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Microorganisms ; 9(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34576892


Treatment of Shiga toxin-producing Escherichia coli O157 (O157) diarrhea with antimicrobials might alter the risk of hemolytic uremic syndrome (HUS). However, full characterization of which antimicrobials might affect risk is lacking, particularly among adults. To inform clinical management, we conducted a case-control study of residents of the FoodNet surveillance areas with O157 diarrhea during a 4-year period to assess antimicrobial class-specific associations with HUS among persons with O157 diarrhea. We collected data from medical records and patient interviews. We measured associations between treatment with agents in specific antimicrobial classes during the first week of diarrhea and development of HUS, adjusting for age and illness severity. We enrolled 1308 patients; 102 (7.8%) developed confirmed HUS. Antimicrobial treatment varied by age: <5 years (12.6%), 5-14 (11.5%), 15-39 (45.4%), ≥40 (53.4%). Persons treated with a ß-lactam had higher odds of developing HUS (OR 2.80, CI 1.14-6.89). None of the few persons treated with a macrolide developed HUS, but the protective association was not statistically significant. Exposure to "any antimicrobial" was not associated with increased odds of HUS. Our findings confirm the risk of ß-lactams among children with O157 diarrhea and extends it to adults. We observed a high frequency of inappropriate antimicrobial treatment among adults. Our data suggest that antimicrobial classes differ in the magnitude of risk for persons with O157 diarrhea.

Emerg Infect Dis ; 22(6): 1044-51, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27191834


Several human adenoviruses (HAdVs) can cause respiratory infections, some severe. HAdV-B7, which can cause severe respiratory disease, has not been recently reported in the United States but is reemerging in Asia. During October 2013-July 2014, Oregon health authorities identified 198 persons with respiratory symptoms and an HAdV-positive respiratory tract specimen. Among 136 (69%) hospitalized persons, 31% were admitted to the intensive care unit and 18% required mechanical ventilation; 5 patients died. Molecular typing of 109 specimens showed that most (59%) were HAdV-B7, followed by HAdVs-C1, -C2, -C5 (26%); HAdVs-B3, -B21 (15%); and HAdV-E4 (1%). Molecular analysis of 7 HAdV-B7 isolates identified the virus as genome type d, a strain previously identified only among strains circulating in Asia. Patients with HAdV-B7 were significantly more likely than those without HAdV-B7 to be adults and to have longer hospital stays. HAdV-B7 might be reemerging in the United States, and clinicians should consider HAdV in persons with severe respiratory infection.

Infecções por Adenovirus Humanos/epidemiologia , Infecções por Adenovirus Humanos/virologia , Adenovírus Humanos/genética , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Infecções por Adenovirus Humanos/diagnóstico , Infecções por Adenovirus Humanos/história , Adenovírus Humanos/classificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Genótipo , História do Século XXI , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oregon/epidemiologia , Filogenia , Vigilância da População , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/história , Índice de Gravidade de Doença , Avaliação de Sintomas , Adulto Jovem
MMWR Morb Mortal Wkly Rep ; 64(14): 399, 2015 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-25879900


On January 8, 2014, the Ohio Department of Health notified the Oregon Public Health Division (OPHD) of campylobacteriosis in two Ohio residents recently returned from Oregon. The travelers reported consuming chicken liver pâté* at an Oregon restaurant. On January 10, OPHD received additional reports of campylobacteriosis in two persons who had consumed chicken liver pâté at another Oregon restaurant. Campylobacter jejuni was isolated in cultures of fecal specimens from three patients. OPHD investigated to determine the sources of the illnesses and to institute preventive measures.

Infecções por Campylobacter/epidemiologia , Campylobacter jejuni/isolamento & purificação , Surtos de Doenças , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Carne/microbiologia , Animais , Infecções por Campylobacter/microbiologia , Galinhas , Culinária , Fezes/microbiologia , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Fígado , Ohio/epidemiologia , Oregon/epidemiologia , Restaurantes