RESUMEN
BACKGROUND: The study aimed to estimate the prevalence of active or previous SARS-CoV-2 infection in asymptomatic adults admitted for elective surgery in Australian hospitals. This surveillance activity was established as part of the National Pandemic Health Intelligence Plan. METHODS: Participants (n = 3037) were recruited from 11 public and private hospitals in four states (NSW, Vic, SA and WA) between 2 June and 17 July 2020, with an overall 66% participation rate. Presence of SARS-CoV-2 viral RNA was assessed by Reverse Transcriptase - Polymerase Chain Reaction (RT-PCR) analysis of nasopharyngeal swabs taken after induction of anaesthesia. Presence of anti-SARS-CoV-2 antibodies was assessed by analysis of serum collected at the same time using a novel dual-antigen ELISA assay. RESULTS: No patient (0/3010) returned a positive RT-PCR result. The Bayesian estimated prevalence of active infection of 0.02% (95% probability interval 0.00-0.11%), with the upper endpoint being 1 in 918. Positive serology (IgG) was observed in 15 of 2991 patients, with a strong positive in five of those individuals (Bayesian estimated seroprevalence 0.16%; 95% probability interval 0.00-0.47%). CONCLUSION: These results confirm that during periods of low community prevalence of SARS-CoV-2 elective surgery patients without fever or respiratory symptoms had a very low prevalence of active SARS-CoV-2 infection.
Asunto(s)
COVID-19/epidemiología , Portador Sano/epidemiología , Procedimientos Quirúrgicos Electivos , Hospitalización , Adulto , Anciano , Anciano de 80 o más Años , Australia , COVID-19/diagnóstico , Prueba de Ácido Nucleico para COVID-19 , Prueba Serológica para COVID-19 , Portador Sano/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa InversaAsunto(s)
ADN Viral/genética , Infecciones por Virus Sincitial Respiratorio/genética , Virus Sincitial Respiratorio Humano/genética , Proteínas Virales de Fusión/genética , Australia , Secuencia de Bases , Humanos , Lactante , Recién Nacido , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa de Transcriptasa InversaAsunto(s)
Adenoma/complicaciones , Neoplasias de las Glándulas Suprarrenales/complicaciones , Ganglios Basales/irrigación sanguínea , Hemorragia Cerebral/etiología , Hipertensión/complicaciones , Hipertensión/etiología , Adenoma/diagnóstico , Adenoma/patología , Adenoma/cirugía , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/cirugía , Antihipertensivos/uso terapéutico , Hemorragia Cerebral/cirugía , Niño , Hematoma/diagnóstico por imagen , Hematoma/etiología , Humanos , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Procedimientos Neuroquirúrgicos , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: Community-onset infections caused by methicillin-resistant Staphylococcus aureus (COMRSA) are being increasingly reported worldwide. METHODS: A retrospective study was performed of 14 patients with 15 episodes of COMRSA bacteremia (COMRSAB) admitted to the Royal Darwin Hospital, Northern Territory, Australia from 1998 to 2001. Isolates from COMRSAB episodes underwent extended susceptibility testing and molecular typing by pulsed field gel electrophoresis and allotyping of the staphylococcal cassette chromosome mec (SCCmec) region by polymerase chain reaction. RESULTS: The proportion of community-onset S. aureus bacteremia episodes that were due to COMRSA increased from 9% in 1998 to 20% in 2001. The clinical features of COMRSAB were similar to those seen with methicillin-susceptible strains, including sepsis, endocarditis and metastatic infection. Ineffective empiric antimicrobial therapy was administered in the majority (80%) of episodes. All COMRSAB isolates tested contained allotype IV SCCmec, which is commonly found in community isolates of MRSA and rarely found in isolates from healthcare-associated MRSA infection. CONCLUSION: The increasing incidence of COMRSAB in our region has resulted in the addition of vancomycin to standard empiric therapy in certain patients with suspected S. aureus bacteremia acquired in the community.