Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 740
Filtrar
1.
J Infect Dev Ctries ; 15(1): 22-31, 2021 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-33571142

RESUMO

In late 2019 a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and spread throughout the world over a short period of time causing a pandemic of a respiratory disease named coronavirus disease 2019 (COVID-19). SARS-CoV-2 is easily transmitted from person to person through respiratory droplets and direct contact. The scarce available data indicate that dental healthcare personnel are at increased risk for acquisition of infection. Following the lockdown lifting, dental schools should be prepared to refunction safely and provide essential educational and healthcare services while protecting their students, patients, and personnel. The generation of aerosols in dental practice, in association with the high-transmissibility of SARS-CoV-2 through aerosol-generation procedures, the simultaneous provision of dental services to patients in the same areas, and the fact that asymptomatic and pre-symptomatic infected persons may transmit the virus, render the implementation of specific infection prevention and control measures imperative for dental schools. Herein we review the few evidence-based data available to guide infection prevention and control measures for COVID-19 in dental schools.


Assuntos
/prevenção & controle , Pessoal de Saúde , Controle de Infecções/métodos , Faculdades de Odontologia , Aerossóis , Infecções Assintomáticas , Portador Sadio/transmissão , Portador Sadio/virologia , Humanos
2.
JAMA Netw Open ; 4(1): e2035057, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33410879

RESUMO

Importance: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiology of coronavirus disease 2019 (COVID-19), is readily transmitted person to person. Optimal control of COVID-19 depends on directing resources and health messaging to mitigation efforts that are most likely to prevent transmission, but the relative importance of such measures has been disputed. Objective: To assess the proportion of SARS-CoV-2 transmissions in the community that likely occur from persons without symptoms. Design, Setting, and Participants: This decision analytical model assessed the relative amount of transmission from presymptomatic, never symptomatic, and symptomatic individuals across a range of scenarios in which the proportion of transmission from people who never develop symptoms (ie, remain asymptomatic) and the infectious period were varied according to published best estimates. For all estimates, data from a meta-analysis was used to set the incubation period at a median of 5 days. The infectious period duration was maintained at 10 days, and peak infectiousness was varied between 3 and 7 days (-2 and +2 days relative to the median incubation period). The overall proportion of SARS-CoV-2 was varied between 0% and 70% to assess a wide range of possible proportions. Main Outcomes and Measures: Level of transmission of SARS-CoV-2 from presymptomatic, never symptomatic, and symptomatic individuals. Results: The baseline assumptions for the model were that peak infectiousness occurred at the median of symptom onset and that 30% of individuals with infection never develop symptoms and are 75% as infectious as those who do develop symptoms. Combined, these baseline assumptions imply that persons with infection who never develop symptoms may account for approximately 24% of all transmission. In this base case, 59% of all transmission came from asymptomatic transmission, comprising 35% from presymptomatic individuals and 24% from individuals who never develop symptoms. Under a broad range of values for each of these assumptions, at least 50% of new SARS-CoV-2 infections was estimated to have originated from exposure to individuals with infection but without symptoms. Conclusions and Relevance: In this decision analytical model of multiple scenarios of proportions of asymptomatic individuals with COVID-19 and infectious periods, transmission from asymptomatic individuals was estimated to account for more than half of all transmissions. In addition to identification and isolation of persons with symptomatic COVID-19, effective control of spread will require reducing the risk of transmission from people with infection who do not have symptoms. These findings suggest that measures such as wearing masks, hand hygiene, social distancing, and strategic testing of people who are not ill will be foundational to slowing the spread of COVID-19 until safe and effective vaccines are available and widely used.


Assuntos
/transmissão , Portador Sadio/transmissão , Número Básico de Reprodução , Portador Sadio/epidemiologia , Técnicas de Apoio para a Decisão , Humanos , Período de Incubação de Doenças Infecciosas
4.
Nature ; 590(7844): 134-139, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33348340

RESUMO

As countries in Europe gradually relaxed lockdown restrictions after the first wave, test-trace-isolate strategies became critical to maintain the incidence of coronavirus disease 2019 (COVID-19) at low levels1,2. Reviewing their shortcomings can provide elements to consider in light of the second wave that is currently underway in Europe. Here we estimate the rate of detection of symptomatic cases of COVID-19 in France after lockdown through the use of virological3 and participatory syndromic4 surveillance data coupled with mathematical transmission models calibrated to regional hospitalizations2. Our findings indicate that around 90,000 symptomatic infections, corresponding to 9 out 10 cases, were not ascertained by the surveillance system in the first 7 weeks after lockdown from 11 May to 28 June 2020, although the test positivity rate did not exceed the 5% recommendation of the World Health Organization (WHO)5. The median detection rate increased from 7% (95% confidence interval, 6-8%) to 38% (35-44%) over time, with large regional variations, owing to a strengthening of the system as well as a decrease in epidemic activity. According to participatory surveillance data, only 31% of individuals with COVID-19-like symptoms consulted a doctor in the study period. This suggests that large numbers of symptomatic cases of COVID-19 did not seek medical advice despite recommendations, as confirmed by serological studies6,7. Encouraging awareness and same-day healthcare-seeking behaviour of suspected cases of COVID-19 is critical to improve detection. However, the capacity of the system remained insufficient even at the low epidemic activity achieved after lockdown, and was predicted to deteriorate rapidly with increasing incidence of COVID-19 cases. Substantially more aggressive, targeted and efficient testing with easier access is required to act as a tool to control the COVID-19 pandemic. The testing strategy will be critical to enable partial lifting of the current restrictive measures in Europe and to avoid a third wave.


Assuntos
/estatística & dados numéricos , /prevenção & controle , Portador Sadio/epidemiologia , Modelos Biológicos , Distribuição por Idade , /transmissão , Portador Sadio/prevenção & controle , Portador Sadio/transmissão , Feminino , França/epidemiologia , Comportamentos Relacionados com a Saúde , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Pandemias/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fatores de Tempo , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Organização Mundial da Saúde
5.
Allergol Immunopathol (Madr) ; 48(5): 500-506, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32771236

RESUMO

The reasons for the relative resistance of children to certain infections such as that caused by coronavirus SARS-CoV2 are not yet fully clear. Deciphering these differences can provide important information about the pathogenesis of the disease. Regarding the SARS-CoV2 virus, children are at the same risk of infection as the general population of all ages, with the most serious cases being found in infants. However, it has been reported that the disease is much less frequent than in adults and that most cases are benign or moderate (even with high viral loads), provided there are no other risk factors or underlying diseases. It is not clear why they have lower morbidity and virtually no mortality. A series of findings, relationships and behavioral patterns between the infectious agent and the child host may account for the lower incidence and a greatly attenuated clinical presentation of the disease in children.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Adulto , Fatores Etários , Portador Sadio/transmissão , Portador Sadio/virologia , Criança , Coinfecção/epidemiologia , Coinfecção/imunologia , Coinfecção/patologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/transmissão , Humanos , Sistema Imunitário , Estilo de Vida , Melatonina/imunologia , Melatonina/metabolismo , Pandemias , Peptidil Dipeptidase A/imunologia , Peptidil Dipeptidase A/metabolismo , Vacinas Pneumocócicas/imunologia , Pneumonia Viral/imunologia , Pneumonia Viral/transmissão , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/patologia
6.
Infect Dis Poverty ; 9(1): 112, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787916

RESUMO

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) had spread worldwide. Although the world has intensively focused on the epidemic center during this period of time, it is imperative to emphasize that more attention should also be paid to some impoverished areas in China since they are more vulnerable to disease outbreak due to their weak health service capacities. Therefore, this study took Liangshan Yi Autonomous Prefecture as an example to analyze the COVID-19 epidemic in the impoverished area, evaluate the control effect and explore future control strategies. METHODS: In this study, we collected information including age, gender, nationality, occupation, and address of all COVID-19 cases reported from 25 January 2020 to 23 April 2020 in Liangshan Prefecture from the Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), which were used under license and not publicly available. Additionally, we retrieved other information of cases through epidemiological investigation reports reviewing. Data were analyzed using the software Excel 2010 and SPSS 17.0. The geographic distribution of cases was mapped using ArcGIS10.2. RESULTS: By 23 April 2020, a total of 13 COVID-19 cases and two asymptomatic SARS-CoV-2 carriers were reported in Liangshan, in three family clusters. Among the cases, eight cases had a history of sojourning in Hubei Province (61.54%), of which six were related to Wuhan. Cases aged under 44 years accounted for 61.54%, with no child case. The delay of patients' hospital visiting, and the low degree of cooperation in epidemiological investigation are problems. CONCLUSIONS: During the study period, Liangshan was well under control. This was mainly contributed to strict preventive strategies aimed at local culture, inter-sectoral coordination and highly degree of public cooperation. Besides, some possible environmentally and culturally preventive factors (e.g., rapid air flow and family concept) would affect disease prevention and control. In the next step, the health education about COVID-19 should be strengthened and carried out according to the special culture of ethnic minorities to enhance public awareness of timely medical treatment.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Áreas de Pobreza , Adulto , Distribuição por Idade , Idoso , Portador Sadio/epidemiologia , Portador Sadio/transmissão , Portador Sadio/virologia , China/epidemiologia , Análise por Conglomerados , Busca de Comunicante , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Quarentena , Análise Espacial , Fatores de Tempo , Adulto Jovem
7.
New Jersey; BMJ Best Practice; Ago. 6, 2020. 194 p.
Monografia em Inglês | BIGG - guias GRADE | ID: biblio-1116708

RESUMO

A potentially severe acute respiratory infection caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1] The clinical presentation is generally that of a respiratory infection with a symptom severity ranging from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal. Characteristic symptoms include fever, cough, and dyspnea, although some patients may be asymptomatic. Complications of severe disease include, but are not limited to, multi-organ failure, septic shock, and blood clots.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/diagnóstico por imagem , Grupos de Risco , Portador Sadio/transmissão , Pessoal de Saúde/organização & administração , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/diagnóstico por imagem , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pandemias/estatística & dados numéricos , Exacerbação dos Sintomas , Betacoronavirus/patogenicidade , Pneumonia Associada a Assistência à Saúde/diagnóstico , China/epidemiologia
8.
Epidemiol Infect ; 148: e132, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32611465

RESUMO

Hubei province in China has had the most confirmed coronavirus disease 2019 (COVID-19) cases and has reported sustained transmission of the disease. Although Lu'an city is adjacent to Hubei province, its community transmission was blocked at the early stage, and the impact of the epidemic was limited. Therefore, we summarised the overall characteristics of the entire epidemic course in Lu'an to help cities with a few imported cases better contain the epidemic. A total of 69 confirmed COVID-19 cases and 11 asymptomatic carriers were identified in Lu'an during the epidemic from 12 January to 21 February 2020. Fifty-two (65.0%) cases were male, and the median age was 40 years. On admission, 56.5% of cases had a fever as the initial symptom, and pneumonia was present in 89.9% of cases. The mean serial interval and the mean duration of hospitalisation were 6.5 days (95% CI: 4.8-8.2) and 18.2 days (95% CI: 16.8-19.5), respectively. A total of 16 clusters involving 60 cases (17 first-generation cases and 43 secondary cases) were reported during the epidemic. We observed that only 18.9% (7/37) index cases resulted in community transmission during the epidemic in Lu'an, indicating that the scale of the epidemic was limited to a low level in Lu'an city. An asymptomatic carrier caused the largest cluster, involving 13 cases. Spread of COVID-19 by asymptomatic carriers represents an enormous challenge for countries responding to the pandemic.


Assuntos
Portador Sadio/virologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Idoso , Portador Sadio/epidemiologia , Portador Sadio/transmissão , Criança , Pré-Escolar , China/epidemiologia , Cidades/epidemiologia , Análise por Conglomerados , Infecções por Coronavirus/transmissão , Feminino , Febre , Humanos , Lactente , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/transmissão , Vigilância da População/métodos , Fatores de Tempo , Adulto Jovem
9.
PLoS One ; 15(4): e0232456, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353071

RESUMO

Since its emergence in the early 2000s, livestock-associated methicillin-resistant Staphylococcus aureus clonal complex 398 (LA-MRSA CC398) has led to an increasing number of human infections in Denmark and other European countries with industrial pig production. LA-MRSA CC398 is primarily associated with skin infections among pig farm workers but is also increasingly recognized as a cause of life-threatening disease among elderly and immunocompromised people. Pig farm workers may serve as vehicles for the spread of LA-MRSA CC398 and other farm-origin bacteria between farms and into the general population. Yet, little is known about the bacterial community dynamics in pig farm workers and other persons with long- and short-term exposure to the pig farm environment. To gain insight into this, we investigated the nasal microbiomes in pig farm workers during a workweek on four LA-MRSA CC398-positive pig farms, as well as in short-term visitors two hours before, immediately after, and 48 hours after a 1-hour visit to another LA-MRSA CC398-positive pig farm. S. aureus and LA-MRSA CC398 carriage was quantified by means of culture, and the composition of the bacterial communities was investigated through sequencing of the 16S rRNA gene. Pig farm workers often carried LA-MRSA CC398 and other bacteria from the pig farm environment, both at work and at home, although at lower levels at home. In contrast, short-term visitors were subject to a less dramatic and rapidly reversible change in the nasal bacterial community composition. These results suggest that pig farm workers may be an important source of LA-MRSA CC398 and perhaps other pathogens of human and veterinary relevance.


Assuntos
Portador Sadio/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Exposição Ocupacional/efeitos adversos , Infecções Estafilocócicas/epidemiologia , Suínos/microbiologia , Adulto , Animais , Portador Sadio/microbiologia , Portador Sadio/transmissão , DNA Bacteriano/isolamento & purificação , Fazendas/estatística & dados numéricos , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/genética , Microbiota/genética , Pessoa de Meia-Idade , Nariz/microbiologia , RNA Ribossômico 16S/genética , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/transmissão , Fatores de Tempo , Adulto Jovem
10.
Infect Immun ; 88(4)2020 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-32014891

RESUMO

Streptococcus pyogenes (group A Streptococcus [GAS]) is a human pathogen responsible for a wide range of diseases. Asymptomatic carriage of GAS in the human pharynx is commonplace and a potential reservoir for GAS transmission. Early studies showed that GAS transmission correlated with high bacterial burdens during the acute symptomatic phase of the disease. Human studies and the nonhuman primate model are generally impractical for investigation of the bacterial mechanisms contributing to GAS transmission and persistence. To address this gap, we adapted an infant mouse model of pneumococcal colonization and transmission to investigate factors that influence GAS transmission and persistence. The model recapitulated the direct correlation between GAS burden and transmission during the acute phase of infection observed in humans and nonhuman primates. Furthermore, our results indicate that the ratio of colonized to uncolonized hosts influences the rates of GAS transmission and persistence. We used the model to test the hypothesis that capsule production influences GAS transmission and persistence in a strain-dependent manner. We detected significant differences in rates of transmission and persistence between capsule-positive (emm3) and capsule-negative (emm87) GAS strains. Capsule was associated with higher levels of GAS shedding, independent of the strain background. In contrast to the capsule-positive emm3 strain, restoring capsule production in emm87 GAS did not increase transmissibility, and the absence of capsule enhanced persistence only in the capsule-negative (emm87) strain background. These data suggest that strain background (capsule positive versus capsule negative) influences the effect of capsule in GAS transmission and persistence and that as-yet-undefined factors are required for the transmission of capsule-negative emm types.


Assuntos
Cápsulas Bacterianas/metabolismo , Carga Bacteriana , Transmissão de Doença Infecciosa , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/transmissão , Streptococcus pyogenes/crescimento & desenvolvimento , Fatores de Virulência/metabolismo , Animais , Animais Recém-Nascidos , Portador Sadio/microbiologia , Portador Sadio/transmissão , Modelos Animais de Doenças , Camundongos
11.
J Microbiol Immunol Infect ; 53(1): 179-182, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31607574

RESUMO

This article reports five invasive Group B streptococcal (GBS) infections that occurred in a neonatal intensive care unit for about 3 months. This outbreak might have been associated with a prolonged GBS colonized infant and adjacent environmental contaminations. Infection control interventions prevented the additional spread of GBS infections.


Assuntos
Portador Sadio/transmissão , Surtos de Doenças , Infecções Estreptocócicas/transmissão , Streptococcus agalactiae/fisiologia , Bacteriemia/microbiologia , Idade Gestacional , Humanos , Recém-Nascido , Controle de Infecções/métodos , Unidades de Terapia Intensiva Neonatal , Meningite/microbiologia , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/complicações
12.
Clin Microbiol Infect ; 26(4): 463-469, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31336200

RESUMO

OBJECTIVES: The objective of this study was to assess the prevalence of maternal recto-vaginal extended-spectrum ß-lactamase producing Enterobacteriacea (ESBL-E) colonization, identify risk factors for maternal and neonatal ESBL-E colonization, and subsequent impact on neonatal mortality. METHODS: A prospective, cross-sectional study was conducted at the University of Abuja Teaching Hospital from April 2016 to May 2017. Maternal-neonatal pairs were screened for ESBL-E exposure at time of delivery. Neonatal mortality was assessed at 28 days. RESULTS: A total of 1161 singleton deliveries were evaluated. In total, 9.7% (113/1161) of mothers and 4.3% (50/1161) of infants had ESBL-E-positive cultures at delivery. Maternal antibiotic exposure was associated with ESBL-E recto-vaginal colonization (18.6% (21/113) vs. 8.4% (88/1048), p < 0.001)). Maternal ESBL-E colonization (adjusted odds ratio (AOR) 14.85; 95% CI 7.83-28.15) and vaginal delivery (AOR 6.35; 95% CI 2.63-17.1) were identified as a risk factor for positive ESBL-E neonatal surface cultures. Neonatal positive ESBL-E surface cultures were a risk factor for neonatal mortality (stillbirths included, AOR 4.84; 95% CI 1.44-16.31). The finding that maternal ESBL-E recto-vaginal colonization appeared protective in regards to neonatal mortality (AOR 0.22; 95% CI .06-0.75) requires further evaluation. CONCLUSIONS: Maternal ESBL-E recto-vaginal colonization is an independent risk factor for neonatal ESBL-E colonization and neonates with positive ESBL-E surface cultures were identified as having increased risk of neonatal mortality.


Assuntos
Portador Sadio/microbiologia , Infecções por Enterobacteriaceae/transmissão , Enterobacteriaceae/fisiologia , Mães , Reto/microbiologia , Vagina/microbiologia , Adulto , Portador Sadio/epidemiologia , Portador Sadio/transmissão , Estudos Transversais , Enterobacteriaceae/enzimologia , Infecções por Enterobacteriaceae/epidemiologia , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Sepse Neonatal/etiologia , Sepse Neonatal/microbiologia , Nigéria/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , beta-Lactamases
13.
Einstein (Sao Paulo) ; 18: eRW4890, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31778464

RESUMO

OBJECTIVE: To demonstrate the impact of pneumococcal conjugate vaccine in Streptococcus pneumoniae carriage status in children younger than 5 years in Latin America and the Caribbean. METHODS: A systematic literature review was carried out on the direct and indirect effects of pneumococcal vaccine in the carriage status, after implementation in childhood immunization programs. Studies carried out in children younger than 5 years were selected from the PubMed® and Virtual Health Library databases, and data collected after implementation of pneumococcal vaccine in Latin America and the Caribbean, between 2008 and 2018. RESULTS: From 1,396 articles identified, 738 were selected based on titles and abstracts. After duplicate removal, 31 studies were eligible for full-text reading, resulting in 6 publications for analysis. All selected publications were observational studies and indicated a decrease in the carriage and vaccine types, and an increase in the circulation of non-vaccine serotypes, such as 6A, 19A, 35B, 21 and 38. We did not identify changes in the antimicrobial resistance after vaccine implementation. CONCLUSION: A decrease in the carriage status of vaccine types and non-vaccine types was detected. The continuous monitoring of pneumococcal vaccine effect is fundamental to demonstrate the impact of the carriage status and, consequently, of invasive pneumococcal disease, allowing better targeting approaches in countries that included pneumococcal vaccine in their immunization programs. Our study protocol was registered in PROSPERO (www.crd.york.ac.uk/prospero) under number CRD42018096719.


Assuntos
Portador Sadio/tratamento farmacológico , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Vacinas Conjugadas/administração & dosagem , Região do Caribe , Portador Sadio/transmissão , Pré-Escolar , Humanos , Programas de Imunização , Lactente , América Latina
14.
J Hosp Infect ; 104(3): 293-297, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31870885

RESUMO

BACKGROUND: Little is known about patient risk factors associated with environmental contamination. AIM: To evaluate the rate of environmental contamination and to investigate individual risk factors. METHODS: A prospective cohort study was conducted. Each day, five rooms occupied by patients were selected. Five critical surfaces were systematically swabbed twice a day before and after cleaning. Clinical characteristics of all patients were collected. Logisitic regression was performed to evaluate the association between environmental contamination and patients' characteristics. FINDINGS: A total of 107 consecutive patients were included and 1052 environmental samples were performed. Nineteen (18%) patients were known previously colonized/infected with a multidrug-resistant organism (MDRO). Respectively, 723 (69%) and 112 (11%) samples grew with ≥1 and >2.5 cfu/cm2 bacteria, resulting in 62 (58%) contaminated rooms. Considering positive samples with at least one pathogenic bacterium, 16 (15%) rooms were contaminated. By univariate and multivariate analysis, no variables analysed were associated with the environmental contamination. Considering contaminated rooms with >2.5 cfu/cm2, three factors were protective for environmental contamination: known MDRO carriers/infected patients (odds ratio: 0.25; 95% confidence interval: 0.09-0.72; P = 0.01), patients with urinary catheter (0.19; 0.04-0.89; P = 0.03) and hospitalization in single room (0.3; 0.15-0.6; P < 0.001). CONCLUSION: This study was conducted in a non-outbreak situation and showed a low rate of environmental contamination with pathogenic bacteria. Only 11% of environmental samples grew with >2.5 cfu/cm2, and they were related to non-pathogenic bacteria. No risk factors associated with environmental contamination were identified.


Assuntos
Bactérias/isolamento & purificação , Infecção Hospitalar/microbiologia , Microbiologia Ambiental , Portador Sadio/microbiologia , Portador Sadio/transmissão , Estudos de Coortes , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Reservatórios de Doenças , Humanos , Quartos de Pacientes , Estudos Prospectivos
16.
J Virol ; 93(21)2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31434730

RESUMO

Senecavirus A (SVA) is a picornavirus that causes acute vesicular disease (VD), that is clinically indistinguishable from foot-and-mouth disease (FMD), in pigs. Notably, SVA RNA has been detected in lymphoid tissues of infected animals several weeks following resolution of the clinical disease, suggesting that the virus may persist in select host tissues. Here, we investigated the occurrence of persistent SVA infection and the contribution of stressors (transportation, immunosuppression, or parturition) to acute disease and recrudescence from persistent SVA infection. Our results show that transportation stress leads to a slight increase in disease severity following infection. During persistence, transportation, immunosuppression, and parturition stressors did not lead to overt/recrudescent clinical disease, but intermittent viremia and virus shedding were detected up to day 60 postinfection (p.i.) in all treatment groups following stress stimulation. Notably, real-time PCR and in situ hybridization (ISH) assays confirmed that the tonsil harbors SVA RNA during the persistent phase of infection. Immunofluorescence assays (IFA) specific for double-stranded RNA (dsRNA) demonstrated the presence of double-stranded viral RNA in tonsillar cells. Most importantly, infectious SVA was isolated from the tonsil of two animals on day 60 p.i., confirming the occurrence of carrier animals following SVA infection. These findings were supported by the fact that contact piglets (11/44) born to persistently infected sows were infected by SVA, demonstrating successful transmission of the virus from carrier sows to contact piglets. Results here confirm the establishment of persistent infection by SVA and demonstrate successful transmission of the virus from persistently infected animals.IMPORTANCE Persistent viral infections have significant implications for disease control strategies. Previous studies demonstrated the persistence of SVA RNA in the tonsil of experimentally or naturally infected animals long after resolution of the clinical disease. Here, we showed that SVA establishes persistent infection in SVA-infected animals, with the tonsil serving as one of the sites of virus persistence. Importantly, persistently infected carrier animals shedding SVA in oral and nasal secretions or feces can serve as sources of infection to other susceptible animals, as evidenced by successful transmission of SVA from persistently infected sows to contact piglets. These findings unveil an important aspect of SVA infection biology, suggesting that persistently infected pigs may function as reservoirs for SVA.


Assuntos
Portador Sadio/veterinária , Transmissão Vertical de Doença Infecciosa/veterinária , Infecções por Picornaviridae/veterinária , Picornaviridae/patogenicidade , Doenças dos Suínos/transmissão , Animais , Portador Sadio/patologia , Portador Sadio/transmissão , Portador Sadio/virologia , Doença Crônica , Feminino , Tonsila Palatina/virologia , Infecções por Picornaviridae/patologia , Infecções por Picornaviridae/transmissão , Infecções por Picornaviridae/virologia , Recidiva , Estresse Fisiológico , Suínos , Doenças dos Suínos/patologia , Doenças dos Suínos/virologia , Viremia/patologia , Viremia/transmissão , Viremia/veterinária , Viremia/virologia , Eliminação de Partículas Virais
18.
J Clin Microbiol ; 57(9)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31270182

RESUMO

We sought here to investigate the patterns of Staphylococcus aureus carriage in the first year of life, its determinants, and the dynamics of transmission between mothers and infants. A prospective longitudinal cohort study of S. aureus carriage among mothers and their infants was performed, including monthly screenings from pregnancy/birth through the first year of the infant's life. Medical and lifestyle data were collected. Infant S. aureus carriage was detected from rectal and nasal swabs, and maternal carriage was detected from nasal and vaginal swabs. Multivariate analysis and a nonlinear mixed model (NLMIXED) were used to determine the predictors of carriage and S. aureus persistence. Of the 671 women recruited, 130 women carried S. aureus at recruitment (19.3%); they and their 132 infants were included in the study. A total of 93% of the infants acquired S. aureus sometime during the first year of life; 64% of these infants acquired the maternal strain, mostly (66%) during the first month of life. We observed that 70 women (52.50%) and 17 infants (14%) carried S. aureus persistently. Early acquisition of S. aureus carriage was associated with longer duration of initial carriage and was the most significant predictor of S. aureus persistence, while day care center attendance was negatively associated with persistent carriage. Methicillin-resistant S. aureus was carried by two infants for only 1 month each and not by any of the mothers. Early acquisition of S. aureus, mostly from the mother, is thus an important determinant of carriage persistence in infancy.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Transmissão Vertical de Doença Infecciosa , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Portador Sadio/transmissão , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Mucosa Nasal/microbiologia , Estudos Prospectivos , Reto/microbiologia , Infecções Estafilocócicas/transmissão , Vagina/microbiologia , Adulto Jovem
19.
J Hosp Infect ; 103(1): 21-26, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31283948

RESUMO

BACKGROUND: Whole genome sequencing (WGS) of Streptococcus pyogenes linked to invasive disease has been used to identify and investigate outbreaks. The clinical application of WGS in real-time for outbreak control is seldom employed. AIMS: A fatal case of bacteraemia at a national orthopaedic hospital prompted an outbreak investigation to identify carriers and halt transmission using real-time WGS. METHODS: Retrospective surveillance was conducted to identify patients with Streptococcus pyogenes infections in the last year. Upon contact tracing, four patients and 179 staff were screened for Streptococcus pyogenes carriage. All isolates identified were emm-typed. WGS was performed in real-time on a subset of isolates. FINDINGS: Twelve isolates of Streptococcus pyogenes from the index case, two patients and eight staff were identified. Six isolates were emm 1.0, including the index case and five staff isolates. The remaining isolates belonged to distinct emm types. WGS analysis was undertaken on the six emm 1.0 isolates. Five were indistinguishable by single nucleotide polymorphism (SNP) analysis, with 0 SNP distance, and one had one SNP difference, supporting the hypothesis of recent local transmission. All screen-positive healthcare workers were offered treatment with penicillin or clindamycin. No further cases were identified. CONCLUSION: The increased molecular discrimination of WGS confirmed the clustering of these cases and the outbreak was contained. This demonstrates the clinical utility of WGS in managing outbreaks of invasive Streptococcus pyogenes in real-time and we recommend its implementation as a routine clinical service.


Assuntos
Bacteriemia/epidemiologia , Portador Sadio/epidemiologia , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/classificação , Sequenciamento Completo do Genoma/métodos , Bacteriemia/microbiologia , Portador Sadio/microbiologia , Portador Sadio/transmissão , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Hospitais , Humanos , Epidemiologia Molecular/métodos , Tipagem Molecular/métodos , Estudos Retrospectivos , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/transmissão , Streptococcus pyogenes/genética , Streptococcus pyogenes/isolamento & purificação
20.
Pathog Dis ; 77(3)2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31247637

RESUMO

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) clones other than Clonal Complex (CC)398, as CC1, have been isolated in pigs in some countries, and appeared to be prevalent in Italy. The aim of this study was to evaluate the capability of Sequence Type (ST)1, CC1, LA-MRSA clone to colonize and to be transmitted among piglets. Eighteen caesarean-derived/colostrum-deprived piglets of 35 days of age were assigned randomly to three groups: four seeder piglets were contaminated with a spa type t127, ST1, SCCmec V, MRSA (Group A), 10 MRSA-negative piglets were exposed to Group A after 2 days post-contamination, dpc (Group B) and 4 piglets were used as control group (Group C). Piglets were evaluated until 44 dpc (Group A) or at 42 days post-exposure, dpe (Group B) and then euthanized and necropsied. All nasal and skin cultures of Group A resulted MRSA-positive throughout the experiment starting from two dpc, while Group C tested always MRSA-negative. At first sampling, all Group B piglets became positive and remained positive throughout the experiment. This is the first colonization/transmission study with a CC1 LA-MRSA in pigs. The results add further knowledge on the ability of CC1 LA-MRSA to colonize pigs, and on colonization/transmission patterns, both suggesting good host adaptation.


Assuntos
Portador Sadio/microbiologia , Portador Sadio/transmissão , Transmissão de Doença Infecciosa , Genótipo , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/veterinária , Suínos/microbiologia , Animais , Itália , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Tipagem de Sequências Multilocus , Cavidade Nasal/microbiologia , Pele/microbiologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/transmissão
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...