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23 pages, 3729 KiB

Open AccessArticle

System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality

by Rodney P. Jones and Andriy Ponomarenko

Infect. Dis. Rep. 2022, 14(3), 287-309; https://doi.org/10.3390/idr14030035 - 21 Apr 2022

Cited by 5 | Viewed by 3164

Abstract

Unexpected outcomes are usually associated with interventions in complex systems. Excess winter mortality (EWM) is a measure of the net effect of all competing forces operating each winter, including influenza(s) and non-influenza pathogens. In this study over 2400 data points from 97 countries [...] Read more.

Unexpected outcomes are usually associated with interventions in complex systems. Excess winter mortality (EWM) is a measure of the net effect of all competing forces operating each winter, including influenza(s) and non-influenza pathogens. In this study over 2400 data points from 97 countries are used to look at the net effect of influenza vaccination rates in the elderly aged 65+ against excess winter mortality (EWM) each year from the winter of 1980/81 through to 2019/20. The observed international net effect of influenza vaccination ranges from a 7.8% reduction in EWM estimated at 100% elderly vaccination for the winter of 1989/90 down to a 9.3% increase in EWM for the winter of 2018/19. The average was only a 0.3% reduction in EWM for a 100% vaccinated elderly population. Such outcomes do not contradict the known protective effect of influenza vaccination against influenza mortality per se—they merely indicate that multiple complex interactions lie behind the observed net effect against all-causes (including all pathogen causes) of winter mortality. This range from net benefit to net disbenefit is proposed to arise from system complexity which includes environmental conditions (weather, solar cycles), the antigenic distance between constantly emerging circulating influenza clades and the influenza vaccine makeup, vaccination timing, pathogen interference, and human immune diversity (including individual history of host-virus, host-antigen interactions and immunosenescence) all interacting to give the observed outcomes each year. We propose that a narrow focus on influenza vaccine effectiveness misses the far wider complexity of winter mortality. Influenza vaccines may need to be formulated in different ways, and perhaps administered over a shorter timeframe to avoid the unanticipated adverse net outcomes seen in around 40% of years. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 502 KiB

Open AccessArticle

Evaluating the Use of Dalbavancin for Off-Label Indications

by Katherine Taylor, John Williamson, Vera Luther, Tyler Stone, James Johnson, Zachary Gruss, Courtney Russ-Friedman, Chris Ohl and James Beardsley

Infect. Dis. Rep. 2022, 14(2), 266-272; https://doi.org/10.3390/idr14020032 - 11 Apr 2022

Cited by 13 | Viewed by 3518

Abstract

(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this [...] Read more.

(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this study was to evaluate the real-world efficacy, safety, and financial impact of off-label dalbavancin use. (2) Methods: This is a retrospective, observational study conducted within a 4-hospital health system. Adult patients who received dalbavancin from January 2018 to January 2021 for an off-label indication were included. The primary outcome was clinical success at 90 days. Secondary outcomes included safety (nephrotoxicity and hepatotoxicity). A pharmacoeconomic analysis was performed by comparing the cost of dalbavancin to the anticipated cost of patient stay if standard IV therapy was given. (3) Results: Forty-eight patients met study criteria. Indications included osteomyelitis (54%), endocarditis (23%), bacteremia (15%), and prosthetic joint infection (8%). The predominant organism was S. aureus (60%), with 42% caused by methicillin-resistant S. aureus. Overall, 41 (85%) patients achieved clinical success at 90 days, including 85% with osteomyelitis, 82% with endocarditis, and 86% with bacteremia. There were no instances of nephrotoxicity or hepatotoxicity. Estimated cost avoidance per patient was USD 5313 and USD 1683 if traditional IV therapy would have been completed in the hospital and skilled nursing facility, respectively. (4) Conclusion: Dalbavancin was associated with a relatively high success rate for the treatment of off-label indications and may be a cost-effective alternative to traditional IV antibiotic therapy. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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8 pages, 1785 KiB

Open AccessArticle

Aluminium Gauze Reduces SARS-CoV-2 Viral Load in Non-Woven Masks Worn by Patients with COVID-19

by Yuto Yasuda, Satoru Mutsuo, Motoaki Hamada, Kazuo Murai, Yutaka Hirayama, Kiyoshi Uemasu, Soichi Arasawa, Daisuke Iwashima and Ken-ichi Takahashi

Infect. Dis. Rep. 2022, 14(2), 250-257; https://doi.org/10.3390/idr14020030 - 6 Apr 2022

Cited by 2 | Viewed by 2690

Abstract

Background: Aluminium reduces severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) survival in experimental settings. It is unknown whether adding an aluminium gauze to a mask reduces the SARS-CoV-2 RNA load in the mask and whether SARS-CoV-2 is detectable in the breath that permeates [...] Read more.

Background: Aluminium reduces severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) survival in experimental settings. It is unknown whether adding an aluminium gauze to a mask reduces the SARS-CoV-2 RNA load in the mask and whether SARS-CoV-2 is detectable in the breath that permeates through such a mask in clinical settings. Methods: Patients admitted to Kishiwada City Hospital, Osaka, Japan, between July 2021 and September 2021 were enrolled in the study. Non-woven masks comprising filters with 99% viral filtration efficacy and aluminium and cotton gauzes attached to plastic collection cases were developed. All participants wore the experimental mask models for three hours. Results: Twenty-nine patients who wore the final model masks were analysed in this study. The Ct values of the nucleocapsid gene and envelope gene of SARS-CoV-2 were significantly higher in the aluminium gauze than in the cotton gauze. SARS-CoV-2 RNA was detected in the masks of 8 out of 12 vaccinated patients (66.7%). Although breath condensates were collected behind both aluminium and cotton gauzes, SARS-CoV-2 RNA was not detected in these condensates. Conclusions: Our study indicated that non-woven masks with an aluminium gauze may obstruct SARS-CoV-2 transmission in clinical settings better than non-woven masks with cotton gauzes. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 587 KiB

Open AccessArticle

Acute Stroke Care during COVID-19: National Data

by Grzegorz Miękisiak, Samuel D. Pettersson, Dariusz Szarek, Piotr Morasiewicz, Justyna Fercho, Stanisław Adamski, Lech Kipiński and Tomasz Szmuda

Infect. Dis. Rep. 2022, 14(2), 198-204; https://doi.org/10.3390/idr14020024 - 16 Mar 2022

Cited by 5 | Viewed by 2997

Abstract

(1) Background: The pandemic of COVID-19 and subsequent lockdown strategies had a profound impact on many aspects of everyday life. During this time the world faced the unprecedented crisis of healthcare disrupting timely care delivery. This study was designed to evaluate the impact [...] Read more.

(1) Background: The pandemic of COVID-19 and subsequent lockdown strategies had a profound impact on many aspects of everyday life. During this time the world faced the unprecedented crisis of healthcare disrupting timely care delivery. This study was designed to evaluate the impact of the pandemic on the acute treatment of stroke in Poland. (2) Methods: The national data on hospitalizations with stroke as a primary diagnosis were obtained from the National Health Fund of Poland. Poisson regression was used to determine the significance of the change in hospital admissions. The differences between proportions were analyzed using the “N-1” Chi-squared test. (3) Results: During the COVID-19 period, the number of hospitalizations dropped by 8.28% with a monthly nadir of 22.02 in April. On a monthly scale during 2020, the greatest decrease was 22.02%. The thrombolysis ratio was also affected, with the highest monthly drop of 15.51% in November. The overall number of in-hospital deaths did not change. (4) Conclusions: The pandemic caused a serious disruption of the acute care of stroke. There is no evidence that the quality of care was seriously compromised. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 302 KiB

Open AccessCommunication

Bacterial Species and Antimicrobial Resistance of Clinical Isolates from Pediatric Patients in Yangon, Myanmar, 2020

by Thida San, Meiji Soe Aung, Nilar San, Myat Myint Zu Aung, Win Lei Yi Mon, Thin Ei Thazin and Nobumichi Kobayashi

Infect. Dis. Rep. 2022, 14(1), 26-32; https://doi.org/10.3390/idr14010004 - 6 Jan 2022

Cited by 6 | Viewed by 3830

Abstract

Antimicrobial resistance (AMR) is a concern in medical care for children who have high burden of infectious diseases. We investigated the prevalence of bacterial species and their susceptibility to antimicrobials of 1019 clinical isolates from pediatric patients in a tertiary-care hospital in Yangon, [...] Read more.

Antimicrobial resistance (AMR) is a concern in medical care for children who have high burden of infectious diseases. We investigated the prevalence of bacterial species and their susceptibility to antimicrobials of 1019 clinical isolates from pediatric patients in a tertiary-care hospital in Yangon, Myanmar for one-year period (2020). The most frequently recovered species was Escherichia coli, followed by Klebsiella pneumoniae and Staphylococcus aureus, all of which accounted for 43% of clinical isolates, while 25% of isolates comprised non-fermenter, including Pseudomonas sp. and Acinetobacter sp. Phenotypically determined ESBL (extended-spectrum beta-lactamase)-positive rates in E. coli, K. pneumoniae, and Enterobacter sp. were 82%, 88%, and 65%, respectively. High rates of multiple drug resistance were noted for E. coli (84%), K. pneumoniae (81%), and Acinetobacter sp. (65%), associated with carbapenem resistance in 48%, 42%, and 59% of isolates, respectively. In contrast, S. aureus isolates exhibited low resistance rates (<30%) to most of antimicrobials, with 22% being resistant to oxacillin/cefoxitin. Fluoroquinolone resistance was found in most of bacterial species with different prevalence rates. The present study revealed the current status on prevalence of bacterial species causing infections in pediatric patients in Myanmar, highlighting the significance to monitor AMR among children. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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6 pages, 400 KiB

Open AccessArticle

Pre-Existing Lymphopenia Increases the Risk of Hospitalization and Death after SARS-CoV-2 Infection

by Riccardo Garbo, Francesca Valent, Gian Luigi Gigli and Mariarosaria Valente

Infect. Dis. Rep. 2022, 14(1), 20-25; https://doi.org/10.3390/idr14010003 - 4 Jan 2022

Cited by 6 | Viewed by 2672

Abstract

There is limited information regarding the severity of COVID-19 in immunocompromized patients. We conducted a retrospective cohort study considering the period from 1 March 2020 to 31 December 2020 to determine whether previously existing lymphopenia increases the risk of hospitalization and death after [...] Read more.

There is limited information regarding the severity of COVID-19 in immunocompromized patients. We conducted a retrospective cohort study considering the period from 1 March 2020 to 31 December 2020 to determine whether previously existing lymphopenia increases the risk of hospitalization and death after SARS-CoV-2 infection in the general population. The laboratory and hospital discharge databases of the Azienda Sanitaria Universitaria Friuli Centrale were used, and 5415 subjects infected with SARS-CoV-2 and with at least one recent absolute lymphocyte count determination before SARS-CoV-2 positivity were included. In total, 817 (15.1%) patients had severe COVID-19. Patients developing severe COVID-19 were more frequently males (44.9% of the severe COVID-19 group vs. 41.5% in the non-severe COVID-19 group; p < 0.0001) and were older (73.2 ± 13.8 vs. 58.4 ± 20.3 years; p < 0.0001). Furthermore, 29.9% of the lymphopenic patients developed severe COVID-19 vs. 14.5% of the non-lymphopenic patients (p < 0.0001). In a logistic regression model, female sex remained a protective factor (OR = 0.514, 95%CI 0.438–0.602, p < 0.0001), while age and lymphopenia remained risk factors for severe COVID-19 (OR = 1.047, 95%CI 1.042–1.053, p < 0.0001 for each additional year of age; OR = 1.715, 95%CI 1.239–2.347, p = 0.0011 for lymphopenia). This provides further information to stratify the risk of COVID-19 severity, which may be an important element in the management of immunosuppressive therapies. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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17 pages, 3394 KiB

Open AccessArticle

A Sensitive, Portable Microfluidic Device for SARS-CoV-2 Detection from Self-Collected Saliva

by Jianing Yang, Mark Kidd, Alan R. Nordquist, Stanley D. Smith, Cedric Hurth, Irvin M. Modlin and Frederic Zenhausern

Infect. Dis. Rep. 2021, 13(4), 1061-1077; https://doi.org/10.3390/idr13040097 - 14 Dec 2021

Cited by 12 | Viewed by 3742

Abstract

Since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December 2019, the spread of SARS-CoV2 infection has been escalating rapidly around the world. In order to provide more timely access to medical intervention, including diagnostic tests and medical [...] Read more.

Since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December 2019, the spread of SARS-CoV2 infection has been escalating rapidly around the world. In order to provide more timely access to medical intervention, including diagnostic tests and medical treatment, the FDA authorized multiple test protocols for diagnostic tests from nasopharyngeal swab, saliva, urine, bronchoalveolar lavage and fecal samples. The traditional diagnostic tests for this novel coronavirus 2019 require standard processes of viral RNA isolation, reverse transcription of RNA to cDNA, then real-time quantitative PCR with the RNA templates extracted from the patient samples. Recently, many reports have demonstrated a direct detection of SARS-Co-V2 genomic material from saliva samples without any RNA isolation step. To make the rapid detection of SARS-Co-V2 infection more accessible, a point-of-care type device was developed for SARS-CoV-2 detection. Herein, we report a portable microfluidic-based integrated detection-analysis system for SARS-CoV-2 nucleic acids detection directly from saliva samples. The saliva cartridge is self-contained and capable of microfluidic evaluation of saliva, from heating, mixing with the primers to multiplex real-time quantitative polymerase chain reaction, detecting SARS-CoV-2 with different primer sets and internal control. The approach has a detection sensitivity of 1000 copies/mL of SARS-CoV-2 RNA or virus, with consistency and automation, from saliva sample-in to result-out. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 547 KiB

Open AccessArticle

Hepatitis B Vaccination in Advanced Chronic Kidney Disease: A Quality Improvement Project at a Veteran Affairs Chronic Kidney Disease Clinic

by Jacob Hettenbaugh, Ryan Mullane, Gayle Gillispie, Valerie Shostrom, Linda Flores, Jennifer A. Fillaus, Marius C. Florescu, Denise Murcek and Ketki K. Tendulkar

Infect. Dis. Rep. 2021, 13(4), 1036-1042; https://doi.org/10.3390/idr13040094 - 6 Dec 2021

Cited by 6 | Viewed by 3351

Abstract

Hepatitis B vaccination is recommended in all patients with end-stage kidney disease (ESKD). However, only 50–60% of these patients achieve protective antibody levels if immunized after starting dialysis. Strategies to overcome this low seroconversion rate include a 6-month vaccination schedule starting earlier [chronic [...] Read more.

Hepatitis B vaccination is recommended in all patients with end-stage kidney disease (ESKD). However, only 50–60% of these patients achieve protective antibody levels if immunized after starting dialysis. Strategies to overcome this low seroconversion rate include a 6-month vaccination schedule starting earlier [chronic kidney disease (CKD) stage 4 and 5] to ensure immunity when patients progress to ESKD. We conducted a quality improvement program to immunize pre-dialysis patients. Patients who were found to have a negative baseline serology with a negative hepatitis B surface antibody level (HBsAb) were offered vaccination on a 6-month schedule (0, 1 and 6 months) with one of two available vaccines within the VA system (Recombivax™ or Engerix™). HBsAb titers were checked 3–4 months later, and titers ≥ 12 mIU/mL were indicative of immunity at VA. Patients who did not seroconvert were offered a repeat schedule of three more doses. We screened 198 patients (187 males and 11 females) with CKD 4 and 5 [glomerular filtration rate (GFR) < 29 mL/min/1.73 m²]. The median age of this cohort was 72 years (range 38–92 years). During the study period of 5 years (2015–2020), 10 patients were excluded since their GFR had improved to more than 30 mL/min/1.73 m², 24 others had baseline immunity and 2 refused vaccination. The hepatitis B vaccination series was not started on 106 patients. Of the remaining 56, 12 patients progressed to ESKD and started dialysis before completion of the vaccination schedule, 6 expired and 1 did not come to clinic in 2020 due to the pandemic. Of the 37 patients who completed the vaccination schedule, 16 achieved seroconversion with adequate HBsAb titers, 10 did not develop immunity despite a second hepatitis B vaccination series, while 11 did not get a second series. Given the low seroconversion rate, albeit in a small cohort, vaccination should be considered in patients with earlier stages of CKD. Other options include studies on FDA approved vaccines of shorter duration. We plan to increase awareness among nephrologists, patients and nursing staff about the importance of achieving immunity against hepatitis B. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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15 pages, 839 KiB

Open AccessArticle

Assessing the Impact of (Self)-Quarantine through a Basic Model of Infectious Disease Dynamics

by József Z. Farkas and Roxane Chatzopoulos

Infect. Dis. Rep. 2021, 13(4), 978-992; https://doi.org/10.3390/idr13040090 - 24 Nov 2021

Cited by 2 | Viewed by 3010

Abstract

We introduce a system of differential equations to assess the impact of (self-)quarantine of symptomatic infectious individuals on disease dynamics. To this end we depart from using the classic bilinear infection process, but remain within the framework of the mass-action assumption. From the [...] Read more.

We introduce a system of differential equations to assess the impact of (self-)quarantine of symptomatic infectious individuals on disease dynamics. To this end we depart from using the classic bilinear infection process, but remain within the framework of the mass-action assumption. From the mathematical point of view, the model we propose is interesting due to the lack of continuous differentiability at disease-free steady states, which implies that the basic reproductive number cannot be computed following established mathematical approaches for certain parameter values. However, we parametrise our mathematical model using published values from the COVID-19 literature, and analyse the model simulations. We also contrast model simulations against publicly available COVID-19 test data, focusing on the first wave of the pandemic during March–July 2020 in the UK. Our simulations indicate that actual peak case numbers might have been as much as 200 times higher than the reported positive test cases during the first wave in the UK. We find that very strong adherence to self-quarantine rules yields (only) a reduction of 22% of peak numbers and delays the onset of the peak by approximately 30–35 days. However, during the early phase of the outbreak, the impact of (self)-quarantine is much more significant. We also take into account the effect of a national lockdown in a simplistic way by reducing the effective susceptible population size. We find that, in case of a 90% reduction of the effective susceptible population size, strong adherence to self-quarantine still only yields a 25% reduction of peak infectious numbers when compared to low adherence. This is due to the significant number of asymptomatic infectious individuals in the population. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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13 pages, 1205 KiB

Open AccessArticle

Step In, Step Out from the First Lockdown: An Exploration of COVID-19 Perceptions in France and Quebec

by Jean-Charles David, Kévin Nadarajah, Anta Niang, Sylvain Delouvée, Martin Goyette, Stéphanie Bordel and Alain Somat

Infect. Dis. Rep. 2021, 13(4), 965-977; https://doi.org/10.3390/idr13040089 - 22 Nov 2021

Cited by 1 | Viewed by 3862

Abstract

Objective. The objective of this research was to describe and analyze the role of psychological and behavioral factors on perceptions of COVID-19 in France and Quebec at three different times during the pandemic. Design. We conducted three qualitative and quantitative studies (Study 1 [...] Read more.

Objective. The objective of this research was to describe and analyze the role of psychological and behavioral factors on perceptions of COVID-19 in France and Quebec at three different times during the pandemic. Design. We conducted three qualitative and quantitative studies (Study 1 N = 255, Study 2 N = 230, Study 3 N = 143). Participants were asked to evaluate psychological and behavioral measures: at the beginning of lockdown (Study 1), during lockdown (Study 2), and during lockdown exit (Study 3). Results. Results of Study 1 show that perceptions of COVID-19 are organized around fear and a sense of threat. During the lockdown, participants mentioned for the first time the health practices to prevent the spread of COVID-19 (Study 2). Psychological and social impacts constitute a central theme in participants’ discourse (Study 2 and 3). Conclusions. The results show that perceptions of risk during a pandemic are socially constructed. Perceptions seem to be influenced by the political and health management of a territory and by the evolution of behavioral and psychological responses. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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8 pages, 1057 KiB

Open AccessArticle

Longitudinal Rise in Seroprevalence of SARS-CoV-2 Infections in Children in Western Germany—A Blind Spot in Epidemiology?

by Folke Brinkmann, Hans H. Diebner, Chantal Matenar, Anne Schlegtendal, Jan Spiecker, Lynn Eitner, Nina Timmesfeld, Christoph Maier and Thomas Lücke

Infect. Dis. Rep. 2021, 13(4), 957-964; https://doi.org/10.3390/idr13040088 - 12 Nov 2021

Cited by 14 | Viewed by 3134

Abstract

SARS-CoV-2 infection rates in children and adolescents are often underestimated due to asymptomatic or oligosymptomatic infections. Seroprevalence studies can reveal the magnitude of “silent” infections in this age group and help to assess the risk of infection for children but also their role [...] Read more.

SARS-CoV-2 infection rates in children and adolescents are often underestimated due to asymptomatic or oligosymptomatic infections. Seroprevalence studies can reveal the magnitude of “silent” infections in this age group and help to assess the risk of infection for children but also their role in spreading the disease. In total, 2045 children and their parents from the Ruhr region were finally included after the exclusion of drop-outs. Seroconversion rates among children of all age groups increased from 0.5% to 8% during the study period and were about three to fourfold higher than the officially registered PCR-based infection rates. Only 41% recalled symptoms of infection; 59% were asymptomatic. In 51% of the infected children, at least one parent also developed SARS-CoV-2 antibodies. Depending on local incidences, the rates of seroconversion rose to different levels during the study period. Although the dynamics of infection within the study cohort mirrors local incidence, the figure of SARS-CoV-2 infections in children and adolescents appears to be high. Reported contact with SARS-CoV-2-infected individuals in the same household carries a high risk of infection. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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8 pages, 982 KiB

Open AccessArticle

Prognostic Role of Anemia in COVID-19 Patients: A Meta-Analysis

by Marco Zuin, Gianluca Rigatelli, Laura Quadretti, Luisella Fogato, Giovanni Zuliani and Loris Roncon

Infect. Dis. Rep. 2021, 13(4), 930-937; https://doi.org/10.3390/idr13040085 - 31 Oct 2021

Cited by 15 | Viewed by 3217

Abstract

Introduction. The prevalence and prognostic implications of anemia in patients infected by the SARS-CoV-2 remains unclear. We performed a systematic review and meta-analysis to assess the prevalence and mortality risk in COVID-19 patients with anemia. Methods. Preferred Reporting Items for Systematic Reviews and [...] Read more.

Introduction. The prevalence and prognostic implications of anemia in patients infected by the SARS-CoV-2 remains unclear. We performed a systematic review and meta-analysis to assess the prevalence and mortality risk in COVID-19 patients with anemia. Methods. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to 1 September 2021, reporting data on the adjusted OR (aOR) for mortality among COVID-19 patients with anemia. The pooled prevalence of anemia among COVID-19 patients was calculated using a random effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (aOR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I² statistic. Results. Five studies, enrolling 9.623 COVID-19 patients [3.707 males (38.5%)], met the inclusion criteria and were included in the final analysis. The pooled prevalence of anemia was 25.6% of cases (95% CI: 8.3–56.5%), with high heterogeneity (I² = 98.9%). Meta-regression showed that the anemia prevalence was influenced by a direct correlation with age (p = 0.007) and chronic kidney disease (p = 0.004) as moderating variables. Conversely, an inverse relationship was observed with male gender (p < 0.0001). Anemia was significantly associated with higher risk of short-term mortality (aOR: 1.69, 95% CI: 1.28–2.24, p < 0.001), with low heterogeneity (I² = 0%). Conclusions. Anemia represents a major comorbidity in about 25% of COVID-19 patients and it is associated with about 70% higher risk of short-term mortality. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 398 KiB

Open AccessArticle

SARS-CoV-2 Serology Testing in an Asymptomatic, At-Risk Population: Methods, Results, Pitfalls

by Theodore Heyming, Kellie Bacon, Bryan Lara, Chloe Knudsen-Robbins, Aprille Tongol and Terence Sanger

Infect. Dis. Rep. 2021, 13(4), 910-916; https://doi.org/10.3390/idr13040082 - 21 Oct 2021

Cited by 1 | Viewed by 2677

Abstract

The primary aim of this study was to determine the seroprevalence of SARS-CoV-2 antibodies in a population of pediatric healthcare workers (HCWs). This study was conducted 14 May–13 July 2020. Study participants included pediatric HCWs at a pediatric hospital with either direct patient [...] Read more.

The primary aim of this study was to determine the seroprevalence of SARS-CoV-2 antibodies in a population of pediatric healthcare workers (HCWs). This study was conducted 14 May–13 July 2020. Study participants included pediatric HCWs at a pediatric hospital with either direct patient contact or close proximity to patient-care areas. SARS-CoV-2 antibodies were assessed via the Wytcote Superbio SARS-CoV-2 IgM/IgG Antibody Fast Detection Kit and the Abbott Architect SARS-CoV-2 IgG assay. Participants underwent RT-PCR testing upon entry to the study and following rapid IgM+/IgG+ results; respiratory panel PCR (RP-PCR) was performed following IgM+ results. A total of 57 of 289 (19.7%) of participants demonstrated positive serology as assessed by the Wytcote rapid kit (12 on Day 1 and 45 throughout the study). However, only one of these participants demonstrated IgG+ serology via the Abbott assay. Two participants tested SARS-CoV-2+ via RT-PCR testing. One individual was adenovirus+ and enterovirus/rhinovirus+. In our study population, we observed a seroprevalence of SARS-CoV-2 antibodies of 0.35%. The lack of concordance between antibody tests suggests that the Wytcote rapid test kit may not be of use as a screening tool. However, the feasibility of the overall process indicates that a similar methodology may have potential for future epidemiologic surveillance. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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12 pages, 657 KiB

Open AccessArticle

Vaccine Hesitancy towards COVID-19 Vaccination: Investigating the Role of Information Sources through a Mediation Analysis

by Chiara Reno, Elisa Maietti, Zeno Di Valerio, Marco Montalti, Maria Pia Fantini and Davide Gori

Infect. Dis. Rep. 2021, 13(3), 712-723; https://doi.org/10.3390/idr13030066 - 12 Aug 2021

Cited by 46 | Viewed by 7970

Abstract

Mass vaccination campaigns have been implemented worldwide to counteract the SARS-CoV-2/COVID-19 pandemic, however their effectiveness could be challenged by vaccine hesitancy. The tremendous rise in the use of social media have made them acquire a leading role as an information source, thus representing [...] Read more.

Mass vaccination campaigns have been implemented worldwide to counteract the SARS-CoV-2/COVID-19 pandemic, however their effectiveness could be challenged by vaccine hesitancy. The tremendous rise in the use of social media have made them acquire a leading role as an information source, thus representing a crucial factor at play that could contribute to increase or mitigate vaccine hesitancy, as information sources play a pivotal role in shaping public opinion and perceptions. The aims of the study were to investigate if information sources could affect the attitude towards COVID-19 vaccination and if they could act as a mediator in the relationship between individual characteristics and vaccine hesitancy. A cross-sectional online survey was conducted by a professional panellist on a representative sample of 1011 citizens from the Emilia-Romagna region in Italy in January 2021. A mediation analysis using structural equation modelling was performed. Our results show how social media directly or indirectly increases vaccine hesitancy towards COVID-19 vaccination, while the opposite effect was observed for institutional websites. Given the global widespread use of social media, their use should be enhanced to disseminate scientifically sound information to a greater audience to counteract vaccine hesitancy, while at the same time continuing to promote and update institutional websites that have proven to be effective in reducing vaccine hesitancy. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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6 pages, 214 KiB

Open AccessArticle

A Case Series of Diarrheal Diseases Associated with Yersinia frederiksenii

by Eugene Y. H. Yeung

Infect. Dis. Rep. 2021, 13(2), 552-557; https://doi.org/10.3390/idr13020051 - 13 Jun 2021

Cited by 2 | Viewed by 4345

Abstract

To date, Yersinia pestis, Yersinia enterocolitica, and Yersinia pseudotuberculosis are the three Yersinia species generally agreed to be pathogenic in humans. However, there are a limited number of studies that suggest some of the “non-pathogenic” Yersinia species may also cause infections. [...] Read more.

To date, Yersinia pestis, Yersinia enterocolitica, and Yersinia pseudotuberculosis are the three Yersinia species generally agreed to be pathogenic in humans. However, there are a limited number of studies that suggest some of the “non-pathogenic” Yersinia species may also cause infections. For instance, Yersinia frederiksenii used to be known as an atypical Y. enterocolitica strain until rhamnose biochemical testing was found to distinguish between these two species in the 1980s. From our regional microbiology laboratory records of 18 hospitals in Eastern Ontario, Canada from 1 May 2018 to 1 May 2021, we identified two patients with Y. frederiksenii isolates in their stool cultures, along with their clinical presentation and antimicrobial management. Both patients presented with diarrhea, abdominal pain, and vomiting for 5 days before presentation to hospital. One patient received a 10-day course of sulfamethoxazole-trimethoprim; his Y. frederiksenii isolate was shown to be susceptible to amoxicillin-clavulanate, ceftriaxone, ciprofloxacin, and sulfamethoxazole-trimethoprim, but resistant to ampicillin. The other patient was sent home from the emergency department and did not require antimicrobials and additional medical attention. This case series illustrated that diarrheal disease could be associated with Y. frederiksenii; the need for antimicrobial treatment should be determined on a case-by-case basis. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

Review

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14 pages, 1061 KiB

Open AccessReview

Oral Fosfomycin Formulation in Bacterial Prostatitis: New Role for an Old Molecule-Brief Literature Review and Clinical Considerations

by Andrea Marino, Stefano Stracquadanio, Carlo Maria Bellanca, Egle Augello, Manuela Ceccarelli, Giuseppina Cantarella, Renato Bernardini, Giuseppe Nunnari and Bruno Cacopardo

Infect. Dis. Rep. 2022, 14(4), 621-634; https://doi.org/10.3390/idr14040067 - 18 Aug 2022

Cited by 13 | Viewed by 4973

Abstract

Bacterial prostatitis infections are described as infections that are difficult-to-treat, due to prostate anatomic characteristics along with clinical difficulty in terms of diagnosis and management. Furthermore, the emergence of multidrug resistant (MDR) bacteria, such as extended-spectrum beta-lactamase (ESBL) producer Escherichia coli, also representing [...] Read more.

Bacterial prostatitis infections are described as infections that are difficult-to-treat, due to prostate anatomic characteristics along with clinical difficulty in terms of diagnosis and management. Furthermore, the emergence of multidrug resistant (MDR) bacteria, such as extended-spectrum beta-lactamase (ESBL) producer Escherichia coli, also representing the main causative pathogen in prostatitis, poses major problems in terms of antibiotic management and favorable clinical outcome. Oral fosfomycin, an antibiotic commonly used for the treatment of uncomplicated urinary tract infections (UTIs), has been recently evaluated for the treatment of bacterial prostatitis due to its favorable pharmacokinetic profile, its activity against MDR gram-positive and gram-negative bacteria, safety profile, and multiple synergic effect with other antibiotics as well as the low resistance rate. This review addresses fosfomycin pharmacokinetics and pharmacodynamics and discusses the latest clinical evidence on its clinical use to treat acute and chronic bacterial prostatitis in hospitalized patients and in outpatients. As described in several reports, oral fosfomycin may represent a valid therapeutic option to treat susceptible germs commonly causing prostatitis, such as E. coli and other Enterobacterales as well as Enterococcus faecium, even as a first-line regimen in particular clinical settings (patients with previous treatment failure, with allergies or outpatients). Stronger data from further studies, including randomized controlled trials, would be helpful to establish the proper dosage and specific indications. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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13 pages, 290 KiB

Open AccessReview

Registry Systems for COVID-19 Vaccines and Rate of Acceptability for Vaccination Before and After Availability of Vaccines in 12 Countries: A Narrative Review

by Dimitrios Papagiannis, Foteini Malli and Konstantinos I. Gourgoulianis

Infect. Dis. Rep. 2022, 14(1), 121-133; https://doi.org/10.3390/idr14010016 - 11 Feb 2022

Cited by 8 | Viewed by 3402

Abstract

Registry systems play a key role in promoting vaccination campaigns in the general population. In the present narrative review, we provide data from 12 12 countries for vaccination acceptance before the availability of COVID-19 vaccines and vaccination coverage once it is available. We [...] Read more.

Registry systems play a key role in promoting vaccination campaigns in the general population. In the present narrative review, we provide data from 12 12 countries for vaccination acceptance before the availability of COVID-19 vaccines and vaccination coverage once it is available. We selected a randomized representative sample of 12 countries from WHO regions and 194 total members by the Open Epi Random Program. We observed the results with different levels of vaccine acceptability between the studies that were performed before the availability of a vaccine against COVID-19 and the vaccination coverage after the availability of the COVID-19 vaccine. All the registry systems that were developed for the recent pandemic achieved the initial functional goals. Twelve months after the vaccination campaign has begun, varying results were reported for vaccination coverage against COVID-19 vaccines with rates as high as 98% (subjects with at least one dose of vaccine) in the United Arabic Emirates, and as low as 24% in South Africa. The United Arabic Emirates stood as the leader of the world with the highest number of vaccinations 88% fully vaccinated citizens followed by Canada with 80% fully vaccinated citizens. The available data suggest that vaccine registry systems could help increase vaccination coverage and aim in the control of future outbreaks. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

19 pages, 1028 KiB

Open AccessReview

Selected Livestock-Associated Zoonoses as a Growing Challenge for Public Health

by Kacper Libera, Kacper Konieczny, Julia Grabska, Wiktoria Szopka, Agata Augustyniak and Małgorzata Pomorska-Mól

Infect. Dis. Rep. 2022, 14(1), 63-81; https://doi.org/10.3390/idr14010008 - 13 Jan 2022

Cited by 18 | Viewed by 5991

Abstract

The aim of this paper is to review the most significant livestock-associated zoonoses. Human and animal health are intimately connected. This idea has been known for more than a century but now it has gained special importance because of the increasing threat from [...] Read more.

The aim of this paper is to review the most significant livestock-associated zoonoses. Human and animal health are intimately connected. This idea has been known for more than a century but now it has gained special importance because of the increasing threat from zoonoses. Zoonosis is defined as any infection naturally transmissible from vertebrate animals to humans. As the frequency and prevalence of zoonotic diseases increase worldwide, they become a real threat to public health. In addition, many of the newly discovered diseases have a zoonotic origin. Due to globalization and urbanization, some of these diseases have already spread all over the world, caused by the international flow of goods, people, and animals. However, special attention should be paid to farm animals since, apart from the direct contact, humans consume their products, such as meat, eggs, and milk. Therefore, zoonoses such as salmonellosis, campylobacteriosis, tuberculosis, swine and avian influenza, Q fever, brucellosis, STEC infections, and listeriosis are crucial for both veterinary and human medicine. Consequently, in the suspicion of any zoonoses outbreak, the medical and veterinary services should closely cooperate to protect the public health. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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18 pages, 1169 KiB

Open AccessReview

Root Causes of Fungal Coinfections in COVID-19 Infected Patients

by Arman Amin, Artin Vartanian, Nicole Poladian, Alexander Voloshko, Aram Yegiazaryan, Abdul Latif Al-Kassir and Vishwanath Venketaraman

Infect. Dis. Rep. 2021, 13(4), 1018-1035; https://doi.org/10.3390/idr13040093 - 4 Dec 2021

Cited by 30 | Viewed by 4986

Abstract

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has infected over 200 million people, causing over 4 million deaths. COVID-19 infection has been shown to lead to hypoxia, immunosuppression, host iron depletion, hyperglycemia secondary to diabetes mellitus, as well [...] Read more.

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has infected over 200 million people, causing over 4 million deaths. COVID-19 infection has been shown to lead to hypoxia, immunosuppression, host iron depletion, hyperglycemia secondary to diabetes mellitus, as well as prolonged hospitalizations. These clinical manifestations provide favorable conditions for opportunistic fungal pathogens to infect hosts with COVID-19. Interventions such as treatment with corticosteroids and mechanical ventilation may further predispose COVID-19 patients to acquiring fungal coinfections. Our literature review found that fungal coinfections in COVID-19 infected patients were most commonly caused by Aspergillus, Candida species, Cryptococcus neoformans, and fungi of the Mucorales order. The distribution of these infections, particularly Mucormycosis, was found to be markedly skewed towards low- and middle-income countries. The purpose of this review is to identify possible explanations for the increase in fungal coinfections seen in COVID-19 infected patients so that physicians and healthcare providers can be conscious of factors that may predispose these patients to fungal coinfections in order to provide more favorable patient outcomes. After identifying risk factors for coinfections, measures should be taken to minimize the dosage and duration of drugs such as corticosteroids, immunosuppressants, and antibiotics. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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16 pages, 1050 KiB

Open AccessReview

SARS-CoV-2 and the Immune Response in Pregnancy with Delta Variant Considerations

by Patrida Rangchaikul and Vishwanath Venketaraman

Infect. Dis. Rep. 2021, 13(4), 993-1008; https://doi.org/10.3390/idr13040091 - 30 Nov 2021

Cited by 23 | Viewed by 4389

Abstract

As of September 2021, there has been a total of 123,633 confirmed cases of pregnant women with SARS-CoV-2 infection in the US according to the CDC, with maternal death being 2.85 times more likely, pre-eclampsia 1.33 times more likely, preterm birth 1.47 times [...] Read more.

As of September 2021, there has been a total of 123,633 confirmed cases of pregnant women with SARS-CoV-2 infection in the US according to the CDC, with maternal death being 2.85 times more likely, pre-eclampsia 1.33 times more likely, preterm birth 1.47 times more likely, still birth 2.84 times more likely, and NICU admission 4.89 times more likely when compared to pregnant women without COVID-19 infection. In our literature review, we have identified eight key changes in the immunological functioning of the pregnant body that may predispose the pregnant patient to both a greater susceptibility to SARS-CoV-2, as well as a more severe disease course. Factors that may impede immune clearance of SARS-CoV-2 include decreased levels of natural killer (NK) cells, Th1 CD4+ T cells, plasmacytoid dendritic cells (pDC), a decreased phagocytic index of neutrophil granulocytes and monocytes, as well as the immunomodulatory properties of progesterone, which is elevated in pregnancy. Factors that may exacerbate SARS-CoV-2 morbidity through hyperinflammatory states include increases in the complement system, which are linked to greater lung injury, as well as increases in TLR-1 and TLR-7, which are known to bind to the virus, leading to increased proinflammatory cytokines such as IL-6 and TNF-α, which are already elevated in normal pregnant physiology. Other considerations include an increase in angiotensin converting enzyme 2 (ACE2) in the maternal circulation, leading to increased viral binding on the host cell, as well as increased IL-6 and decreased regulatory T cells in pre-eclampsia. We also focus on how the Delta variant has had a concerning impact on SARS-CoV-2 cases in pregnancy, with an increased case volume and proportion of ICU admissions among the infected expecting mothers. We propose that the effects of the Delta variant are due to a combination of (1) the Delta variant itself being more transmissible, contagious, and efficient at infecting host cells, (2) initial evidence pointing to the Delta variant causing a significantly greater viral load that accumulates more rapidly in the respiratory system, (3) the pregnancy state being more susceptible to SARS-CoV-2 infection, as discussed in-depth, and (4) the lower rates of vaccination in pregnant women compared to the general population. In the face of continually evolving strains and the relatively low awareness of COVID-19 vaccination for pregnant women, it is imperative that we continue to push for global vaccine equity. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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10 pages, 1208 KiB

Open AccessReview

Update on the Epidemiology of Macrolide-Resistant Mycoplasma pneumoniae in Europe: A Systematic Review

by Daniela Loconsole, Anna Lisa De Robertis, Anna Sallustio, Francesca Centrone, Caterina Morcavallo, Silvia Campanella, Marisa Accogli and Maria Chironna

Infect. Dis. Rep. 2021, 13(3), 811-820; https://doi.org/10.3390/idr13030073 - 2 Sep 2021

Cited by 21 | Viewed by 3335

Abstract

Macrolide-resistant Mycoplasma pneumoniae (MR-MP) infections cause upper and lower respiratory tract infections in both children and adults, and are characterized by a longer duration of symptoms. Here, we undertook a systematic review of studies on MR-MP in Europe. The review meets PRISMA guidelines. [...] Read more.

Macrolide-resistant Mycoplasma pneumoniae (MR-MP) infections cause upper and lower respiratory tract infections in both children and adults, and are characterized by a longer duration of symptoms. Here, we undertook a systematic review of studies on MR-MP in Europe. The review meets PRISMA guidelines. The PubMed, Scopus, and Science Direct databases were searched using suitable keywords to identify relevant studies published from 2010 to 2021; 21 studies were included. Overall, a low level of MR-MP spread was reported in Europe. MR-MP spread increased during epidemic waves registered in Europe, particularly in Italy and Scotland, where the highest MR-MP infection rates were registered during the 2010–2011 epidemic. By contrast, no MR-MP infections were reported in Finland and the Netherlands. Continued monitoring of MR-MP in Europe is needed to maintain the low rates of infection. Moreover, a coordinated and structured pan-European surveillance program adequate for public health surveillance is advisable, with the purpose of containing the spread of antimicrobial resistance. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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Other

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8 pages, 1766 KiB

Open AccessCase Report

Enterobius vermicularis Related Acute Appendicitis: A Case Report and Review of the Literature

by Shabnam Chhetri, Ahmed Hamood Al Mamari, Mahmood Mausd Al Awfi, Nasser Humaid Nasser Al Khaldi, Nibras Mejbel Abed, Nenad Pandak, Faryal Khamis, Zakariya Al Balushi, Rashid Mohammed Khamis Alalawi, Sultan Al Lawati, Muna Ba’Omar, Nasser Shukaili and Seif Al-Abri

Infect. Dis. Rep. 2023, 15(4), 417-424; https://doi.org/10.3390/idr15040042 - 10 Jul 2023

Cited by 4 | Viewed by 4131

Abstract

While the debate on the association between Enterobius vermicularis (E. vermicularis) and acute appendicitis has not been settled, a few case reports of this very rare encounter are beginning to come to light. E. vermicularis is one of the most common [...] Read more.

While the debate on the association between Enterobius vermicularis (E. vermicularis) and acute appendicitis has not been settled, a few case reports of this very rare encounter are beginning to come to light. E. vermicularis is one of the most common parasitic infections around the world, and acute appendicitis, on the other hand, is also a commonly encountered condition in general surgery. However, the association between these two conditions remains controversial. Here we present a case report of a young woman with appendicitis associated with E. vermicularis. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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5 pages, 479 KiB

Open AccessCase Report

Mesenteric Lymphadenitis Presenting as Acute Abdomen in a Child with Multisystem Inflammatory Syndrome

by Evangelos Blevrakis, Eleni Vergadi, Maria Stefanaki, Iris Alexiadi-Oikonomou, Glykeria Rouva, Ioannis Germanakis and Emmanouil Galanakis

Infect. Dis. Rep. 2022, 14(3), 428-432; https://doi.org/10.3390/idr14030046 - 6 Jun 2022

Cited by 4 | Viewed by 6672

Abstract

Multisystem inflammatory syndrome in children (MIS-C) may develop as a rare complication following COVID-19. MIS-C presentation varies substantially, but fever and gastrointestinal symptoms are the most prominent. Indeed, gastrointestinal involvement may be severe enough to present as acute abdomen, posing challenges to clinicians. [...] Read more.

Multisystem inflammatory syndrome in children (MIS-C) may develop as a rare complication following COVID-19. MIS-C presentation varies substantially, but fever and gastrointestinal symptoms are the most prominent. Indeed, gastrointestinal involvement may be severe enough to present as acute abdomen, posing challenges to clinicians. We present herein the case of a healthy five-year-old male who presented with fever, vomiting, and abdominal pain, resembling acute abdomen. The patient had no history of SARS-CoV-2 infection or exposure, and MIS-C diagnosis was initially surpassed unnoticed. The patient underwent exploratory laparotomy that only revealed mesenteric lymphadenitis. Postoperatively, the patient met the clinical and laboratory diagnostic criteria of MIS-C. SARS-CoV-2 exposure was serologically confirmed and MIS-C treatment was commenced, resulting in defervescence and a satisfactory outcome. In young patients presenting with acute abdomen, surgeons should be aware of MIS-C, so that earlier diagnosis and appropriate treatment are made prior to surgical interventions. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 917 KiB

Open AccessCase Report

Warm Autoimmune Hemolytic Anemia and Pure Red Cell Aplasia during a Severe COVID-19 B.1.1.7 Infection

by Anukul Ghimire, Jaye Platnich and Utkarsh Chauhan

Infect. Dis. Rep. 2022, 14(3), 413-419; https://doi.org/10.3390/idr14030044 - 2 Jun 2022

Cited by 4 | Viewed by 2692

Abstract

Warm autoimmune hemolytic anemia (AIHA) is a rare complication of COVID-19 infection. We report a case of warm AIHA in a patient with COVID-19 pneumonia treated with methylprednisolone and several red blood cell transfusions. Despite treatment of the warm AIHA, the patient’s reticulocyte [...] Read more.

Warm autoimmune hemolytic anemia (AIHA) is a rare complication of COVID-19 infection. We report a case of warm AIHA in a patient with COVID-19 pneumonia treated with methylprednisolone and several red blood cell transfusions. Despite treatment of the warm AIHA, the patient’s reticulocyte count remained low, and his biochemical markers were suggestive of pure red cell aplasia, which was later attributed to a concurrent parvovirus B19 infection. This case highlights an unusual situation of two separate hematological processes caused by two separate and simultaneous viral infections. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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5 pages, 973 KiB

Open AccessCase Report

Generalized Tetanus in a Canadian Farmer Following Orthopedic Surgery

by Utkarsh Chauhan, Anukul Ghimire, Milan Raval, Curtiss Boyington, Adrienne Haponiuk, Gregory Koller, Jeffrey Korzan and Elaine Yacyshyn

Infect. Dis. Rep. 2022, 14(2), 273-277; https://doi.org/10.3390/idr14020033 - 13 Apr 2022

Viewed by 3046

Abstract

Tetanus is extremely rare in developed countries. We report the first documented case of tetanus in the province of Alberta since 2016: a farmer that developed trismus, shoulder stiffness, and fevers eight days following orthopedic surgery. Tetanus immunoglobulin elicited rapid recovery. We highlight [...] Read more.

Tetanus is extremely rare in developed countries. We report the first documented case of tetanus in the province of Alberta since 2016: a farmer that developed trismus, shoulder stiffness, and fevers eight days following orthopedic surgery. Tetanus immunoglobulin elicited rapid recovery. We highlight risk factors, pathogenesis, epidemiology, and diagnostic challenges. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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13 pages, 12517 KiB

Open AccessSystematic Review

Vaccine-Induced Subacute Thyroiditis (De Quervain’s) after mRNA Vaccine against SARS-CoV-2: A Case Report and Systematic Review

by Giuseppe Pipitone, Lorenzo Vittorio Rindi, Nicola Petrosillo, Nunzio Adalberto Maria Foti, Grazia Caci, Chiara Iaria, Davide Roberto Donno, Evangelo Boumis, Giuseppe Paviglianiti and Fabrizio Taglietti

Infect. Dis. Rep. 2022, 14(1), 142-154; https://doi.org/10.3390/idr14010018 - 21 Feb 2022

Cited by 10 | Viewed by 3894

Abstract

De Quervain’s thyroiditis, sometimes referred to as subacute thyroiditis (SAT), is the most common granulomatous disease of the thyroid, typically found after a viral infection in middle-aged women. The mRNA encoding for the angiotensin-converting enzyme-2 (ACE-2) receptor is expressed in follicular thyroid cells, [...] Read more.

De Quervain’s thyroiditis, sometimes referred to as subacute thyroiditis (SAT), is the most common granulomatous disease of the thyroid, typically found after a viral infection in middle-aged women. The mRNA encoding for the angiotensin-converting enzyme-2 (ACE-2) receptor is expressed in follicular thyroid cells, making them a potential target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Besides infection, SARS-CoV-2 vaccines have also been implicated in SAT pathogenesis. We present a case of a woman developing SAT following vaccination with Comirnaty by Pfizer Inc. (New-York, USA). We performed a systematic review of similar cases available in the literature to provide a better understanding of the topic. We searched the databases PubMed and Embase and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Patient records were then sorted according to the type of administered vaccine and a statistical analysis of the extracted data was performed. No statistically significant difference between mRNA vaccines and other vaccines in inducing SAT was found, nor was any found in terms of patient demographics, symptoms at presentation, initial, or follow-up blood tests. In our case report, we described the possible association between SARS-CoV-2 mRNA-based vaccine Comirnaty and SAT. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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5 pages, 2654 KiB

Open AccessBrief Report

Successful Treatment of Bacteremia and Ventilator-Associated Pneumonia Caused by KPC/OXA-48-like Klebsiella pneumoniae Co-Producer with a Continuous Infusion of High-Dose Meropenem Plus Fosfomycin Guided by Real-Time Therapeutic Drug Monitoring

by Pier Giorgio Cojutti, Giacomo Fornaro, Milo Gatti, Matteo Rinaldi, Paolo Gaibani, Maddalena Giannella, Federico Pea and Pierluigi Viale

Infect. Dis. Rep. 2022, 14(1), 88-92; https://doi.org/10.3390/idr14010010 - 21 Jan 2022

Cited by 4 | Viewed by 3219

Abstract

Bacteremia and ventilator-associated pneumonia due to a pan-resistant Klebsiella pneumoniae strain co-producing KPC and OXA-48 carbapenemases was successfully treated in a COVID-19 critically ill patient with a combination therapy of a high-dose continuous infusion of meropenem (up to 3 g every 6 h, [...] Read more.

Bacteremia and ventilator-associated pneumonia due to a pan-resistant Klebsiella pneumoniae strain co-producing KPC and OXA-48 carbapenemases was successfully treated in a COVID-19 critically ill patient with a combination therapy of a high-dose continuous infusion of meropenem (up to 3 g every 6 h, daily) plus fosfomycin (up to 24 g/daily) that was guided by real-time therapeutic drug monitoring. Clinical pharmacological advice was helpful in maximizing, over time, the pharmacodynamic target attainment of both antibiotics. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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8 pages, 1020 KiB

Open AccessBrief Report

A SWOT Analysis of the Guidelines on Prevention of HIV/AIDS in Japan in the Context of COVID-19

by Kazuki Shimizu

Infect. Dis. Rep. 2021, 13(4), 949-956; https://doi.org/10.3390/idr13040087 - 5 Nov 2021

Cited by 2 | Viewed by 8272

Abstract

In January 2018, the Minister of Health, Labour and Welfare, Japan, released an amended Guideline on the Prevention of Specified Infectious Diseases on Acquired Immunodeficiency Syndrome (AIDS) to propose measures to control the human immunodeficiency virus (HIV)/AIDS. Content analysis was performed to examine [...] Read more.

In January 2018, the Minister of Health, Labour and Welfare, Japan, released an amended Guideline on the Prevention of Specified Infectious Diseases on Acquired Immunodeficiency Syndrome (AIDS) to propose measures to control the human immunodeficiency virus (HIV)/AIDS. Content analysis was performed to examine the strengths, weaknesses, opportunities, and threats of the guidelines in the context of the ongoing COVID-19 pandemic, thus aiming to promote discussions on the guideline itself and the national HIV/AIDS strategy in Japan in the years ahead. The strengths included the incorporation of the latest scientific advancements, clarification of high-risk populations, an alignment with measures against sexually transmitted diseases (STDs), and willingness towards international cooperation in the Asia-Pacific region. The weaknesses that were exposed included a lack of explicit targets for controlling and containing HIV/AIDS, insufficient descriptions about pre-exposure prophylaxis (PrEP), and aggregated discussions on HIV/AIDS among foreign residents. Although several opportunities for re-energizing the discussions around HIV/AIDS were recognized, insufficient political will and funding, along with the emergence of the ongoing COVID-19 pandemic, could operate as threats. Addressing barriers that were recognized before 2019 and exposed due to the COVID-19 pandemic, and tackling underlying health inequalities through the concept of social determinants of health will be critical. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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7 pages, 1507 KiB

Open AccessCase Report

Autochthonous North American Leprosy: A Second Case in Canada

by Prenilla Naidu, Rahul Sharma, Jamil N. Kanji, Vilma Marks and Arienne King

Infect. Dis. Rep. 2021, 13(4), 917-923; https://doi.org/10.3390/idr13040083 - 22 Oct 2021

Cited by 4 | Viewed by 3213

Abstract

Autochthonous leprosy was reported in the Southern USA in 2011 and has comprised an average of 34% of new cases from 2015 to 2020 in that country. We report a similar case in a patient from Western Canada. A 50-year old male patient [...] Read more.

Autochthonous leprosy was reported in the Southern USA in 2011 and has comprised an average of 34% of new cases from 2015 to 2020 in that country. We report a similar case in a patient from Western Canada. A 50-year old male patient presented with a four-year history of a chronic rash. Pathology stains revealed acid-fast bacilli prompting specialist referral. Examination was suspicious for leprosy, which was confirmed on slit skin smears and molecular testing. The patient responded well to treatment. Genotypic testing mapped the organism to the 3I-2 SNP type, which is of European origin and is the type found in implicated armadillo species in North America. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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9 pages, 1135 KiB

Open AccessSystematic Review

Viral Load Difference between Symptomatic and Asymptomatic COVID-19 Patients: Systematic Review and Meta-Analysis

by Marco Zuin, Valentina Gentili, Carlo Cervellati, Roberta Rizzo and Giovanni Zuliani

Infect. Dis. Rep. 2021, 13(3), 645-653; https://doi.org/10.3390/idr13030061 - 16 Jul 2021

Cited by 33 | Viewed by 5474

Abstract

We conducted a systematic review and meta-analysis to investigate the possible difference in the SARS-CoV-2 viral load between asymptomatic and symptomatic COVID-19 patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE, [...] Read more.

We conducted a systematic review and meta-analysis to investigate the possible difference in the SARS-CoV-2 viral load between asymptomatic and symptomatic COVID-19 patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE, Scopus, Web of Science and Google Scholar for all investigations in the English language, reporting data on the threshold cycle (C_t) from real-time RT-PCR assays for the RNA-dependent RNA polymerase (RdRp), envelope (E) and nucleocapsid (N) SARS-CoV-2 genes in asymptomatic and symptomatic COVID-19 patients. Results: Overall, 703 COVID-19 patients (553 symptomatic and 150 asymptomatic) were analyzed. Five investigations reported the mean age of patients, evidencing that asymptomatic patients were younger than symptomatic patients (34.0 vs. 40.3 years, respectively). Pooled data regarding the levels of expression of the RdRp gene revealed no significant difference between symptomatic and asymptomatic subjects. Similarly, no differences were observed comparing the mean C_t values for the E and N genes. Based on real-time RT-PCR data, no differences exist in the viral load between symptomatic and asymptomatic COVID-19 subjects considering C_t values for RdRp, E and N genes’ expression. Asymptomatic subjects may represent a reservoir of the infection and significantly contribute to the maintenance of the pandemic. Full article

(This article belongs to the Special Issue Feature Papers in Infectious Diseases)

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