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1.
Biomed Res Int ; 2021: 5313832, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34485513

RESUMO

Background: Coinfections have a potential role in increased morbidity and mortality rates during pandemics. Our investigation is aimed at evaluating the viral coinfection prevalence in COVID-19 patients. Methods: We systematically searched scientific databases, including Medline, Scopus, WOS, and Embase, from December 1, 2019, to December 30, 2020. Preprint servers such as medRxiv were also scanned to find other related preprint papers. All types of studies evaluating the viral coinfection prevalence in COVID-19 patients were considered. We applied the random effects model to pool all of the related studies. Results: Thirty-three studies including 10484 patients were identified. The viral coinfection estimated pooled prevalence was 12.58%; 95% CI: 7.31 to 18.96). Blood viruses (pooled prevalence: 12.48%; 95% CI: 8.57 to 16.93) had the most frequent viral coinfection, and respiratory viruses (pooled prevalence: 4.32%; 95% CI: 2.78 to 6.15) had less frequent viral coinfection. The herpesvirus pooled prevalence was 11.71% (95% CI: 3.02 to 24.80). Also, the maximum and minimum of viral coinfection pooled prevalence were in AMRO and EMRO with 15.63% (95% CI: 3.78 to 33.31) and 7.05% (95% CI: 3.84 to 11.07), respectively. Conclusion: The lowest rate of coinfection belonged to respiratory viruses. Blood-borne viruses had the highest coinfection rate. Our results provide important data about the prevalence of blood-borne viruses among COVID-19 patients which can be critical when it comes to their treatment procedure.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Humanos , Pandemias/prevenção & controle , Prevalência , SARS-CoV-2/patogenicidade , Viroses/epidemiologia , Viroses/virologia , Vírus/patogenicidade
2.
J Assoc Physicians India ; 69(8): 11-12, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472817

RESUMO

COVID 19 since its onset in Wuhan in 2019 has overburdened our existing health resources and infrastructure. Dengue virus has been endemic in Asian countries since decades. Both being viruses with similar clinical profile and overlapping laboratory parameters has posed a great challenge for Asian countries to combat a co epidemic, creating a double burden. We, as clinicians must be more vigilant in diagnosing the patients so that dengue is not missed in this covid pandemic era and does not progress to life threatening dengue shock syndrome. More importantly, we should emphasize on preventive measures for prevention of dengue so that we can reduce the burden on health care system.


Assuntos
COVID-19 , Coinfecção , Dengue , Coinfecção/epidemiologia , Dengue/complicações , Dengue/diagnóstico , Dengue/epidemiologia , Humanos , Pandemias , SARS-CoV-2
3.
J Trop Pediatr ; 67(4)2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34478546

RESUMO

BACKGROUND AND OBJECTIVES: Assessing the co-infections with COVID-19 is crucial to delineate its true clinical impact. Pediatric information in this aspect is limited. Our study aims to analyze the spectrum of co-infections in pediatric COVID-19 patients and determine the clinical as well as laboratory parameters predicting co-infection. METHODOLOGY: In this prospective observational study conducted from June to December 2020 in a single tertiary care institution, data pertaining to demographic, illness and treatment-related variables were analyzed among two subsets of pediatric patients of age 1 month-12 years with RT-PCR-confirmed COVID-19 infection-Group A: those with confirmed co-infection and Group B: moderate to severe disease without co-infection. Among Group A, etiology of co-infection was characterized through relevant microbiological examination within 48 h admission. RESULT: Among our study population, 15.03% and 20.6% had co-infections and moderate to severe disease respectively. Among those with confirmed co-infection, 32.5%, 11.6% and 6.97% recorded blood culture, respiratory secretion and CSF growth, respectively, the picture being dominated by Methicillin resistant and sensitive Staphylococcus aureus. Serum serology demonstrated Scrub typhus infection to be most prevalent. Concurrent respiratory viral infections were seen in 11.6%. Children with co-infection had significantly higher morbidity and need for supportive therapy. Predictors of co-infection were localization of infection, Neutrophil count ≥10×109, age-specific lymphopenia, CRP > 100 mg/dl and hyperferritinemia. CONCLUSION: Co-infections are an important factor prognosticating pediatric COVID infection. Their early detection, prompt and appropriate treatment is of paramount importance.


Assuntos
COVID-19 , Coinfecção , Infecções Estafilocócicas , Criança , Coinfecção/epidemiologia , Humanos , Estudos Prospectivos , SARS-CoV-2 , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia
4.
Ethiop J Health Sci ; 31(3): 653-662, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483623

RESUMO

Background: Tuberculosis and human immunodeficiency virus (HIV) are among the major health problems in Ethiopia. This study assessed the proportion of tuberculosis lymphadenitis (TBLN), HIV infection and their co-infection among TBLN presumptive individuals at the selected hospitals in Northwest Ethiopia. Methods: Institution based cross sectional study was carried out. Data on demographic and clinical variables were collected with standardized questionnaire. Microbiological culture was done on specimen obtained by fine needle aspirates. The HIV status was determined by rapid anti-HIV antibody test. Data was entered and scrutinized using SPSS version 20 statistical packages. A stepwise logistic regression model was used. The result was considered as statistically significant at P<0. 05. Results: A total of 381 lymphadenitis patients were included in the study. The overall prevalence of TBLN and HIV were at 250(65.6%) and 9(2.4%), respectively and their co-infection was at 6(2.4%). Based on the cytological examination, 301(79.0%) of them were diagnosed as TBLN. The age group, (P=0.01) and residency, (P=0.01) were found significantly associated with TBLN. Similarly, unsafe sex was also statistically significant for HIV infection (P=0.007). Conclusion: Tuberculosis lymphadenitis is the leading cause of TB and lymphadenitis in the region. However, TBLN-HIV coinfection was promisingly low. High rate of discrepancy was noticed between cytological and culture results. Hence, the TBLN diagnostic criteria shall pursue revision.


Assuntos
Coinfecção , Infecções por HIV , Linfadenite , Mycobacterium tuberculosis , Tuberculose dos Linfonodos , Coinfecção/epidemiologia , Estudos Transversais , Etiópia/epidemiologia , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Linfadenite/epidemiologia , Linfadenite/etiologia , Tuberculose dos Linfonodos/epidemiologia
5.
J Pak Med Assoc ; 71(8): 1984-1988, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34418015

RESUMO

OBJECTIVE: To molecularly characterise the relationship between Epstein-Barr virus (EBV) genotypes and Pashtun ethnicity. METHODS: The cross-sectional study was conducted from November 2018 to December 2019 after approval from the Gomal University, Dera Ismail Khan, Pakistan, and comprised blood samples from transgender sex workers who were seropositive for human immunodeficiency virus-1 and seronegative for human immunodeficiency virus residing in two cities of Khyber Pakhtunkhwa province and Islamabad, the federal capital. Formalin-fixed paraffin-embedded (FFPE). Samples were collected from the partner institute along with the patients data, but without any follow-up from the study subjects which was purely on the basis of physical availability. ß-globin gene and EBER-1(EBV encoded small RNA-1) were amplified for qualitative assessment and existence of Epstein-Barr virus. Characterisation of EBNA-2 (EBV Nuclear Antigen-2 was done through nested polymerase chain reaction. RESULTS: Of the 80 subjects, 40(50%) each were seropositive and seronegative individuals. The overall mean age was 28±6.917 years. Among the seropositive group, 38(95%) were homosexual and 2(5%) were heterosexual. Among the seropositive group, 16(40%) had Epstein-Barr virus genotype 1 and 6(15%) had genotype 2, while co-infections were found in 2(5%) subjects. In the seronegative group, 36(90%) subjects had Epstein-Barr virus genotype 1, while there was no case of genotype 2 or co-infection. EBV-2 genotypes with HIV seropositivity showed strong association (p=0.005). Amplification for the EBER-1 gene was done in all the 80(100%) samples. CONCLUSIONS: Epstein-Barr virus EBV genotype 1 was found to be the most frequent type, while genotype 2 and co-infections were detected in only seropositive samples.


Assuntos
Coinfecção , Infecções por Vírus Epstein-Barr , Infecções por HIV , Adulto , Coinfecção/epidemiologia , Estudos Transversais , Infecções por Vírus Epstein-Barr/epidemiologia , Infecções por HIV/epidemiologia , Herpesvirus Humano 4 , Humanos , Adulto Jovem
6.
Emerg Microbes Infect ; 10(1): 1660-1668, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34350810

RESUMO

The coronavirus disease (COVID-19) pandemic is a major challenge worldwide. However, the epidemic potential of common human coronaviruses (HCoVs) remains unclear. This study aimed to determine the epidemiological and co-infection characteristics of common HCoVs in individuals with influenza-like illness (ILI) and severe acute respiratory infection (SARI). This retrospective, observational, multicentre study used data collected from patients admitted to nine sentinel hospitals with ILI and SARI from January 2015 through December 2020 in Shanghai, China. We prospectively tested patients for a total of 22 respiratory pathogens using multi-real-time polymerase chain reaction. Of the 4541 patients tested, 40.37% (1833/4541) tested positive for respiratory pathogens and 3.59% (163/4541) tested positive for common HCoVs. HCoV infection was more common in the non-endemic season for respiratory pathogens (odds ratio: 2.33, 95% confidence interval: 1.64-3.31). HCoV-OC43 (41.72%, 68/163) was the most common type of HCoV detected. The co-infection rate was 31.29% (51/163) among 163 HCoV-positive cases, with HCoV-229E (53.13%, 17/32), the HCoV type that was most frequently associated with co-infection. Respiratory pathogens responsible for co-infections with HCoVs included parainfluenza virus, rhinovirus/enterovirus, influenza A virus, and adenovirus. Furthermore, we identified one patient co-infected with HCoV-OC43 and HCoV-NL63/HKU1. The prevalence of common HCoVs remains low in ILI/SARI cases, in Shanghai. However, the seasonal pattern of HCoVs may be opposite to that of other respiratory pathogens. Moreover, HCoVs are likely to co-exist with specific respiratory pathogens. The potential role of co-infections with HCoVs and other pathogenic microorganisms in infection and pathogenesis of ILI and SARI warrants further study.


Assuntos
Alphacoronavirus , COVID-19/epidemiologia , COVID-19/virologia , Coinfecção/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Alphacoronavirus/classificação , Alphacoronavirus/genética , COVID-19/diagnóstico , COVID-19/história , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/história , Feminino , História do Século XXI , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Vigilância em Saúde Pública , Estudos Retrospectivos , SARS-CoV-2/classificação , SARS-CoV-2/genética , Estações do Ano
7.
J Gen Virol ; 102(8)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34424158

RESUMO

Bovine astrovirus (BoAstV) belongs to genus Mamastravirus (MAstV). It can be detected in the faeces of both diarrhoeal and healthy calves. However, its prevalence, genetic diversity, and association with cattle diarrhoea are poorly understood. In this study, faecal samples of 87 diarrhoeal and 77 asymptomatic calves from 20 farms in 12 provinces were collected, and BoAstV was detected with reverse transcription-polymerase chain reaction (RT-PCR). The overall prevalence rate of this virus in diarrhoeal and asymptomatic calves was 55.17 % (95 % CI: 44.13, 65.85 %) and 36.36 % (95 % CI: 25.70, 48.12 %), respectively, indicating a correlation between BoAstV infection and calf diarrhoea (OR=2.15, P=0.024). BoAstV existed mainly in the form of co-infection (85.53 %) with one to five of nine viruses, and there was a strong positive correlation between BoAstV co-infection and calf diarrhoea (OR=2.83, P=0.004). Binary logistic regression analysis confirmed this correlation between BoAstV co-infection and calf diarrhoea (OR=2.41, P=0.038). The co-infection of BoAstV and bovine rotavirus (BRV) with or without other viruses accounted for 70.77 % of all the co-infection cases. The diarrhoea risk for the calves co-infected with BoAstV and BRV was 8.14-fold higher than that for the calves co-infected with BoAstV and other viruses (OR=8.14, P=0.001). Further, the co-infection of BoAstV/BRV/bovine kobuvirus (BKoV) might increase the risk of calf diarrhoea by 14.82-fold, compared with that of BoAstV and other viruses (OR=14.82, P <0.001). Then, nearly complete genomic sequences of nine BoAstV strains were assembled by using next-generation sequencing (NGS) method. Sequence alignment against known astrovirus (AstV) strains at the levels of both amino acids and nucleotides showed a high genetic diversity. Four genotypes were identified, including two known genotypes MAstV-28 (n=3) and MAstV-33 (n=2) and two novel genotypes designated tentatively as MAstV-34 (n=1) and MAstV-35 (n=3). In addition, seven out of nine BoAstV strains showed possible inter-genotype recombination and cross-species recombination. Therefore, our results increase the knowledge about the prevalence and the genetic evolution of BoAstV and provide evidence for the association between BoAstV infection and calf diarrhoea.


Assuntos
Infecções por Astroviridae , Doenças dos Bovinos , Coinfecção , Diarreia , Animais , Animais Recém-Nascidos/virologia , Infecções por Astroviridae/epidemiologia , Infecções por Astroviridae/veterinária , Infecções por Astroviridae/virologia , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/virologia , China/epidemiologia , Coinfecção/epidemiologia , Coinfecção/veterinária , Coinfecção/virologia , Diarreia/epidemiologia , Diarreia/veterinária , Diarreia/virologia , Fezes/virologia , Prevalência
8.
Virol J ; 18(1): 159, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344406

RESUMO

BACKGROUND: The multifaceted non-pharmaceutical interventions (NPIs) taken during the COVID-19 pandemic not only decrease the spreading of the SARS-CoV-2, but have impact on the prevalence of other viruses. This study aimed to explore the prevalence of common respiratory viruses among hospitalized children with lower respiratory tract infections (LRTI) in China during the COVID-19 pandemic. METHODS: Respiratory specimens were obtained from children with LRTI at Children's Hospital of Fudan University for detection of respiratory syncytial virus (RSV), adenovirus (ADV), parainfluenza virus (PIV) 1 to 3, influenza virus A (FluA), influenza virus B (FluB), human metapneumovirus (MPV) and rhinovirus (RV). The data were analyzed and compared between the year of 2020 (COVID-19 pandemic) and 2019 (before COVID-19 pandemic). RESULTS: A total of 7107 patients were enrolled, including 4600 patients in 2019 and 2507 patients in 2020. Compared with 2019, we observed an unprecedented reduction of RSV, ADV, FluA, FluB, and MPV infections in 2020, despite of reopening of schools in June, 2020. However, the RV infection was significantly increased in 2020 and a sharp increase was observed especially after reopening of schools. Besides, the PIV infection showed resurgent characteristic after September of 2020. The mixed infections were significantly less frequent in 2020 compared with the year of 2019. CONCLUSIONS: The NPIs during the COVID-19 pandemic have great impact on the prevalence of common respiratory viruses in China. Meanwhile, we do need to be cautious of a possible resurgence of some respiratory viruses as the COVID-19 restrictions are relaxed.


Assuntos
COVID-19/epidemiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Distribuição por Idade , COVID-19/prevenção & controle , Criança , Pré-Escolar , China/epidemiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Feminino , Hospitalização , Hospitais Pediátricos , Humanos , Lactente , Masculino , Prevalência , SARS-CoV-2 , Estações do Ano , Vírus/classificação , Vírus/isolamento & purificação
9.
Ann Clin Microbiol Antimicrob ; 20(1): 51, 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353332

RESUMO

PURPOSE: In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control groups from the pre-pandemic and pandemic era. METHODS: Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data. RESULTS: In total, 4859 positive culture results from 3532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p = 0.001 for both comparisons). Interestingly, Acinetobacter baumannii was the main pathogen in the respiratory infections of COVID-19 patients (9.76%) and the rate was significantly higher than pre-pandemic (3.49%, p < 0.002) and pandemic era control groups (3.11%, p < 0.001). CONCLUSION: Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL-producing Enterobacterales, the frequency of multidrug-resistant (MDR) A. baumannii is higher.


Assuntos
Infecções Bacterianas/microbiologia , COVID-19/microbiologia , Coinfecção/microbiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Criança , Pré-Escolar , Coinfecção/epidemiologia , Feminino , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Turquia/epidemiologia , Adulto Jovem
10.
Emerg Med J ; 38(9): 685-691, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34289966

RESUMO

BACKGROUND: Guidelines recommend maximal efforts to obtain blood and sputum cultures in patients with COVID-19, as bacterial coinfection is associated with worse outcomes. The aim of this study was to evaluate the yield of bacteriological tests, including blood and sputum cultures, and the association of multiple biomarkers and the Pneumonia Severity Index (PSI) with clinical and microbiological outcomes in patients with COVID-19 presenting to the emergency department (ED). METHODS: This is a substudy of a large observational cohort study (PredictED study). The PredictED included adult patients from whom a blood culture was drawn at the ED of Haga Teaching Hospital, The Netherlands. For this substudy, all patients who tested positive for SARS-CoV-2 by PCR in March and April 2020 were included. The primary outcome was the incidence of bacterial coinfection. We used logistic regression analysis for associations of procalcitonin, C reactive protein (CRP), ferritin, lymphocyte count and PSI score with a severe disease course, defined as intensive care unit admission and/or 30-day mortality. The area under the receiver operating characteristics curve (AUC) quantified the discriminatory performance. RESULTS: We included 142 SARS-CoV-2 positive patients. On presentation, the median duration of symptoms was 8 days. 41 (29%) patients had a severe disease course and 24 (17%) died within 30 days. The incidence of bacterial coinfection was 2/142 (1.4%). None of the blood cultures showed pathogen growth while 6.3% was contaminated. The AUCs for predicting severe disease were 0.76 (95% CI 0.68 to 0.84), 0.70 (0.61 to 0.79), 0.62 (0.51 to 0.74), 0.62 (0.51 to 0.72) and 0.72 (0.63 to 0.81) for procalcitonin, CRP, ferritin, lymphocyte count and PSI score, respectively. CONCLUSION: Blood cultures appear to have limited value while procalcitonin and the PSI appear to be promising tools in helping physicians identify patients at risk for severe disease course in COVID-19 at presentation to the ED.


Assuntos
Infecções Bacterianas/diagnóstico , Técnicas Bacteriológicas/métodos , COVID-19/diagnóstico , Coinfecção/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/sangue , Infecções Bacterianas/complicações , Infecções Bacterianas/microbiologia , Técnicas Bacteriológicas/estatística & dados numéricos , Proteína C-Reativa/análise , COVID-19/sangue , COVID-19/complicações , COVID-19/virologia , Teste de Ácido Nucleico para COVID-19 , Coinfecção/sangue , Coinfecção/epidemiologia , Coinfecção/microbiologia , Serviço Hospitalar de Emergência , Feminino , Ferritinas/sangue , Humanos , Incidência , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Pró-Calcitonina/sangue , Prognóstico , Curva ROC , Estudos Retrospectivos , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença
11.
J Clin Lab Anal ; 35(8): e23868, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34273182

RESUMO

BACKGROUND: Studies have reported coinfection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease-2019 (COVID-19), with other viruses that cause respiratory tract infections (RTIs). We investigated the coinfection rate of SARS-CoV-2 and other RTI-causing viruses, and whether the cycle threshold (Ct) value of a real-time reverse transcriptase PCR (RT-PCR) differed when the coinfection occurred during the first wave of COVID-19 in Daegu, Republic of Korea, in 2020. METHODS: After performing PCR for SARS-CoV-2, we additionally tested for the presence of RTI-causing viruses to check for coinfection. Subsequently, we identified the specific coexisting respiratory viruses and calculated the coinfection rate. In addition, based on the coinfection status, we compared the Ct values obtained from RT-PCR for SARS-CoV-2 in patients who tested positive for COVID-19 PCR. RESULTS: Of 13,717 patients, 123 had positive results on COVID-19 PCR testing and six tested positive for an RTI-causing virus. Thus, the coinfection rate was 4.9%. There were no statistically significant differences in the mean Ct values of SARS-CoV-2 RT-PCR between coinfected and non-coinfected patients. CONCLUSION: This study computed the coinfection rate of SARS-CoV-2 and RTI-causing viruses and revealed that the mean Ct values in SARS-CoV-2 real-time RT-PCR did not differ according to the coinfection status.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/epidemiologia , Coinfecção/epidemiologia , Coinfecção/virologia , Infecções Respiratórias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , República da Coreia/epidemiologia , Infecções Respiratórias/etiologia , Infecções Respiratórias/virologia , SARS-CoV-2/genética , Centros de Atenção Terciária/estatística & dados numéricos
12.
J Infect ; 83(3): 306-313, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34302864

RESUMO

BACKGROUND: We aimed to describe the epidemiology, risk factors, and clinical outcomes of co-infections and superinfections in onco-hematological patients with COVID-19. METHODS: International, multicentre cohort study of cancer patients with COVID-19. All patients were included in the analysis of co-infections at diagnosis, while only patients admitted at least 48 h were included in the analysis of superinfections. RESULTS: 684 patients were included (384 with solid tumors and 300 with hematological malignancies). Co-infections and superinfections were documented in 7.8% (54/684) and 19.1% (113/590) of patients, respectively. Lower respiratory tract infections were the most frequent infectious complications, most often caused by Streptococcus pneumoniae and Pseudomonas aeruginosa. Only seven patients developed opportunistic infections. Compared to patients without infectious complications, those with infections had worse outcomes, with high rates of acute respiratory distress syndrome, intensive care unit (ICU) admission, and case-fatality rates. Neutropenia, ICU admission and high levels of C-reactive protein (CRP) were independent risk factors for infections. CONCLUSIONS: Infectious complications in cancer patients with COVID-19 were lower than expected, affecting mainly neutropenic patients with high levels of CRP and/or ICU admission. The rate of opportunistic infections was unexpectedly low. The use of empiric antimicrobials in cancer patients with COVID-19 needs to be optimized.


Assuntos
COVID-19 , Coinfecção , Neoplasias , Superinfecção , Estudos de Coortes , Coinfecção/epidemiologia , Humanos , Unidades de Terapia Intensiva , Neoplasias/complicações , Neoplasias/epidemiologia , SARS-CoV-2
13.
Am J Trop Med Hyg ; 105(1): 254-260, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34232911

RESUMO

Diarrheal disease is the second most frequent cause of mortality in children younger than 5 years worldwide, causing more than half a million deaths each year. Our knowledge of the epidemiology of potentially pathogenic agents found in children suffering from diarrhea in sub-Saharan African countries is still patchy, and thereby hinders implementation of effective preventative interventions. The lack of cheap, easy-to-use diagnostic tools leads to mostly symptomatic and empirical case management. An observational study with a total of 241 participants was conducted from February 2017 to August 2018 among children younger than 5 years with diarrhea in Lambaréné, Gabon. Clinical and demographic data were recorded, and a stool sample was collected. The samples were examined using a commercial rapid immunoassay to detect Rotavirus/adenovirus, conventional bacterial culture for Salmonella spp., and multiplex real-time PCR for Cryptosporidium spp., Giardia lamblia, Cyclospora cayetanensis, enterotoxigenic Escherichia coli (ETEC), and enteroinvasive Escherichia coli (EIEC)/Shigella. At least one infectious agent was present in 121 of 241 (50%) samples. The most frequently isolated pathogens were EIEC/Shigella and ETEC (54/179; 30.2% and 44/179; 24.6%, respectively), followed by G. lamblia (33/241; 13.7%), Cryptosporidium spp. (31/241; 12.9%), and Rotavirus (23/241; 9.5%). Coinfection with multiple pathogens was observed in 33% (40/121) of the positive cases with EIEC/Shigella, ETEC, and Cryptosporidium spp. most frequently identified. Our results provide new insight into the possible causes of diarrheal disease in the Moyen-Ogooué region of Gabon and motivate further research on possible modes of infection and targeted preventive measures.


Assuntos
Infecções por Adenoviridae/epidemiologia , Diarreia/microbiologia , Diarreia/parasitologia , Infecções por Protozoários/epidemiologia , Infecções por Protozoários/parasitologia , Infecções por Rotavirus/epidemiologia , Infecções por Adenoviridae/virologia , Adenovírus Humanos , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/parasitologia , Diarreia/epidemiologia , Feminino , Gabão/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino
14.
J Infect Dev Ctries ; 15(6): 761-765, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-34242183

RESUMO

INTRODUCTION: The aim of this study is to determine the coinfections with other respiratory pathogens in SARS-CoV-2 infected children patients in a pediatric unit in Istanbul. METHODOLOGY: This retrospective descriptive study was conducted in a 1000-bedded tertiary education and research hospital in Istanbul. All children hospitalized with the diagnosis of SARS-CoV-2 infection had been investigated for respiratory agents in nasopharyngeal secretions. Laboratory confirmation of SARS-CoV-2 and the other respiratory pathogens were performed using reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: A total of 209 hospitalized children with suspected SARS-CoV-2 infection between March 2020-May 2020 were enrolled in this study. Among 209 children, 93 (44.5%) were RT-PCR positive for SARS-CoV-2 infection, and 116 (55.5%) were RT-PCR negative. The most common clinical symptoms in all children with SARS-CoV-2 infection were fever (68.8%) and cough (57.0%). The other clinical symptoms in decreasing rates were headache (10.8%), myalgia (5.4%), sore throat (3.2%), shortness of breath (3.2%), diarrhea (2.2%) and abdominal pain in one child. In 7 (7.5%) patients with SARS-CoV-2 infection, coinfection was detected. Two were with rhinovirus/enterovirus, two were with Coronavirus NL63, one was with adenovirus, and one was with Mycoplasma pneumoniae. In one patient, two additional respiratory agents (rhinovirus/enterovirus and adenovirus) were detected. There was a significantly longer hospital stay in patients with coinfection (p = 0.028). CONCLUSIONS: Although the coinfection rate was low in SARS-CoV-2 infected patients in our study, we found coinfection as a risk factor for length of hospital stay in the coinfected patient group.


Assuntos
COVID-19/microbiologia , COVID-19/virologia , Coinfecção/microbiologia , Coinfecção/virologia , Vírus/genética , Adenoviridae/genética , Adolescente , COVID-19/diagnóstico , Criança , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/isolamento & purificação , Nasofaringe/microbiologia , Nasofaringe/virologia , Pesquisa Qualitativa , Sistema Respiratório/microbiologia , Sistema Respiratório/virologia , Estudos Retrospectivos , SARS-CoV-2/genética , Centros de Atenção Terciária/estatística & dados numéricos , Turquia/epidemiologia , Vírus/classificação , Vírus/isolamento & purificação
15.
BMC Infect Dis ; 21(1): 649, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225661

RESUMO

BACKGROUND: Mycoplasma genitalium (MG) causes urogenital tract infections and is associated with reproductive morbidity. Although MG has been reported across many regions and population groups, it is not yet routinely tested for in China. Our study contributes to current research by reporting the prevalence and correlates of MG infection in patients attending a sexually transmitted infection (STI) clinic in Guangdong from Jan 2017-May 2018. METHODS: Urethral (from 489 men) and endo-cervical (from 189 women) samples, blood samples, and patient histories (via questionnaires) were collected. Doctors clinically diagnosed anogenital warts (GW) during the examination (n = 678). The presence of MG was evaluated using an in-house via polymerase chain reaction protocol. We also tested all participants for herpes simplex virus-2 (HSV-2), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), syphilis and HIV. Univariate and multivariate logistic regression were used to evaluate factors associated with MG. RESULTS: MG was detected in 7.2% (49/678) of the patients (men, 7.4%; women, 6.9%). The MG positivity rate was 14.2% among symptomatic patients, and 5.6% for asymptomatic patients, respectively. Only 36.7% (18/49) Mg positive patients were symptomatic. Among the MG-infected patients, 10.2% were co-infected with CT, 6.1% with NG, 8.2% with HSV-2, 4.1% with syphilis and 22.4% with GW. Presentation with clinical symptoms was significantly associated with MG infection [OR = 2.52 (2.03-3.13)]. In our analysis, MG was not associated with other STIs. CONCLUSIONS: MG is a relatively common infection among individuals attending an STI clinic in Guangdong Province. Routine testing of symptomatic patients may be necessary, and more epidemiological studies are needed to provide evidence for future testing guidelines.


Assuntos
Coinfecção/epidemiologia , Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
16.
Pediatr Infect Dis J ; 40(8): e313-e316, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34250979

RESUMO

Masking and social distancing have been adopted to mitigate the severe acute respiratory syndrome coronavirus 2 pandemic. We evaluated the indirect impact of severe acute respiratory syndrome coronavirus 2 prevention strategies on invasive Staphylococcus aureus, Streptococcus pneumoniae (pneumococcus) and Group A Streptococcus in Houston area children. We observed a decline in invasive pneumococcal disease and invasive Group A Streptococcus temporally associated with social distancing/masking/school closures.


Assuntos
COVID-19/epidemiologia , Infecções Pneumocócicas/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estreptocócicas/epidemiologia , COVID-19/microbiologia , COVID-19/prevenção & controle , Criança , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/virologia , Hospitalização , Humanos , Pandemias , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/virologia , Estudos Prospectivos , SARS-CoV-2/isolamento & purificação , Infecções Estafilocócicas/prevenção & controle , Infecções Estafilocócicas/virologia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/prevenção & controle , Infecções Estreptocócicas/virologia , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pyogenes/isolamento & purificação
17.
Vaccine ; 39(35): 5002-5006, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34304929

RESUMO

PURPOSE: Lower respiratory infections remain the most lethal communicable disease worldwide. Viral and bacterial coinfections (VBC) are common complications in patients with seasonal influenza and are associated with around 25% of all influenza-related deaths. The burden of pneumonia in patients with VBC in Spain is poorly characterized. To address this question, we aimed to provide population data over a period of six consecutive influenza seasons, from 2009-10 to 2014-15. METHODS: We used the discharge report from the Minimum Basic Data Set (MBDS), published annually by the Spanish Ministry of Health, to retrospectively analyse hospital discharge data in individuals aged ≥60 years with a diagnosis of pneumonia and influenza, based on the International Classification of Diseases (ICD-9-CM codes 480-486 and 487-488, respectively), from 1 October 2009 to 30 September 2015. RESULTS: In total, 1933 patients ≥60 years old were hospitalized for pneumonia and influenza, of whom 55.2% were male. The median age was 74 years (interquartile range [IRQ] 15); half of the patients were ≥75 years old. Influenza was the main diagnosis in 64.4% of the patients, and all-cause pneumonia in 15.8%, half of whom were assigned a diagnostic code for pneumococcal pneumonia. The mean annual hospitalization rate was 2.99 per 100,000 population (95% CI 2.9-3.1) throughout the study period, while the highest rate, 5.6 per 100,000 population (95% CI 5.2-6.0), was observed in the 2013-14 season. The mean annual mortality rate was 0.5 deaths per 100,000 population (95% CI 0.4-0.6) and in-hospital case fatality rate was 16.1% (95% CI 14.5-17.8). CONCLUSIONS: In Spain, community-acquired pneumonia and influenza continue to be an important cause of hospitalization and mortality in patients over 60 years of age. There is an urgent need to further develop prevention strategies such as joint vaccination for both pathologies.


Assuntos
Coinfecção , Influenza Humana , Pneumonia Pneumocócica , Pneumonia Viral , Adolescente , Idoso , Coinfecção/epidemiologia , Hospitalização , Humanos , Influenza Humana/complicações , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Estações do Ano , Espanha/epidemiologia
18.
Future Microbiol ; 16: 919-925, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34319168

RESUMO

In the absence of potent antimicrobial agents, it is estimated that bacterial infections could cause millions of deaths. The emergence of COVID-19, its complex pathophysiology and the high propensity of patients to coinfections has resulted in therapeutic regimes that use a cocktail of antibiotics for disease management. Suboptimal antimicrobial stewardship in this era and the slow pace of drug discovery could result in large-scale drug resistance, narrowing future antimicrobial therapeutics. Thus, judicious use of current antimicrobials is imperative to keep up with existing and emerging infectious pathogens. Here, we provide insights into the potential implications of suboptimal antimicrobial stewardship, resulting from the emergence of COVID-19, on the spread of antimicrobial resistance.


Assuntos
Gestão de Antimicrobianos/métodos , Infecções Bacterianas , COVID-19/epidemiologia , Coinfecção , Micoses , Anti-Infecciosos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Coinfecção/tratamento farmacológico , Coinfecção/epidemiologia , Desinfecção das Mãos , Humanos , Micoses/tratamento farmacológico , Micoses/epidemiologia
19.
Sci Rep ; 11(1): 13971, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34234167

RESUMO

To unravel the source of SARS-CoV-2 introduction and the pattern of its spreading and evolution in the United Arab Emirates, we conducted meta-transcriptome sequencing of 1067 nasopharyngeal swab samples collected between May 9th and Jun 29th, 2020 during the first peak of the local COVID-19 epidemic. We identified global clade distribution and eleven novel genetic variants that were almost absent in the rest of the world and that defined five subclades specific to the UAE viral population. Cross-settlement human-to-human transmission was related to the local business activity. Perhaps surprisingly, at least 5% of the population were co-infected by SARS-CoV-2 of multiple clades within the same host. We also discovered an enrichment of cytosine-to-uracil mutation among the viral population collected from the nasopharynx, that is different from the adenosine-to-inosine change previously reported in the bronchoalveolar lavage fluid samples and a previously unidentified upregulation of APOBEC4 expression in nasopharynx among infected patients, indicating the innate immune host response mediated by ADAR and APOBEC gene families could be tissue-specific. The genomic epidemiological and molecular biological knowledge reported here provides new insights for the SARS-CoV-2 evolution and transmission and points out future direction on host-pathogen interaction investigation.


Assuntos
COVID-19/epidemiologia , COVID-19/imunologia , Coinfecção/epidemiologia , Genômica , Imunidade Inata , Mutação , SARS-CoV-2/genética , Adulto , COVID-19/transmissão , Citidina Desaminase/genética , Feminino , Perfilação da Expressão Gênica , Genoma Viral/genética , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Especificidade de Órgãos , SARS-CoV-2/imunologia
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