Kellam
- Department of Medicine, Division of Infectious Diseases, Imperial College London, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark E J Woolhouse
- Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Biological Sciences, University of Edinburgh, Edinburgh, UK
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Woodley CM, Nixon GL, Basilico N, Parapini S, Hong WD, Ward SA, Biagini GA, Leung SC, Taramelli D, Onuma K, Hasebe T, O'Neill PM. Enantioselective Synthesis and Profiling of Potent, Nonlinear Analogues of Antimalarial Tetraoxanes E209 and N205. ACS Med Chem Lett 2021; 12:1077-1085. [PMID: 34267877 PMCID: PMC8274084 DOI: 10.1021/acsmedchemlett.1c00031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/17/2021] [Indexed: 01/09/2023] Open
Abstract
Synthetic endoperoxide antimalarials, such as 1,2,4-trioxolanes and 1,2,4,5-tetraoxanes, are promising successors for current front-line antimalarials, semisynthetic artemisinin derivatives. However, limited solubility of second-generation analogues in biological-relevant media represents a barrier in clinical development. We present methodology for the synthesis of nonlinear analogues of second-generation tetraoxane antimalarials E209 and N205 to investigate reduced molecular symmetry on in vitro antimalarial activity and physicochemical properties. While maintaining good antimalarial activity and metabolic stability, head-to-head comparison of linear and nonlinear counterparts showed up to 10-fold improvement in FaSSIF solubility for three of the four analogues studied. Pharmacokinetic studies in rats comparing a selected nonlinear analogue 14a and its parent N205 showed improvement on oral absorption and exposure in vivo with more than double the AUC and a significant increase in oral bioavailability (76% versus 41%). These findings provide support for further in vivo efficacy studies in preclinical animal species.
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Affiliation(s)
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Nicoletta Basilico
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.,Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Milano, 20133 Milano, Italy
| | - Silvia Parapini
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.,Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Milano, 20133 Milano, Italy
| | - Weiqian David Hong
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Stephen A Ward
- Centre for Drugs and Diagnostics. Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Giancarlo A Biagini
- Centre for Drugs and Diagnostics. Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Suet C Leung
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Donatella Taramelli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.,Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Milano, 20133 Milano, Italy
| | - Keiko Onuma
- Eisai Co.,Ltd. Tsukuba Research Laboratories, 5-1-3 Tokodai, Tsukubashi, Ibaraki 300-2635, Japan
| | - Takashi Hasebe
- Eisai Co.,Ltd. Tsukuba Research Laboratories, 5-1-3 Tokodai, Tsukubashi, Ibaraki 300-2635, Japan
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
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Martins Ronchi DC, Scaranello Malaquias MA, Rebutini PZ, Panini do Carmo LA, Neto PC, Marini ES, Prokopenko A, Nagashima S, Zanluca C, Duarte Dos Santos CN, de Noronha L. Placental Morphologic Similarities Between ZIKV-Positive and HIV-Positive Pregnant Women. Front Immunol 2021; 12:684194. [PMID: 34177930 PMCID: PMC8219962 DOI: 10.3389/fimmu.2021.684194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022] Open
Abstract
Zika virus (ZIKV) caused global concern due to Brazil's unexpected epidemic, and it was associated with congenital microcephaly and other gestational intercurrences. The study aimed to analyze the placenta morphometric changes of ZIKV-infected pregnant women (ZIKV group; n = 23) compared to placentas of HIV-infected (HIV group; n = 24) and healthy pregnant women (N-control group; n = 22). It also analyzed the relationship between the morphometric results and pathological alterations on conventional microscopy, gestational trimester of infection, and presence of the congenital Zika syndrome (CZS). There was a significant increase in area (p = 0.0172), as well as a higher number of knots (p = 0.0027), sprouts (p < 0.0001), and CD163 +Hofbauer cells (HCs) (p < 0.0001) in the ZIKV group compared to the N-control group, suggesting that villous dysmaturity and HCs hyperplasia could be associated with ZIKV infections. The HIV group had a higher area (p < 0.0001), perimeter (p = 0.0001), sprouts (p < 0.0001), and CD163 + HCs (p < 0.0001) compared to the N-control group, demonstrating that the morphometric abnormalities found in the ZIKV and HIV group are probably similar. However, when ZIKV and HIV groups are compared, it was observed a higher number of sprouts (p = 0.0066) and CD163+ HCs (p < 0.0001) in the first one, suggesting that placental ZIKV congenital changes could be more pronounced.
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Affiliation(s)
- Daiane Cristine Martins Ronchi
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Mineia Alessandra Scaranello Malaquias
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Patrícia Zadorosnei Rebutini
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Letícia Arianne Panini do Carmo
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Plínio Cézar Neto
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Emily Scaranello Marini
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Amanda Prokopenko
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Seigo Nagashima
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Camila Zanluca
- Molecular Virology Laboratory, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil
| | | | - Lúcia de Noronha
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Liu J, Chen Y, Hu P, Gan L, Tan Q, Huang X, Ma Z, Lin C, Wu D, Zhu X, Zhang D. Caregivers: the potential infection resources for the sustaining epidemic of hand, foot, and mouth disease/herpangina in Guangdong, China? Arch Public Health 2021; 79:54. [PMID: 33892784 PMCID: PMC8063478 DOI: 10.1186/s13690-021-00574-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/03/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although several measures have been taken to control hand foot and mouth disease (HFMD) and herpangina (HA), these two diseases have been prevalent in China for 10 years with high incidence. We suspected that adults' inapparent infection might be the cause of the continued prevalence of HFMD/HA infection in mainland China. METHODS To explore the role of adults (especially caregivers) in the transmission process of HFMD/HA among children, 330 HFMD/HA cases and 330 healthy children (controls) were selected for a case-control study. Then, data were analyzed by logistic regression. RESULTS Single-variable analyses revealed that caregivers who tested positive for enterovirus was a significant risk factor of HFMD/HA transmission to children (adjusted odds ratio (OR) = 9.22; 95% CI, 1.16 to 73.23). In the final multivariable model, caregiver behavior, such as cooling children's food with mouth (OR = 1.85; 95% CI, 1.11 to 3.08) and feeding children with their own tableware (OR = 2.19; 95% CI, 1.07 to 4.45), significantly increased the risk of transmitting HFMD/HA to children. On the contrary, washing hands before feeding children reduced such risk. CONCLUSIONS These results implied that the caregivers might be the infectious source or carriers of enterovirus. Therefore, preventing or treating the caregivers' enterovirus infection and improving their hygiene habits, especially when they are in contact with children, could provide a breakthrough for the effective control of HFMD/HA.
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Affiliation(s)
- Jundi Liu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Zhongshan Center for Diseases Prevention and Control, Zhongshan, China
| | - Yan Chen
- Medical College of Shaoguan University, Shaoguan, China
| | - Peipei Hu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lin Gan
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qimin Tan
- Yonghe Community Health Service Center, Yongning Street, Zengcheng District, Guangzhou, China
| | - Xinqiao Huang
- Yonghe Community Health Service Center, Yongning Street, Zengcheng District, Guangzhou, China
| | - Zhanzhong Ma
- Clinical Laboratory, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, China
| | - Cuiji Lin
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Dawei Wu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xun Zhu
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Dingmei Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Aubry F, Dabo S, Manet C, Filipović I, Rose NH, Miot EF, Martynow D, Baidaliuk A, Merkling SH, Dickson LB, Crist AB, Anyango VO, Romero-Vivas CM, Vega-Rúa A, Dusfour I, Jiolle D, Paupy C, Mayanja MN, Lutwama JJ, Kohl A, Duong V, Ponlawat A, Sylla M, Akorli J, Otoo S, Lutomiah J, Sang R, Mutebi JP, Cao-Lormeau VM, Jarman RG, Diagne CT, Faye O, Faye O, Sall AA, McBride CS, Montagutelli X, Rašić G, Lambrechts L. Enhanced Zika virus susceptibility of globally invasive Aedes aegypti populations. Science 2021; 370:991-996. [PMID: 33214283 DOI: 10.1126/science.abd3663] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
The drivers and patterns of zoonotic virus emergence in the human population are poorly understood. The mosquito Aedes aegypti is a major arbovirus vector native to Africa that invaded most of the world's tropical belt over the past four centuries, after the evolution of a "domestic" form that specialized in biting humans and breeding in water storage containers. Here, we show that human specialization and subsequent spread of A. aegypti out of Africa were accompanied by an increase in its intrinsic ability to acquire and transmit the emerging human pathogen Zika virus. Thus, the recent evolution and global expansion of A. aegypti promoted arbovirus emergence not solely through increased vector-host contact but also as a result of enhanced vector susceptibility.
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Affiliation(s)
- Fabien Aubry
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Stéphanie Dabo
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Caroline Manet
- Mouse Genetics Laboratory, Institut Pasteur, Paris, France
| | - Igor Filipović
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Noah H Rose
- Department of Ecology & Evolutionary Biology, Princeton University, Princeton, NJ, USA.,Princeton Neuroscience Institute, Princeton University, Princeton, NJ, USA
| | - Elliott F Miot
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France.,Collège Doctoral, Sorbonne Université, Paris, France
| | - Daria Martynow
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Artem Baidaliuk
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France.,Collège Doctoral, Sorbonne Université, Paris, France
| | - Sarah H Merkling
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Laura B Dickson
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Anna B Crist
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Victor O Anyango
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Claudia M Romero-Vivas
- Laboratorio de Enfermedades Tropicales, Departamento de Medicina, Fundación Universidad del Norte, Barranquilla, Colombia
| | - Anubis Vega-Rúa
- Institut Pasteur of Guadeloupe, Laboratory of Vector Control Research, Transmission Reservoir and Pathogens Diversity Unit, Morne Jolivière, Guadeloupe, France
| | - Isabelle Dusfour
- Vector Control and Adaptation, Institut Pasteur de la Guyane, Vectopole Amazonien Emile Abonnenc, Cayenne, French Guiana, France
| | - Davy Jiolle
- MIVEGEC, Montpellier University, IRD, CNRS, Montpellier, France.,Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | - Christophe Paupy
- MIVEGEC, Montpellier University, IRD, CNRS, Montpellier, France.,Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | - Martin N Mayanja
- Department of Arbovirology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Julius J Lutwama
- Department of Arbovirology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Veasna Duong
- Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Alongkot Ponlawat
- Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Massamba Sylla
- Unité d'Entomologie, de Bactériologie, de Virologie, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop, Dakar, Senegal
| | - Jewelna Akorli
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Sampson Otoo
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joel Lutomiah
- Arbovirus/Viral Hemorrhagic Fevers Laboratory, Center for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rosemary Sang
- Arbovirus/Viral Hemorrhagic Fevers Laboratory, Center for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - John-Paul Mutebi
- Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | | | - Richard G Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Cheikh T Diagne
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, Dakar, Senegal
| | - Oumar Faye
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, Dakar, Senegal
| | - Ousmane Faye
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, Dakar, Senegal
| | - Amadou A Sall
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, Dakar, Senegal
| | - Carolyn S McBride
- Department of Ecology & Evolutionary Biology, Princeton University, Princeton, NJ, USA.,Princeton Neuroscience Institute, Princeton University, Princeton, NJ, USA
| | | | - Gordana Rašić
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Louis Lambrechts
- Insect-Virus Interactions Unit, Institut Pasteur, UMR2000, CNRS, Paris, France.
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Majumder MAA, Rahman S, Cohall D, Bharatha A, Singh K, Haque M, Gittens-St Hilaire M. Antimicrobial Stewardship: Fighting Antimicrobial Resistance and Protecting Global Public Health. Infect Drug Resist 2020; 13:4713-4738. [PMID: 33402841 PMCID: PMC7778387 DOI: 10.2147/idr.s290835] [Citation(s) in RCA: 272] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Antimicrobial resistance (AMR) is a serious threat to global public health. It increases morbidity and mortality, and is associated with high economic costs due to its health care burden. Infections with multidrug-resistant (MDR) bacteria also have substantial implications on clinical and economic outcomes. Moreover, increased indiscriminate use of antibiotics during the COVID-19 pandemic will heighten bacterial resistance and ultimately lead to more deaths. This review highlights AMR's scale and consequences, the importance, and implications of an antimicrobial stewardship program (ASP) to fight resistance and protect global health. Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. ASP has been very successful in promoting antimicrobials' appropriate use by implementing evidence-based interventions. The "One Health" approach, a holistic and multisectoral approach, is also needed to address AMR's rising threat. AMS practices, principles, and interventions are critical steps towards containing and mitigating AMR. Evidence-based policies must guide the "One Health" approach, vaccination protocols, health professionals' education, and the public's awareness about AMR.
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Affiliation(s)
- Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Sayeeda Rahman
- School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
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