1
|
Michelin L, Bellei N, Ferreira da Costa Gomes M, Raboni SM, Kairalla M, Correa RA, Levi M, Chebabo A, Ballalai I, Cimerman S, Roteli-Martins CM, Aidé S, Dalcolmo MP, de Veras BMG, De Ávila Kfouri R, Cintra O. Respiratory syncytial virus: challenges in diagnosis and impact on the elderly: Recommendations from a multidisciplinary panel. Hum Vaccin Immunother 2024; 20:2388943. [PMID: 39161095 PMCID: PMC11340750 DOI: 10.1080/21645515.2024.2388943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024] Open
Abstract
Respiratory syncytial virus (RSV) is an important cause of respiratory illness. While most attention is paid to childhood infection, the RSV burden in adults ≥60 y should also be considered. In Brazil, this is generally underrecognized, where greater focus is toward other respiratory pathogens. This article presents insights from a multidisciplinary panel gathered to review epidemiologic data and current diagnostic approaches to RSV in Brazil (and their limitations) and develop communication strategies to improve knowledge and awareness. National surveillance data indicate a steady increase in cases of RSV-related severe acute respiratory illness (RSV-SARI) in those aged ≥60 y in recent years, with high fatality rates (>30%). Routine RSV testing in older individuals with respiratory symptoms is relatively low. Educational activities targeted toward health-care professionals and the general public are critical to raising awareness of the importance of RSV in older individuals, particularly as protective vaccines are now available.
Collapse
Affiliation(s)
| | - Nancy Bellei
- Laboratório de Virologia Clínica, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Disciplina de Infectologia, São Paulo, Brazil
| | | | - Sonia M Raboni
- Molecular Virology Research Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Ricardo Amorim Correa
- Departamento de Clínica Médica, Serviço de Pneumologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Monica Levi
- Sociedade Brasileira de Imunizações (SBim), São Paulo, Brazil
| | - Alberto Chebabo
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Isabela Ballalai
- Sociedade Brasileira de Imunizações (SBim), Rio de Janeiro, Brazil
| | - Sergio Cimerman
- Sociedade Brasileira de Imunizações (SBim), São Paulo, Brazil
- Instituto de Infectologia Emílio Ribas, São Paulo, Brazil
- Universidade Paulista (UNIP) - Campus Alphaville, São Paulo, Brazil
| | | | - Susana Aidé
- Maternal and Child Department, Faculty of Medicine, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | | | | | - Renato De Ávila Kfouri
- Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Sociedade Brasileira de Imunizações (SBim), São Paulo, Brazil
| | | |
Collapse
|
2
|
Allam VSRR, Patel VK, De Rubis G, Paudel KR, Gupta G, Chellappan DK, Singh SK, Hansbro PM, Oliver BGG, Dua K. Exploring the role of the ocular surface in the lung-eye axis: Insights into respiratory disease pathogenesis. Life Sci 2024; 349:122730. [PMID: 38768774 DOI: 10.1016/j.lfs.2024.122730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
Chronic respiratory diseases (CRDs) represent a significant proportion of global health burden, with a wide spectrum of varying, heterogenic conditions largely affecting the pulmonary system. Recent advances in immunology and respiratory biology have highlighted the systemic impact of these diseases, notably through the elucidation of the lung-eye axis. The current review focusses on understanding the pivotal role of the lung-eye axis in the pathogenesis and progression of chronic respiratory infections and diseases. Existing literature published on the immunological crosstalk between the eye and the lung has been reviewed. The various roles of the ocular microbiome in lung health are also explored, examining the eye as a gateway for respiratory virus transmission, and assessing the impact of environmental irritants on both ocular and respiratory systems. This novel concept emphasizes a bidirectional relationship between respiratory and ocular health, suggesting that respiratory diseases may influence ocular conditions and vice versa, whereby this conception provides a comprehensive framework for understanding the intricate axis connecting both respiratory and ocular health. These aspects underscore the need for an integrative approach in the management of chronic respiratory diseases. Future research should further elucidate the in-depth molecular mechanisms affecting this axis which would pave the path for novel diagnostics and effective therapeutic strategies.
Collapse
Affiliation(s)
- Venkata Sita Rama Raju Allam
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden; Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Vyoma K Patel
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, P.O. Box 123, Broadway, Ultimo, NSW 2007, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia; School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Gabriele De Rubis
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, P.O. Box 123, Broadway, Ultimo, NSW 2007, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Keshav Raj Paudel
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, School of Life Sciences, Faculty of Science, Sydney, NSW 2007, Australia
| | - Gaurav Gupta
- Centre for Global Health Research, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, India; School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India; School of Pharmacy, Suresh Gyan Vihar University, Jagatpura, Jaipur, India
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Sachin Kumar Singh
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia; School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Philip M Hansbro
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, School of Life Sciences, Faculty of Science, Sydney, NSW 2007, Australia
| | - Brian Gregory George Oliver
- Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia; School of Life Science, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, P.O. Box 123, Broadway, Ultimo, NSW 2007, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia.
| |
Collapse
|
3
|
Dörr T, Güsewell S, Flury D, Süveges M, Gaza Valera CB, Botero-Mesa S, Zanella MC, Iten A, Balmelli C, Troillet N, Tschudin-Sutter S, W Schreiber P, Jent P, Damonti L, Sommerstein R, Portmann L, Vuichard-Gysin D, Cusini A, Nussbaumer-Ochsner Y, Heininger U, Berger C, Zimmermann P, Gardiol C, Keiser O, Schlegel M, Kohler P, P Kuster S. Association of institutional masking policies with healthcare-associated SARS-CoV-2 infections in Swiss acute care hospitals during the BA.4/5 wave (CH-SUR study): a retrospective observational study. Antimicrob Resist Infect Control 2024; 13:64. [PMID: 38886813 PMCID: PMC11184728 DOI: 10.1186/s13756-024-01422-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave. METHODS SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model. RESULTS We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies. CONCLUSIONS Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.
Collapse
Affiliation(s)
- Tamara Dörr
- Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St Gallen, Rorschacher Strasse 95, St. Gallen, CH-9007, Switzerland
| | - Sabine Güsewell
- Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St Gallen, Rorschacher Strasse 95, St. Gallen, CH-9007, Switzerland
| | - Domenica Flury
- Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St Gallen, Rorschacher Strasse 95, St. Gallen, CH-9007, Switzerland
| | - Maria Süveges
- Faculté de Médecine de l'Université de Genève, Institut de Santé Globale, 24 rue du Général- Dufour, Genève 4, 1211, Switzerland
| | - Camille Beatrice Gaza Valera
- Faculté de Médecine de l'Université de Genève, Institut de Santé Globale, 24 rue du Général- Dufour, Genève 4, 1211, Switzerland
| | - Sara Botero-Mesa
- Faculté de Médecine de l'Université de Genève, Institut de Santé Globale, 24 rue du Général- Dufour, Genève 4, 1211, Switzerland
| | - Marie-Céline Zanella
- Service de prévention et contrôle de l'infection, Direction médicale et qualité, Hôpitaux universitaires Genève, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
- Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
| | - Anne Iten
- Service de prévention et contrôle de l'infection, Direction médicale et qualité, Hôpitaux universitaires Genève, Rue Gabrielle-Perret-Gentil 4, Genève, 1205, Switzerland
| | - Carlo Balmelli
- Infection Control Programme, EOC Hospitals, Viale Officina 3, Bellinzona, 6500, Switzerland
| | - Nicolas Troillet
- Service of Infectious Diseases, Central Institute, Valais Hospitals, Av. Grand-Champsec 80, Sion, 1951, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University of Basel, Petersgraben 4, Basel, 4031, Switzerland
| | - Peter W Schreiber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
| | - Philipp Jent
- Department of Infectious Diseases, Bern University Hospital (Inselspital), University of Bern, Länggassstrasse 122, Bern, 3012, Switzerland
| | - Lauro Damonti
- Department of Infectious Diseases, Bern University Hospital (Inselspital), University of Bern, Länggassstrasse 122, Bern, 3012, Switzerland
| | - Rami Sommerstein
- Department of Infectious Diseases, Bern University Hospital (Inselspital), University of Bern, Länggassstrasse 122, Bern, 3012, Switzerland
- Faculty of Health Sciences and Medicine, Clinic St. Anna, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Lea Portmann
- Faculty of Health Sciences and Medicine, Clinic St. Anna, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Danielle Vuichard-Gysin
- Department of Infectious Diseases, Thurgau Cantonal Hospital, Spitalcampus 1, Muensterlingen, 8596, Switzerland
| | - Alexia Cusini
- Department of Infectious Diseases, Cantonal Hospital Graubuenden, Loëstrasse 170, Chur, 7000, Switzerland
| | - Yvonne Nussbaumer-Ochsner
- Klinik für Innere Medizin, Kantonsspital Spitäler Schaffhausen, Geissbergstrasse 81, Schaffhausen, 8208, Switzerland
| | - Ulrich Heininger
- Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Spitalstrasse 33, Basel, 4056, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, 8032, Switzerland
| | - Petra Zimmermann
- Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, Fribourg, 1700, Switzerland
- Department of Paediatrics, Fribourg Hospital HFR, Chemin des Pensionnats 2-6, Fribourg, Villars-sur-Glâne, 1752, Switzerland
| | - Céline Gardiol
- Swiss Federal Office of Public Health, Schwarzenburgstrasse 157, Bern, 3003, Switzerland
| | - Olivia Keiser
- Faculté de Médecine de l'Université de Genève, Institut de Santé Globale, 24 rue du Général- Dufour, Genève 4, 1211, Switzerland
| | - Matthias Schlegel
- Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St Gallen, Rorschacher Strasse 95, St. Gallen, CH-9007, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St Gallen, Rorschacher Strasse 95, St. Gallen, CH-9007, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases, Infection Prevention and Travel Medicine, Cantonal Hospital St Gallen, Rorschacher Strasse 95, St. Gallen, CH-9007, Switzerland.
| |
Collapse
|
4
|
Centrone F, Loconsole D, Marziani A, Orlando VA, delle Fontane A, Minelli M, Chironna M. Respiratory Syncytial Virus (RSV) Hospitalizations in the Elderly in a Tertiary Care Hospital in Southern Italy as a Useful Proxy for Targeting Vaccine Preventive Strategies. Infect Dis Rep 2024; 16:491-498. [PMID: 38920893 PMCID: PMC11204164 DOI: 10.3390/idr16030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy. Fifty-two RSV-positive patients were identified from the 2014-2015 to the 2022-2023 seasons. RSV type B was found in 71.2% of cases. The median age was 78 years (IQR: 72-84) and 40.4% of the subjects had at least one comorbidity; 5.8% needed intensive care. The use of combined rapid tests for SARS-CoV-2/influenza/RSV identification in primary care settings may contribute to an improved definition of the burden of RSV in the elderly. The implementation of an anti-RSV vaccination strategy in the elderly population would reduce direct and indirect infection costs. More robust epidemiological data in Italy are needed for targeted preventive strategies.
Collapse
Affiliation(s)
- Francesca Centrone
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Daniela Loconsole
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Alfredo Marziani
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Valentina Annachiara Orlando
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Arianna delle Fontane
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Martina Minelli
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (D.L.); (A.M.); (V.A.O.); (A.d.F.); (M.M.)
| |
Collapse
|
5
|
Correa RA, Arancibia F, De Ávila Kfouri R, Chebabo A, García G, Gutiérrez Robledo LM, Lopardo G, Nemerovsky J, Pérez CM, Rendon A, Ruiz-Palacios GM, Aggarwal B, Berzanskis A, Cintra O. Understanding the Burden of Respiratory Syncytial Virus in Older Adults in Latin America: An Expert Perspective on Knowledge Gaps. Pulm Ther 2024; 10:1-20. [PMID: 38358618 PMCID: PMC10881952 DOI: 10.1007/s41030-024-00253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024] Open
Abstract
Respiratory syncytial virus (RSV) is a significant global health concern and major cause of hospitalization, particularly among infants and older adults. The clinical impact of RSV is well characterized in infants; however, in many countries, the burden and risk of RSV in older populations are overlooked. In Latin America, there are limited data on RSV epidemiology and disease management in older adults. Therefore, the impact of RSV in this region needs to be addressed. Here, current insights on RSV infections in older populations in Latin America, including those with underlying health conditions, are discussed. We also outline the key challenges limiting our understanding of the burden of RSV in Latin America in a worldwide context and propose an expert consensus to improve our understanding of the burden of RSV in the region. By so doing, we aim to ultimately improve disease management and outcomes of those at risk and to alleviate the impact on healthcare systems.A graphical plain language summary is available with this article.
Collapse
Affiliation(s)
- Ricardo Amorim Correa
- Medical School, Pulmonology and Thoracic Surgery Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Arancibia
- Pulmonary Department, Instituto Nacional del Tórax and Clínica Santa María, Santiago de Chile, Chile
| | - Renato De Ávila Kfouri
- Pediatric Infectious Disease Specialist, Brazilian Pediatric Society and Brazilian Immunization, São Paulo, Brazil
| | - Alberto Chebabo
- University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luis Miguel Gutiérrez Robledo
- National Institute of Medical Sciences and Nutrition "S Zubiran" and National Institute of Geriatric Medicine, Mexico City, Mexico
| | - Gustavo Lopardo
- Infectious Diseases Department, Hospital Bernardo Houssay, Buenos Aires, Argentina
| | - Julio Nemerovsky
- Geriatrician Physician, Argentine Society of Gerontology and Geriatrics, Buenos Aires, Argentina
| | - Carlos M Pérez
- Faculty of Medicine and Science, Universidad San Sebastian, Santiago, Chile
| | - Adrian Rendon
- Universidad Autonoma de Nuevo León, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias (CIPTIR), Monterrey, Mexico
| | - Guillermo M Ruiz-Palacios
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | | | | | | |
Collapse
|
6
|
O'Callaghan C, Cloutman-Green E, Brierley J. Pandemic preparedness: is the UK ready for a pandemic that affects children? BMJ 2023; 383:2804. [PMID: 38016735 DOI: 10.1136/bmj.p2804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Chris O'Callaghan
- University College London, Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre. London
| | - Elaine Cloutman-Green
- Great Ormond Street Hospital, Great Ormond Street, London
- Department of Civil, Environmental and Geomatic Engineering, University College London
| | - Joe Brierley
- Paediatric Bioethics Centre, Great Ormond Street Hospital, London
| |
Collapse
|
7
|
Olsen M, Demaneuf T, Singh G, Goldsworthy A, Jones P, Morgan M, Nassar R, Senok A, Ghemrawi R, Almheiri R, Marzooqi HA, Almansoori S, Albastaki A, Almansoori R, McKirdy S, Alghafri R, Tajouri L. Do mobile phone surfaces carry SARS-CoV-2 virus? A systematic review warranting the inclusion of a "6th" moment of hand hygiene in healthcare. J Infect Public Health 2023; 16:1750-1760. [PMID: 37738691 DOI: 10.1016/j.jiph.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Mobile phones, used in billions throughout the world, are high-touch devices subject to a dynamic contamination of microorganisms and rarely considered as an important fomite to sanitise systematically. The emergence of SARS-CoV-2 resulted in the COVID-19 pandemic, arguably the most impactful pandemic of the 21st century with millions of deaths and disruption of all facets of modern life globally. AIM To perform a systematic review of the literature exploring SARS-CoV-2 presence as a contaminant on mobile phones. METHODS A systematic search (PubMed and Google Scholar) of literature was undertaken from December 2019 to March 2023 identifying English language studies. Studies included in this review specifically identified or tested for the contamination of the SARS-CoV-2 virus or genome on mobile phones while studies testing for SARS-COV-2 in environments and/or other fomites samples than but not mobile phones were excluded. RESULTS A total of 15 studies with reports of SARS-CoV-2 contamination on mobile phones between 2020 and 2023 were included. Amongst all studies, which encompassed ten countries, 511 mobile phones were evaluated for the presence of SARS-CoV-2 contamination and 45% (231/511) were positive for SARS-CoV-2. All studies were conducted in the hospital setting and two studies performed additional testing in residential isolation rooms and a patient's house. Four studies (3 in 2020 and one in 2021) reported 0% contamination while two other studies (in 2020 and 2022) reported 100% of mobile phone contamination with SARS-COV-2. All other studies report mobile phones positive for the virus within a range of 4-77%. CONCLUSION A total of 45% of mobile phones are contaminated with SARS-CoV-2 virus. These devices might be an important fomite vector for viral dissemination worldwide. Competent health authorities are advised/recommended to start a global implementation of mobile phone decontamination by introducing regulations and protocols in public health and health care settings such as the 6th moment of hand washing.
Collapse
Affiliation(s)
- Matthew Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | | | - Gobinddeep Singh
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Adrian Goldsworthy
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Peter Jones
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Mark Morgan
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates; School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rose Ghemrawi
- College of Pharmacy, Al Ain University, P.O. Box 112612, Abu Dhabi, United Arab Emirates
| | - Reem Almheiri
- General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates
| | - Hussain Al Marzooqi
- Dubai Police Scientists Council, Dubai Police, Dubai, United Arab Emirates; General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates
| | - Sumaya Almansoori
- General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates
| | - Abdullah Albastaki
- Dubai Police Scientists Council, Dubai Police, Dubai, United Arab Emirates; General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates
| | - Rashid Almansoori
- Dubai Police Scientists Council, Dubai Police, Dubai, United Arab Emirates; General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates
| | - Simon McKirdy
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Rashed Alghafri
- Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia; General Department of Forensic Sciences and Criminology, Dubai Police, Dubai, United Arab Emirates
| | - Lotti Tajouri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia; Dubai Police Scientists Council, Dubai Police, Dubai, United Arab Emirates; Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia.
| |
Collapse
|
8
|
Zhao L, Wu L, Xu W, Wei J, Niu X, Liu G, Yu L, Wu Y, Zhou Q, Liu L. Diagnostic techniques for critical respiratory infections: Update on current methods. Heliyon 2023; 9:e18957. [PMID: 37600408 PMCID: PMC10432708 DOI: 10.1016/j.heliyon.2023.e18957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Respiratory infections, whether chronic or acute, are frequent in both children and adults and result in an economic burden in health care systems. In particular, for an immunocompromised patient, respiratory infection leads to acute hypoxemic respiratory failure, a leading cause of intensive care unit (ICU) admission. Most respiratory infections are caused by bacteria, viruses, parasites, smoking, or air pollution. Over the last two decades, considerable improvements have been made in understanding and identifying respiratory infections. Various biosensing techniques have been developed with a range of targets to identify the infection at earlier stages. Recently, nanomaterials have been effectively applied to improve biosensors and their analytical performances. This review discusses recent biosensor developments for identifying respiratory infections caused by viruses and bacteria assisted by different types of nanomaterials and target molecules.
Collapse
Affiliation(s)
| | | | | | - Jing Wei
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| | - Xiaorong Niu
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| | - GuoYin Liu
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| | - Li Yu
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| | - Ying Wu
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| | - Qiang Zhou
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| | - Lu Liu
- Chaoyang District of the Third Hospital, 1268 Jiuzhou Street, Xihu District, Nanchang City, Jiangxi Province, China
| |
Collapse
|
9
|
Jaggessar A, Velic A, Spann K, Yarlagadda PKDV. Titanium dioxide nanostructures that reduce the infectivity of respiratory syncytial virus. MATERIALS TODAY. PROCEEDINGS 2023:S2214-7853(23)03330-8. [PMID: 38620140 PMCID: PMC10289122 DOI: 10.1016/j.matpr.2023.05.711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
The spread of respiratory diseases has gained significant attention since the detection and rapid global spread of COVID-19. Respiratory viruses are commonly transmitted when an infected person coughs or sneezes onto a surface, infecting persons who subsequently contact this surface. For this reason, developing surfaces with inherent antipathogenic properties is crucially needed for controlling the spread of deadly pathogens. Recent studies have established the antipathogenic potential of hydrothermally synthesised titanium dioxide (TiO2) nanostructured surfaces against bacteria strains (Gram-positive and negative) and several respiratory viruses, including SARS-CoV-2, HRV-16 and HCoV-NL63. This study investigates the antiviral behaviour of TiO2 nanostructured surfaces against Respiratory Syncytial Virus (RSV), a respiratory virus commonly contracted by children, to reduce viral transmission in high-traffic environments such as hospitals and childcare centers. Mimicking droplets produced when a person coughs or sneezes, RSV droplets were exposed to nanostructured surfaces to investigate their antiviral potential. Results show that nanostructured TiO2 reduced the RSV infectious viral load at all timepoints compared to control surfaces, showing 1.7, 2.6 and 3.2 log reductions after 2-, 5- and 7-hours exposure, respectively. Interestingly, virus exposed to nanostructured surfaces showed little to no infectivity after 5 h exposure while viable virus was still detected on control surfaces after 7 h exposure. These encouraging results establish TiO2 nanostructured surfaces as a potential method for reducing transmission and spread of respiratory viruses and bacterial strains.
Collapse
Affiliation(s)
- Alka Jaggessar
- Queensland University of Technology, School of Mechanical, Medical and Process Engineering, 2 George Street, Brisbane 4000, Australia
- Queensland University of Technology, Centre for Biomedical Technologies, 2 George Street, Brisbane 4000, Australia
| | - Amar Velic
- Queensland University of Technology, School of Mechanical, Medical and Process Engineering, 2 George Street, Brisbane 4000, Australia
- Queensland University of Technology, Centre for Biomedical Technologies, 2 George Street, Brisbane 4000, Australia
| | - Kirsten Spann
- Queensland University of Technology, School of Biomedical Science, 2 George Street, Brisbane 4000, Australia
- Queensland University of Technology, Centre for Immunology and Infection Control, 2 George Street, Brisbane 4000, Australia
| | - Prasad K D V Yarlagadda
- University of Southern Queensland, School of Engineering, Springfield Central Queensland, 4300, Australia
| |
Collapse
|
10
|
Teirlinck AC, Johannesen CK, Broberg EK, Penttinen P, Campbell H, Nair H, Reeves RM, Bøås H, Brytting M, Cai W, Carnahan A, Casalegno JS, Danis K, De Gascun C, Ellis J, Emborg HD, Gijon M, Guiomar R, Hirve SS, Jiřincová H, Nohynek H, Oliva JA, Osei-Yeboah R, Paget J, Pakarna G, Pebody R, Presser L, Rapp M, Reiche J, Rodrigues AP, Seppälä E, Socan M, Szymanski K, Trebbien R, Večeřová J, van der Werf S, Zambon M, Meijer A, Fischer TK. New perspectives on respiratory syncytial virus surveillance at the national level: lessons from the COVID-19 pandemic. Eur Respir J 2023; 61:2201569. [PMID: 37012081 PMCID: PMC10069872 DOI: 10.1183/13993003.01569-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/10/2023] [Indexed: 04/05/2023]
Abstract
The emergence of SARS-CoV-2 and the resulting coronavirus disease 2019 (COVID-19) pandemic has led to the reconsideration of surveillance strategies for respiratory syncytial virus (RSV) and other respiratory viruses. The COVID-19 pandemic and the non-pharmaceutical interventions for COVID-19 had a substantial impact on RSV transmission in many countries, with close to no transmission detected during parts of the usual season of 2020–2021. Subsequent relaxation of social restrictions has resulted in unusual out-of-season resurgences of RSV in several countries, causing a higher healthcare burden and often a higher proportion of hospitalisations than usual among children older than 1 year in age [1]. In case of an emerging infectious disease with pandemic potential, preparedness to scale up surveillance for the emerging disease while continuing the maintenance of surveillance activities of pre-existing seasonal diseases is necessary. Learning from the COVID-19 pandemic and considering the effects of this pandemic, we provide recommendations that can guide towards sustainable RSV surveillance with the potential to be integrated into the broader perspective of respiratory surveillance. https://bit.ly/40TsO0G
Collapse
Affiliation(s)
- Anne C Teirlinck
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Caroline K Johannesen
- Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, and University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Harish Nair
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Håkon Bøås
- Norwegian Institute of Public Health, Oslo, Norway
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Wei Cai
- Robert Koch Institute, Berlin, Germany
| | | | - Jean-Sebastien Casalegno
- Centre National de Référence des virus des infections respiratoires dont la grippe, Hospices Civils de Lyon, Lyon, France
| | - Kostas Danis
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | | | | | | | - Raquel Guiomar
- National Institute of Health Ricardo Jorge, Lisbon, Portugal
| | | | | | - Hanna Nohynek
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Jesus Angel Oliva
- Instituto de Salud Carlos III Madrid, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | | | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Lance Presser
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Marie Rapp
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | | | - Maja Socan
- National Institute of Public Health, Ljubljana, Slovenia
| | - Karol Szymanski
- National Institute of Public Health NIH National Research Institute, Warsaw, Poland
| | | | | | | | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Thea K Fischer
- Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, and University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| |
Collapse
|
11
|
Clinical impact of healthcare-associated respiratory syncytial virus in hospitalized adults. Infect Control Hosp Epidemiol 2023; 44:433-439. [PMID: 36372395 PMCID: PMC10015267 DOI: 10.1017/ice.2022.128] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the clinical impact of healthcare-associated (HA) respiratory syncytial virus (RSV) in hospitalized adults. DESIGN Retrospective cohort study within a prospective, population-based, surveillance study of RSV-infected hospitalized adults during 3 respiratory seasons: October 2017-April 2018, October 2018-April 2019, and October 2019-March 2020. SETTING The study was conducted in 2 academically affiliated medical centers. PATIENTS Each HA-RSV patient (in whom RSV was detected by PCR test ≥4 days after hospital admission) was matched (age, sex, season) with 2 community-onset (CO) RSV patients (in whom RSV was detected ≤3 days of admission). METHODS Risk factors and outcomes were compared among HA-RSV versus CO-RSV patients using conditional logistic regression. Escalation of respiratory support associated with RSV detection (day 0) from day -2 to day +4 was explored among HA-RSV patients. RESULTS In total, 84 HA-RSV patients were matched to 160 CO-RSV patients. In HA-RSV patients, chronic kidney disease was more common, while chronic respiratory conditions and obesity were less common. HA-RSV patients were not more likely to be admitted to an ICU or require mechanical ventilation, but they more often required a higher level of care at discharge compared with CO-RSV patients (44% vs 14%, respectively). Also, 29% of evaluable HA-RSV patients required respiratory support escalation; these patients were older and more likely to have respiratory comorbidities, to have been admitted to intensive care, and to die during hospitalization. CONCLUSIONS HA-RSV in adults may be associated with escalation in respiratory support and an increased level of support in living situation at discharge. Infection prevention and control strategies and RSV vaccination of high-risk adults could mitigate the risk of HA-RSV.
Collapse
|
12
|
Löwensteyn YN, Willemsen JE, Mazur NI, Scheltema NM, van Haastregt NCJ, Buuren AAAT, van Roessel I, Scheepmaker D, Nair H, van de Ven PM, Bont LJ. Nosocomial RSV-related In-hospital Mortality in Children <5 Years: A Global Case Series. Pediatr Infect Dis J 2023; 42:1-7. [PMID: 36476518 PMCID: PMC9891274 DOI: 10.1097/inf.0000000000003747] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND According to the World Health Organization, the global burden of nosocomial infections is poorly characterized as surveillance systems are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on community-acquired infection. We aimed to characterize children with nosocomial RSV-related mortality and to understand the potential impact of RSV immunization strategies. MATERIALS RSV GOLD is a global registry of children younger than 5 years who died with laboratory-confirmed RSV infection. We compared clinical and demographic characteristics of children with nosocomial and community-acquired RSV in-hospital mortality. RESULTS We included 231 nosocomial and 931 community-acquired RSV-related in-hospital from deaths from 65 countries. Age at death was similar for both groups (5.4 vs. 6 months). A higher proportion of nosocomial deaths had comorbidities (87% vs. 57%; P < 0.001) or was born preterm (46% vs. 24%; P < 0.001) than community-acquired deaths. The proportion of nosocomial deaths among all RSV deaths was lower in LMICs than in upper-middle-income countries (UMICs) and HICs (12% vs. 18% and 26%, respectively). CONCLUSIONS This is the first global case series of children dying with nosocomial RSV infection. Future infant-targeted immunization strategies could prevent the majority of nosocomial RSV-related deaths. Although nosocomial RSV deaths are expected to occur at highest rates in LMICs, the number of reported nosocomial RSV deaths was low in these countries. Hospital-based surveillance is needed to capture the full burden of nosocomial RSV mortality in LMICs.
Collapse
Affiliation(s)
- Yvette N. Löwensteyn
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Joukje E. Willemsen
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Natalie I. Mazur
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Nienke M. Scheltema
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Nynke C. J. van Haastregt
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Amber A. A. ten Buuren
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Ichelle van Roessel
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Dunja Scheepmaker
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, Zeist, The Netherlands
| | - Peter M. van de Ven
- Julius Center for Health Sciences and Primary Care, Department of Data Science and Biostatistics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Louis J. Bont
- Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, Zeist, The Netherlands
| |
Collapse
|
13
|
Busack B, Shorr AF. Going Viral-RSV as the Neglected Adult Respiratory Virus. Pathogens 2022; 11:1324. [PMID: 36422576 PMCID: PMC9692430 DOI: 10.3390/pathogens11111324] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 09/17/2023] Open
Abstract
Human respiratory syncytial virus (RSV) is increasingly recognized as a significant viral pathogen in adults with acute respiratory illness, particularly in the elderly, the immunocompromised, and those with underlying cardiopulmonary disease. Although long acknowledged as one of the most common causes of upper respiratory tract infections (URI) in children since its discovery in 1956, the true burden of disease in adults is likely significantly under-recognized. The emerging evidence of RSV as a driver of morbidity and mortality in elderly and immunocompromised patients has sparked advances in vaccine development and renewed interest in quantifying the true burden of disease. This review attempts to summarize the findings of the most recent evidence investigating the burden of RSV related disease in adults and to highlight where future research is needed.
Collapse
Affiliation(s)
- Bethany Busack
- Department of Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA
- Pulmonary and Critical Care Medicine Section, Medstar Washington Hospital Center, Washington, DC 20010, USA
| | - Andrew F. Shorr
- Department of Medicine, Medstar Washington Hospital Center, Washington, DC 20010, USA
- Pulmonary and Critical Care Medicine Section, Medstar Washington Hospital Center, Washington, DC 20010, USA
| |
Collapse
|
14
|
Dalziel SR, Haskell L, O'Brien S, Borland ML, Plint AC, Babl FE, Oakley E. Bronchiolitis. Lancet 2022; 400:392-406. [PMID: 35785792 DOI: 10.1016/s0140-6736(22)01016-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/27/2022] [Accepted: 05/26/2022] [Indexed: 02/06/2023]
Abstract
Viral bronchiolitis is the most common cause of admission to hospital for infants in high-income countries. Respiratory syncytial virus accounts for 60-80% of bronchiolitis presentations. Bronchiolitis is diagnosed clinically without the need for viral testing. Management recommendations, based predominantly on high-quality evidence, advise clinicians to support hydration and oxygenation only. Evidence suggests no benefit with use of glucocorticoids or bronchodilators, with further evidence required to support use of hypertonic saline in bronchiolitis. Evidence is scarce in the intensive care unit. Evidence suggests use of high-flow therapy in bronchiolitis is limited to rescue therapy after failure of standard subnasal oxygen only in infants who are hypoxic and does not decrease rates of intensive care unit admission or intubation. Despite systematic reviews and international clinical practice guidelines promoting supportive rather than interventional therapy, universal de-implementation of interventional care in bronchiolitis has not occurred and remains a major challenge.
Collapse
Affiliation(s)
- Stuart R Dalziel
- Department of Surgery, The University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand; Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
| | - Libby Haskell
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand; Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand
| | - Sharon O'Brien
- Emergency Department, Perth Children's Hospital, Perth, WA, Australia; School of Nursing, Curtin University, Perth, WA, Australia
| | - Meredith L Borland
- Emergency Department, Perth Children's Hospital, Perth, WA, Australia; Division of Paediatrics, School of Medicine, University of Western Australia, Perth, WA, Australia; Division of Emergency Medicine, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Amy C Plint
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada; Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada; Emergency Department, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Franz E Babl
- Department of Emergency Medicine, Royal Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Ed Oakley
- Department of Emergency Medicine, Royal Children's Hospital, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| |
Collapse
|
15
|
Baier C, Huang J, Reumann K, Indenbirken D, Thol F, Koenecke C, Ebadi E, Heim A, Bange FC, Haid S, Pietschmann T, Fischer N. Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients. Antimicrob Resist Infect Control 2022; 11:88. [PMID: 35729671 PMCID: PMC9210056 DOI: 10.1186/s13756-022-01120-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) causes community-acquired respiratory tract infections during winter. However, outbreaks in hospitals also occur repeatedly. In particular, patients with hematologic malignancies are at an increased risk for a severe and potentially fatal course of RSV infection. Here we present the investigation of an RSV outbreak in a hematology ward for adults following the ORION statement. Methods An epidemiologic and molecular outbreak analysis was performed. We developed and employed a minimal oligonucleotide probe set in target capture probe sequencing that allows cost-effective RSV-A or -B capturing to reconstruct RSV genomes from clinical samples. Results Four adult patients were involved in the outbreak caused by RSV-B in March 2019. The enforcement of the pre-existing infection control measures by effective training of hospital staff contributed to a successful containment. PCR-based RSV screening on the ward enabled early detection of new cases and rapid isolation measures. The molecular analysis demonstrated that the outbreak sequences were highly related and distinct to other RSV-B strains circulating at the same time. Conclusions A multimodal infection control concept is essential for the timely detection and control of RSV outbreaks in patients with hematological disease. Among other measures, preventive screening for respiratory viruses is recommended. Furthermore, the integration of conventional and molecular epidemiology, such as whole-genome sequencing and variant calling, significantly contributes to the understanding of transmission pathways. Based on this, appropriate conclusions can be drawn for targeted prevention measures that have prepared us for the COVID-19 pandemic beyond the RSV approach described here. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01120-z.
Collapse
|
16
|
Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc07. [PMID: 35707229 PMCID: PMC9174886 DOI: 10.3205/dgkh000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Germany, guidelines for hygiene in hospitals are given in form of recommendations by the Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, "KRINKO"). The KRINKO and its voluntary work are legitimized by the mandate according to § 23 of the Infection Protection Act (Infektionsschutzgesetz, "IfSG"). The original German version of this document was published in February 2021 and has now been made available to the international professional public in English. The guideline provides recommendations on infection prevention and control for immunocompromised individuals in health care facilities. This recommendation addresses not only measures related to direct medical care of immunocompromised patients, but also management aspects such as surveillance, screening, antibiotic stewardship, and technical/structural aspects such as patient rooms, air quality, and special measures during renovations.
Collapse
|
17
|
Saravanos GL, Hsu P, Isaacs D, Macartney K, Wood NJ, Britton PN. Respiratory Syncytial Virus-attributable Deaths in a Major Pediatric Hospital in New South Wales, Australia, 1998-2018. Pediatr Infect Dis J 2022; 41:186-191. [PMID: 34845151 DOI: 10.1097/inf.0000000000003398] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection and an important contributor to child mortality. In this study, we estimated the frequency and described the clinical features of RSV-attributable deaths in Australian children. METHODS We conducted a retrospective observational study of RSV-associated deaths in hospitalized children <16 years of age over a 21-year period (1998-2018) in a pediatric tertiary/quaternary referral hospital in New South Wales (NSW), Australia. RSV-associated deaths were identified, reviewed, and classified according to RSV contribution to death. For 'RSV-attributable' deaths, we estimated frequency, case fatality ratio (CFR), and population death rate. We described demographic and clinical features of cases. RESULTS There were 20 RSV-attributable deaths. RSV was considered the primary cause of death for five cases and a contributory cause for 15 cases. The CFR among hospitalized cases was 0.2% (20/9779). The annual death rate was 0.6 per 10,000 hospitalized children. The population death rate was 1.2 (95% confidence interval 0.5-2.7) per million children <16 years of age in NSW. The median age at death was 28.7 months (interquartile range 8.8-75.0). All children had at least one medical comorbidity. Over half the deaths occurred in children ≥2 years of age (11, 55%). RSV healthcare-associated infection (RSV-HAI) was common (11, 55%). CONCLUSIONS RSV-attributable death is infrequent in this setting. Deaths occurred exclusively in children with medical comorbidity and a high proportion were RSV-HAI. Children with medical comorbidity, including those ≥2 years of age, should be prioritized for targeted prevention of RSV disease.
Collapse
Affiliation(s)
- Gemma L Saravanos
- From the Discipline of Child and Adolescent Health, University of Sydney
- National Centre for Immunisation Research and Surveillance
| | - Peter Hsu
- From the Discipline of Child and Adolescent Health, University of Sydney
- Department of Allergy and Immunology, The Children's Hospital at Westmead
| | - David Isaacs
- From the Discipline of Child and Adolescent Health, University of Sydney
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead
| | - Kristine Macartney
- From the Discipline of Child and Adolescent Health, University of Sydney
- National Centre for Immunisation Research and Surveillance
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead
| | - Nicholas J Wood
- From the Discipline of Child and Adolescent Health, University of Sydney
- National Centre for Immunisation Research and Surveillance
- Department of General Paediatric Medicine, The Children's Hospital at Westmead
| | - Philip N Britton
- From the Discipline of Child and Adolescent Health, University of Sydney
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead
- Sydney Medical School and Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
18
|
Kielt MJ, Murphy A, Smathers J, Bates M, Nelin LD, Shepherd EG. In-hospital respiratory viral infections for patients with established BPD in the SARS-CoV-2 era. Pediatr Pulmonol 2022; 57:200-208. [PMID: 34596351 PMCID: PMC8662151 DOI: 10.1002/ppul.25714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/13/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Our objective was to test the hypothesis that in-hospital respiratory viral infections (RVI) would be significantly lower in a cohort of patients with established bronchopulmonary dysplasia (BPD) exposed to a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prevention protocol when compared to historical controls. STUDY DESIGN On April 1, 2020, we implemented a universal infection prevention protocol to minimize the risk of nosocomial SARS-CoV-2 transmission in a dedicated BPD intensive care unit. We performed a retrospective cohort study and included patients with established BPD, as defined by the 2019 Neonatal Research Network criteria, admitted to our center who underwent real-time polymerase-chain-reaction RVI testing between January 1, 2015 and March 31, 2021. We excluded patients readmitted from home. We compared the proportion of positive tests to the number of tests performed and the distribution of viral respiratory pathogens in the pre- and post-SARS-CoV-2 eras. RESULTS Among 176 patients included in the study, 663 RVI tests were performed and 172 (26%) tests were positive. The median number of tests performed, measured in tests per patient per month, in the SARS-CoV-2 era was not significantly different compared to the pre-SARS-CoV-2 era (0.45 vs. 0.34 tests per patient per month, p = .07). The proportion of positive RVI tests was significantly lower in the SARS-CoV-2 era when compared to the pre-SARS-CoV-2 era (0.06 vs. 0.30, p < .0001). No patients tested positive for SARS-CoV-2 in the SARS-CoV-2 era. CONCLUSIONS Infection prevention measures developed in response to the SARS-CoV-2 pandemic may reduce the risk of RVIs in hospitalized patients with established BPD.
Collapse
Affiliation(s)
- Matthew J Kielt
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Angela Murphy
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jodi Smathers
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - MaLeah Bates
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Leif D Nelin
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, Ohio, USA.,Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Edward G Shepherd
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, Ohio, USA
| |
Collapse
|
19
|
Simpson R, Sandrin R. The use of personal protective equipment (PPE) by police during a public health crisis: An experimental test of public perception. JOURNAL OF EXPERIMENTAL CRIMINOLOGY 2022; 18:297-319. [PMID: 33456429 PMCID: PMC7794074 DOI: 10.1007/s11292-020-09451-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 05/09/2023]
Abstract
OBJECTIVES To experimentally evaluate the effects of personal protective equipment (PPE) on participants' perceptions of police during the COVID-19 pandemic. METHODS As part of the experimental paradigm, participants were randomly assigned to read a fictitious news article about the utility of PPE (i.e., pro-PPE, anti-PPE, or neutral), and then rate images of a police officer using different items of PPE (i.e., masks, goggles, face shields, and/or medical gloves) along eight dimensions. RESULTS The analyses reveal that participants overwhelmingly perceived the use of PPE as both important and beneficial, regardless of condition. The analyses also reveal that the use of PPE impacted perceptions of the pictured officer, but that the specific perceptual effects of such PPE varied by the item used. CONCLUSIONS Police worldwide have attempted to reduce the risks associated with COVID-19 by using PPE. In addition to functional benefits, many items of PPE also present perceptual benefits.
Collapse
Affiliation(s)
- Rylan Simpson
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia Canada
| | - Ryan Sandrin
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia Canada
| |
Collapse
|
20
|
Abstract
Human respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus that can result in epidemics of seasonal respiratory infections. Generally, one of the two genotypes (A and B) predominates in a single season and alternate annually with regional variation. RSV is a known cause of disease and death at both extremes of ages in the pediatric and elderly, as well as immunocompromised populations. The clinical impact of RSV on the hospitalized adults has been recently clarified with the expanded use of multiplex molecular assays. Among adults, RSV can produce a wide range of clinical symptoms due to upper respiratory tract infections potentially leading to severe lower respiratory tract infections, as well as exacerbations of underlying cardiac and lung diseases. While supportive care is the mainstay of therapy, there are currently multiple therapeutic and preventative options under development.
Collapse
Affiliation(s)
- Hannah H Nam
- Department of Infectious Diseases, University of California, Irvine, Orange, California
| | - Michael G Ison
- Division of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
21
|
Otomaru H, Sornillo JBT, Kamigaki T, Bado SLP, Okamoto M, Saito-Obata M, Inobaya MT, Segubre-Mercado E, Alday PP, Saito M, Tallo VL, Quiambao BP, Oshitani H, Cook AR. Risk of Transmission and Viral Shedding From the Time of Infection for Respiratory Syncytial Virus in Households. Am J Epidemiol 2021; 190:2536-2543. [PMID: 34216204 PMCID: PMC8634588 DOI: 10.1093/aje/kwab181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 11/12/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection worldwide, but reports of temporal changes in the risk of transmission among close contacts has been scarce. This study aimed to examine an association between the viral load trajectory and transmission risk to develop a better control strategy for the disease spread. We conducted a household-based prospective cohort study in Biliran Province, the Philippines, and enrolled 451 participants to observe the development of acute respiratory infection. Including the cases found at the health-care facility, we analyzed the data of viral loads with symptom records obtained from 172 followed participants who had household member positive for RSV with a rapid test during an RSV outbreak in 2018-2019. We developed a model estimating a temporal change in the viral shedding from the infection and evaluated transmission dynamics. We found that most transmission events occurred within approximately 7 days of the household exposure, including potential presymptomatic transmissions. The inferred risk of infection among those younger than 5 years was 3.5 times higher than that of those older than 5 years. This finding suggested that the initial week after the household exposure is particularly important for preventing RSV spread.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Alex R Cook
- Correspondence to Dr. Alex Cook, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 12 Science Drive 2, Singapore, Singapore 117549 (e-mail: )
| |
Collapse
|
22
|
Observational Study of Hand Hygiene Compliance at a Trauma Hospital in Iraqi Kurdistan. J 2021. [DOI: 10.3390/j4040054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Healthcare-associated infections, commonly caused by poor hand hygiene, represent a significant source of disease and economic burden for healthcare systems, especially those in resource-limited settings. The few existing studies on hand hygiene compliance in resource-limited hospital settings suggest that compliance is insufficient. The difference in compliance rates between units in resource-limited trauma hospitals is largely unknown. We aimed to assess hand hygiene compliance rates among healthcare workers at a trauma hospital in Iraqi Kurdistan and compare the levels of compliance between the emergency room (ER), the intensive care unit (ICU), and the acute care ward (ACW). We carried out overt observations in 2018 using the validated World Health Organization ‘five moments for hand hygiene’ observational tool. We observed a total of 622 hand hygiene opportunities performed by 149 healthcare workers. Hand hygiene compliance was defined as handwashing with soap and water or the use of alcohol-based hand rub, in accordance with the ‘five moments for hand hygiene’ concept. Overall, the hand hygiene compliance rate was found to be 6.8% (95% confidence interval 5.0–9.1). Compliance was significantly lower in the ER (1.0%), compared with the ICU (8.1%) (p = 0.0012), and the ACW (11.1%) (p < 0.0001). In all three units, the availability of alcohol-based hand rub and handwashing sinks was insufficient in relation to the number of patient beds. We conclude that the overall level of hand hygiene compliance was low, with the lowest level of compliance in the ER. Our findings call for improved resource allocation and strengthened hand hygiene routines. These relatively simple measures could potentially lower the incidence of healthcare-associated infections and improve the mortality and morbidity of patients in already overburdened healthcare systems.
Collapse
|
23
|
Parente C, Montgomery R, Berry L, Mahida N. Impact of universal mask wearing in reducing healthcare-associated respiratory virus infections in haematology patients. J Hosp Infect 2021; 119:192-193. [PMID: 34757036 DOI: 10.1016/j.jhin.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022]
Affiliation(s)
- C Parente
- Department of Clinical Microbiology, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK
| | - R Montgomery
- Infection Prevention and Control Department, Nottingham City Hospital, Nottingham University Hospitals, Nottingham, UK
| | - L Berry
- Department of Clinical Virology, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK
| | - N Mahida
- Department of Clinical Microbiology, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK.
| |
Collapse
|
24
|
Occupational Health and Safety Measures in Healthcare Settings during COVID-19: Strategies for Protecting Staff, Patients and Visitors. Disaster Med Public Health Prep 2021; 17:e48. [PMID: 34517932 PMCID: PMC8523969 DOI: 10.1017/dmp.2021.294] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The COVID-19 (SARS-CoV-2) pandemic has profoundly impacted almost every aspect of healthcare systems worldwide, placing the health and safety of frontline healthcare workers at risk, and it still continues to remain an important public health challenge. Several hospitals have put in place strategies to manage space, staff, and supplies in order to continue to deliver optimum care to patients while at the same time protecting the health and safety of staff and patients. However, the emergence of the second and third waves of the virus with the influx of new cases continue to add an additional level of complexity to the already challenging situation of containing the spread and lowering the rate of transmission, thus pushing healthcare systems to the limit. In this narrative review paper, we describe various strategies including administrative controls, environmental controls, and use of personal protective equipment, implemented by occupational health and safety departments for the protection of healthcare workers, patients, and visitors from SARS-CoV-2 virus infection. The protection and safeguard of the health and safety of healthcare workers and patients through the implementation of effective infection control measures, adequate management of possible outbreaks and minimization of the risk of nosocomial transmission is an important and effective strategy of SARS-CoV-2 pandemic management in any healthcare facility. High quality patient care hinges on ensuring that the care providers are well protected and supported so they can provide the best quality of care to their patients.
Collapse
|
25
|
Wang H, Chen L, Zheng Y, Zheng D, Zhang Y, Wu J, Chen B. Evaluation of the effect of surgical nursing management in the control of nosocomial infection. Minerva Surg 2021; 77:296-299. [PMID: 34342403 DOI: 10.23736/s2724-5691.21.09033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Houxia Wang
- Department of Emergency, Liyang People's Hospital, Liyang, China
| | - Ling Chen
- Lung Disease Division, Changzhou Hospital of traditional Chinese Medicine, Changzhou, China
| | - Yapping Zheng
- Department of Neurology, Liyang People's Hospital, Liyang, China
| | - Danping Zheng
- Department of Nursing, Liyang People's Hospital, Liyang, China
| | - Yidan Zhang
- Hospital Infection Management Department, Liyang People's Hospital, Liyang, China
| | - Jie Wu
- Hospital Infection Management Department, Liyang People's Hospital, Liyang, China
| | - Bo Chen
- Intravenous Drug Dispensing Center, Liyang People's Hospital, Liyang, China -
| |
Collapse
|
26
|
Chorazka M, Flury D, Herzog K, Albrich WC, Vuichard-Gysin D. Clinical outcomes of adults hospitalized for laboratory confirmed respiratory syncytial virus or influenza virus infection. PLoS One 2021; 16:e0253161. [PMID: 34292983 PMCID: PMC8297903 DOI: 10.1371/journal.pone.0253161] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/28/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives Respiratory syncytial virus (RSV) can cause severe disease in adults, but far less is known than for influenza. The aim of our study was to compare the disease course of RSV infections with influenza infections among hospitalized adults. Methods We retrieved clinical data from an ongoing surveillance of adults hospitalized with RSV or influenza virus infection in two acute care hospitals in North-Eastern Switzerland during the winter seasons 2017/2018 and 2018/2019. Our main analysis compared the odds between RSV and influenza patients for admission to an intensive care unit (ICU) or in-hospital death within 7 days after admission. Results There were 548 patients, of whom 79 (14.4%) had an RSV and 469 (85.6%) an influenza virus infection. Both groups were similar with respect to age, sex, smoking status, nutritional state, and comorbidities. More RSV patients had an infiltrate on chest radiograph on admission (46.4% vs 29.9%, p = .007). The proportion of patients with RSV who died or were admitted to ICU within seven days after admission was 19.0% compared to 10.2% in influenza patients (p = .024). In multivariable analysis, a higher leukocyte count (adjusted OR 1.07, 95% CI 1.02–1.13, p = .013) and the presence of a pneumonic infiltrate (aOR 3.41, 95% CI 1.93–6.02) significantly increased the risk for experiencing the adverse primary outcome while the effect of the underlying viral pathogen became attenuated (aOR 1.18, 95% CI 0.58–2.41, p = .0.655). Conclusions Our results suggest that RSV is responsible for clinical courses at least as severe as influenza in adults. This supports the need for better guidance on diagnostic strategies as well as on preventive and therapeutic measures for hospitalized adults with RSV infection.
Collapse
Affiliation(s)
- Magdalena Chorazka
- Department of Internal Medicine, Cantonal Hospital Muensterlingen, Thurgau Hospital Group, Muensterlingen, Switzerland
| | - Domenica Flury
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Kathrin Herzog
- Department of Clinical Microbiology, Thurgau Hospital Group, Muensterlingen, Switzerland
| | - Werner C. Albrich
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Danielle Vuichard-Gysin
- Department of Internal Medicine, Cantonal Hospital Muensterlingen, Thurgau Hospital Group, Muensterlingen, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Muensterlingen, Thurgau Hospital Group, Muensterlingen, Switzerland
- * E-mail:
| |
Collapse
|
27
|
Wark PA, MacIntyre CR, Bell S, Oliver B, Marks GB. We are not doing enough to prevent the spread of COVID-19 and other respiratory viruses in Australian hospitals. Med J Aust 2021; 215:152-153.e1. [PMID: 34291464 PMCID: PMC8447400 DOI: 10.5694/mja2.51183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Peter Ab Wark
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW
| | | | - Scott Bell
- QIMR Berghofer Medical Research Institute, Brisbane, QLD.,Adult Cystic Fibrosis Centre, Prince Charles Hospital, Brisbane, QLD
| | - Brian Oliver
- Respiratory Research Group, University of Technology Sydney, Sydney, NSW
| | | |
Collapse
|
28
|
Weldetsadik AY, Riedel F. Respiratory syncytial virus in severe lower respiratory infections in previously healthy young Ethiopian infants. BMC Pediatr 2021; 21:201. [PMID: 33910510 PMCID: PMC8080344 DOI: 10.1186/s12887-021-02675-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Respiratory Syncytial Virus (RSV) is the commonest cause of acute lower respiratory infections (ALRI) in infants. However, the burden of RSV is unknown in Ethiopia. We aimed to determine the prevalence, seasonality and predictors of RSV infection in young infants with ALRI for the first time in Ethiopia. METHODS We performed RSV immuno-chromatographic assay from nasopharyngeal swabs of infants, 29 days to 6 months of age. We included the first 10 eligible infants in each month from June 2018 to May 2019 admitted in a tertiary pediatric center. Clinical, laboratory and imaging data were also collected, and chi-square test and regression were used to assess associated factors with RSV infection. RESULTS Among a total of 117 study children, 65% were male and mean age was 3 months. Bronchiolitis was the commonest diagnosis (49%). RSV was isolated from 26 subjects (22.2%) of all ALRI, 37% of bronchiolitis and 11% of pneumonia patients. Although RSV infection occurred year round, highest rate extended from June to November. No clinical or laboratory parameter predicted RSV infection and only rainy season (Adjusted Odds Ratio (AOR) 10.46 [95%. C.I. 1.95, 56.18]) was independent predictor of RSV infection. CONCLUSIONS RSV was isolated in a fifth of young infants with severe ALRI, mostly in the rainy season. Diagnosis of RSV infection in our setting require specific tests as no clinical parameter predicted RSV infection. Since RSV caused less than a quarter of ALRI in our setting, the other causes should be looked for in future studies.
Collapse
Affiliation(s)
| | - Frank Riedel
- Pediatric Pulmonology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
29
|
Yeh JC, Subbiah IM, Dhawan N, Thompson BW, Hildner Z, Jawed A, Prommer E, Sinclair CT. Visitation policies at NCI-designated comprehensive cancer centers during the COVID-19 pandemic. Support Care Cancer 2021; 29:4895-4898. [PMID: 33796936 PMCID: PMC8016614 DOI: 10.1007/s00520-021-06183-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/24/2021] [Indexed: 11/24/2022]
Abstract
Purpose Family/caregiver visitation provides critical support for patients confronting cancer and is associated with positive outcomes. However, the COVID-19 pandemic brought historic disruptions including widespread visitation restrictions. Here, we characterize in-depth the visitor policies of NCI-designated comprehensive cancer centers (CCCs) and analyze geographic/temporal patterns across CCCs. Methods The public-facing CCC websites, including archived webpages, were reviewed to abstract initial visitation policies and revisions, including end-of-life (EoL) exceptions and timing of visitation restrictions relative to regional lockdowns. Chi-squared and Fisher’s exact tests were employed to analyze associations between geographic region, timing, and severity of restrictions. Results Most CCCs (n=43, 86%) enacted visitation restrictions between March 15 and April 15, 2020. About half barred all visitors for COVID-negative inpatients (n=24, 48%) or outpatients (n=26, 52%). Most (n=36, 72%) prohibited visitors for patients with confirmed/suspected COVID-19. Most (n=40, 80%) published EoL exceptions but the specifics were highly variable. The median time from initial restrictions to government-mandated lockdowns was 1 day, with a wide range (25 days before to 26 days after). There was no association between timing of initial restrictions and geographic location (p=0.14) or severity of inpatient policies (p=1.0), even among centers in the same city. Outpatient policies published reactively (after lockdown) were more restrictive than those published proactively (p=0.04). Conclusion CCCs enacted strict but strikingly variable COVID-19 visitation restrictions, with important implications for patients/families seeking cancer care. A unified, evidence-based approach to visitation policies is needed to balance proven infection control measures with the needs of patients and families.
Collapse
Affiliation(s)
- Jonathan C Yeh
- Section of Palliative Care, Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA, USA
| | - Ishwaria M Subbiah
- Department of Palliative, Rehabilitation and Integrative Medicine, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA.
| | - Natasha Dhawan
- Hematology and Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Benjamin W Thompson
- Section of Palliative Care, Department of Medicine, Prisma Health, Columbia, SC, USA
| | - Zachary Hildner
- Division of Palliative Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Areeba Jawed
- Department of Medicine, Division of Nephrology and Supportive Care, Wayne State University School of Medicine, Detroit, MI, USA
| | - Eric Prommer
- UCLA/VA Hospice and Palliative Medicine Program, UCLA School of Medicine, Los Angeles, CA, USA
| | - Christian T Sinclair
- Division of Palliative Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| |
Collapse
|
30
|
Abstract
OBJECTIVES To assess the overall burden and outcomes of acute respiratory infections in paediatric inpatients with congenital heart disease (CHD). METHODS This is a retrospective cross-sectional study of non-neonates <1 year with CHD in the Kid's Inpatient Database from 2012. We compared demographics, clinical characteristics, cost, length of stay, and mortality rate for those with and without respiratory infections. We also compared those with respiratory infections who had critical CHD versus non-critical CHD. Multi-variable regression analyses were done to look for associations between respiratory infections and mortality, length of stay, and cost. RESULTS Of the 28,696 infants with CHD in our sample, 26% had respiratory infections. Respiratory infection-associated hospitalisations accounted for $440 million in costs (32%) for all CHD patients. After adjusting for confounders including severity, mortality was higher for those with respiratory infections (OR 1.5, p = 0.003), estimated mean length of stay was longer (14.7 versus 12.2 days, p < 0.001), and estimated mean costs were higher ($53,760 versus $46,526, p < 0.001). Compared to infants with respiratory infections and non-critical CHD, infants with respiratory infections and critical CHD had higher mortality (4.5 versus 2.3%, p < 0.001), longer mean length of stay (20.1 versus 15.5 days, p < 0.001), and higher mean costs ($94,284 versus $52,585, p < 0.001). CONCLUSION Acute respiratory infections are a significant burden on infant inpatients with CHD and are associated with higher mortality, costs, and longer length of stay; particularly in those with critical CHD. Future interventions should focus on reducing the burden of respiratory infections in this population.
Collapse
|
31
|
Park CE. Diagnostic Methods of Respiratory Virus Infections and Infection Control. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Chang-Eun Park
- Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University, Cheonan, Korea
| |
Collapse
|
32
|
Rose EB, Washington EJ, Wang L, Benowitz I, Thornburg NJ, Gerber SI, Peret TCT, Langley GE. Multiple Respiratory Syncytial Virus Introductions Into a Neonatal Intensive Care Unit. J Pediatric Infect Dis Soc 2021; 10:118-124. [PMID: 32249314 DOI: 10.1093/jpids/piaa026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/06/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Outbreaks of respiratory syncytial virus (RSV) in neonatal intensive care units (NICUs) are of concern because of the risk of severe disease in young infants. We describe an outbreak of RSV in a NICU and use whole genome sequencing (WGS) to better understand the relatedness of viruses among patients. METHODS An investigation was conducted to identify patients and describe their clinical course. Infection control measures were implemented to prevent further spread. Respiratory specimens from outbreak-related patients and the community were tested using WGS. Phylogenetic trees were constructed to understand relatedness of the viruses. RESULTS Seven patients developed respiratory symptoms within an 11-day span in December 2017 and were diagnosed with RSV; 6 patients (86%) were preterm and 1 had chronic lung disease. Three patients required additional respiratory support after symptom onset, and none died. Six of 7 patients were part of the same cluster based on > 99.99% nucleotide agreement with each other and 3 unique single-nucleotide polymorphisms were identified in viruses sequenced from those patients. The seventh patient was admitted from the community with respiratory symptoms and had a genetically distinct virus that was not related to the other 6. Implementation of enhanced infection control measures likely limited the spread. CONCLUSIONS Using WGS, we found 2 distinct introductions of RSV into a NICU, highlighting the risk of healthcare-associated infections during RSV season. Early recognition and infection control measures likely limited spread, emphasizing the importance of considering RSV in the differential diagnosis of respiratory infections in healthcare settings.
Collapse
Affiliation(s)
- Erica Billig Rose
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Erica J Washington
- Louisiana Department of Health, Office of Public Health, Infectious Disease Epidemiology Section, New Orleans, Louisiana, USA
| | - Lijuan Wang
- IHRC Inc, contracting agency to the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Isaac Benowitz
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie J Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Teresa C T Peret
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gayle E Langley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
33
|
Kumari S, Chatterjee K. Biomaterials-based formulations and surfaces to combat viral infectious diseases. APL Bioeng 2021; 5:011503. [PMID: 33598595 PMCID: PMC7881627 DOI: 10.1063/5.0029486] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022] Open
Abstract
Rapidly growing viral infections are potent risks to public health worldwide. Accessible virus-specific antiviral vaccines and drugs are therapeutically inert to emerging viruses, such as Zika, Ebola, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, discovering ways to prevent and control viral infections is among the foremost medical challenge of our time. Recently, innovative technologies are emerging that involve the development of new biomaterial-based formulations and surfaces endowed with broad-spectrum antiviral properties. Here, we review emerging biomaterials technologies for controlling viral infections. Relevant advances in biomaterials employed with nanotechnology to inactivate viruses or to inhibit virus replication and further their translation in safe and effective antiviral formulations in clinical trials are discussed. We have included antiviral approaches based on both organic and inorganic nanoparticles (NPs), which offer many advantages over molecular medicine. An insight into the development of immunomodulatory scaffolds in designing new platforms for personalized vaccines is also considered. Substantial research on natural products and herbal medicines and their potential in novel antiviral drugs are discussed. Furthermore, to control contagious viral infections, i.e., to reduce the viral load on surfaces, current strategies focusing on biomimetic anti-adhesive surfaces through nanostructured topography and hydrophobic surface modification techniques are introduced. Biomaterial surfaces functionalized with antimicrobial polymers and nanoparticles against viral infections are also discussed. We recognize the importance of research on antiviral biomaterials and present potential strategies for future directions in applying these biomaterial-based approaches to control viral infections and SARS-CoV-2.
Collapse
Affiliation(s)
- Sushma Kumari
- Department of Materials Engineering, Indian Institute of Science, Bangalore 560012, India
| | - Kaushik Chatterjee
- Department of Materials Engineering, Indian Institute of Science, Bangalore 560012, India
| |
Collapse
|
34
|
Hababou Y, Taleb A, Recoing A, Moreau F, Simon I, Muller de Schongor F, Gault E, Rameix-Welti MA. Molecular investigation of a RSV outbreak in a geriatric hospital. BMC Geriatr 2021; 21:120. [PMID: 33579210 PMCID: PMC7880219 DOI: 10.1186/s12877-021-02064-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce. METHODS RSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed. RESULTS Molecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak's cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died. CONCLUSIONS This case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.
Collapse
Affiliation(s)
- Yohan Hababou
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Assia Taleb
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Amélie Recoing
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Frédérique Moreau
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Isabelle Simon
- AP-HP, Université Paris Saclay, Hôpital Sainte Perrine, Equipe opérationnelle d'hygiène, Paris, France
| | | | - Elyanne Gault
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France.,Université Paris-Saclay, INSERM, Université de Versailles St. Quentin, UMR 1173 (2I), Versailles, France
| | - Marie-Anne Rameix-Welti
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France. .,Université Paris-Saclay, INSERM, Université de Versailles St. Quentin, UMR 1173 (2I), Versailles, France.
| |
Collapse
|
35
|
Anforderungen an die Infektionsprävention bei der medizinischen Versorgung von immunsupprimierten Patienten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:232-264. [PMID: 33394069 PMCID: PMC7780910 DOI: 10.1007/s00103-020-03265-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
36
|
Transmission of SARS CoV-2 virus through the ocular mucosa worth taking precautions. VACUNAS (ENGLISH EDITION) 2021. [PMCID: PMC7882915 DOI: 10.1016/j.vacune.2021.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
|
37
|
Newman H, Tshabalala D, Mabunda S, Nkosi N, Carelson C. Rapid testing for respiratory syncytial virus in a resource-limited paediatric intensive care setting. Afr J Lab Med 2020; 9:1084. [PMID: 38361787 PMCID: PMC10867673 DOI: 10.4102/ajlm.v9i1.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 08/12/2020] [Indexed: 02/17/2024] Open
Abstract
We analysed the performance characteristics of the respiratory syncytial virus lateral flow rapid antigen assay in use when compared to a multiplex polymerase chain reaction for detection of respiratory viruses. The study was conducted at a tertiary paediatric hospital in Port Elizabeth, South Africa, from 01 January 2017 to 31 December 2018. We found the clinical sensitivity (36.8%) of the rapid test to be too low for routine diagnostic use. Knowledge of assay performance characteristics of rapid tests are important for appropriate interpretation of rapid test results.
Collapse
Affiliation(s)
- Howard Newman
- National Health Laboratory Service, Virology, Port Elizabeth, South Africa
- Department of Pathology, Division of Medical Virology, Stellenbosch University, Cape Town, South Africa
- Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Donald Tshabalala
- Department of Paediatrics, Nelson Mandela Academic Hospital, Mthatha, South Africa
- Department of Paediatrics, Walter Sisulu University, Mthatha, South Africa
| | - Sikhumbuzo Mabunda
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
- Mpumalanga Department of Health, Nelspruit, South Africa
| | - Nokwazi Nkosi
- Department of Pathology, Division of Medical Virology, Stellenbosch University, Cape Town, South Africa
- National Health Laboratory Service, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Candice Carelson
- National Health Laboratory Service, Virology, Port Elizabeth, South Africa
| |
Collapse
|
38
|
Franck KT, Schneider UV, Ma CMG, Knudsen D, Lisby G. Evaluation of immuview RSV antigen test (SSI siagnostica) and BinaxNOW RSV card (alere) for rapid detection of respiratory syncytial virus in retrospectively and prospectively collected respiratory samples. J Med Virol 2020; 92:2992-2998. [PMID: 32725889 DOI: 10.1002/jmv.26369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/06/2020] [Accepted: 07/20/2020] [Indexed: 12/16/2022]
Abstract
Human orthopneumovirus, formerly known as respiratory syncytial virus (RSV), is a frequent cause of hospitalization among infants due to respiratory tract infection. Fast, reliable, and easy to perform tests are needed to optimize treatment and to identify children that should be contact isolated to avoid nosocomial outbreaks. We prospectively tested 200 respiratory samples with a new assay (ImmuView RSV Antigen Test, SSI Diagnostica) and compared the results to the Alere BinaxNOW RSV Card by using our laboratory-developed real-time reverse transcription polymerase chain reaction (PCR) as reference. In addition, 300 retrospectively collected respiratory samples were included in the study. The sensitivities of both antigen kits were very low (<50%). Sensitivities were higher when samples came from children less than 6 years, when samples came from nasopharynx or lower respiratory airways, or when samples were positive for RSV serotype A compared to when samples came from adults, samples were throat swabs, or samples were positive for RSV serotype B. In conclusion, the ImmuView RSV antigen kit did not perform well and may at the most be used as a quick guidance for clinical decision. Thus, it cannot stand alone without reverse transcription PCR confirmation of negative results.
Collapse
Affiliation(s)
- Kristina T Franck
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Uffe V Schneider
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
- Uffe V. Schneider, Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - Chih M G Ma
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Danah Knudsen
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Gorm Lisby
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
39
|
Białobrzeska W, Firganek D, Czerkies M, Lipniacki T, Skwarecka M, Dziąbowska K, Cebula Z, Malinowska N, Bigus D, Bięga E, Pyrć K, Pala K, Żołędowska S, Nidzworski D. Electrochemical Immunosensors Based on Screen-Printed Gold and Glassy Carbon Electrodes: Comparison of Performance for Respiratory Syncytial Virus Detection. BIOSENSORS 2020; 10:E175. [PMID: 33202922 PMCID: PMC7698328 DOI: 10.3390/bios10110175] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022]
Abstract
This paper presents the development and comparison of label-free electrochemical immunosensors based on screen-printed gold and glassy carbon (GC) disc electrodes for efficient and rapid detection of respiratory syncytial virus (RSV). Briefly, the antibody specific to the F protein of RSV was successfully immobilized on modified electrodes. Antibody coupling on the Au surface was conducted via 4-aminothiophenol (4-ATP) and glutaraldehyde (GA). The GC surface was modified with poly-L-lysine (PLL) for direct anti-RSV conjugation after EDC/NHS (1-Ethyl-3-(3-dimethylaminopropyl)carbodiimide/N-Hydroxysuccinimide) activation. Electrochemical characterizations of the immunosensors were carried out by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). GC-based immunosensors show a dynamic range of antigen detection from 1.0 × 105 PFU/mL to 1.5×107 PFU/mL, more than 1.0 × 105 PFU/mL to 1.0 × 107 PFU/mL for the Au-based sensor. However, the GC platform is less sensitive and shows a higher detection limit (LOD) for RSV. The limit of detection of the Au immunosensor is 1.1 × 103 PFU/mL, three orders of magnitude lower than 2.85 × 106 PFU/mL for GC. Thus, the Au-based immunosensor has better analytical performance for virus detection than a carbon-based platform due to high sensitivity and very low RSV detection, obtained with good reproducibility.
Collapse
Affiliation(s)
- Wioleta Białobrzeska
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
- SensDx, 14b Postępu St., 02-676 Warszawa, Poland; (N.M.); (K.P.)
| | - Daniel Firganek
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
| | - Maciej Czerkies
- Institute of Fundamental Technological Research Polish Academy of Sciences, Pawińskiego 5B, 02-106 Warszawa, Poland; (M.C.); (T.L.)
| | - Tomasz Lipniacki
- Institute of Fundamental Technological Research Polish Academy of Sciences, Pawińskiego 5B, 02-106 Warszawa, Poland; (M.C.); (T.L.)
| | - Marta Skwarecka
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
| | - Karolina Dziąbowska
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
- SensDx, 14b Postępu St., 02-676 Warszawa, Poland; (N.M.); (K.P.)
| | - Zofia Cebula
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
| | | | - Daniel Bigus
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
| | - Ewelina Bięga
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
| | - Krzysztof Pyrć
- Malopolska Centre of Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Krakow, Poland;
| | - Katarzyna Pala
- SensDx, 14b Postępu St., 02-676 Warszawa, Poland; (N.M.); (K.P.)
| | - Sabina Żołędowska
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
- SensDx, 14b Postępu St., 02-676 Warszawa, Poland; (N.M.); (K.P.)
| | - Dawid Nidzworski
- Institute of Biotechnology and Molecular Medicine, 3 Trzy Lipy St., 80-172 Gdansk, Poland; (D.F.); (M.S.); (K.D.); (Z.C.); (D.B.); (E.B.); (S.Ż.); (D.N.)
- SensDx, 14b Postępu St., 02-676 Warszawa, Poland; (N.M.); (K.P.)
| |
Collapse
|
40
|
Xu R, Fathima P, Strunk T, de Klerk N, Snelling TL, Richmond PC, Keil AD, Moore HC. RSV prophylaxis use in high-risk infants in Western Australia, 2002-2013: a record linkage cohort study. BMC Pediatr 2020; 20:490. [PMID: 33092566 PMCID: PMC7584096 DOI: 10.1186/s12887-020-02390-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The monoclonal antibody, palivizumab is licensed for use in high-risk infants to prevent severe illness caused by respiratory syncytial virus (RSV). The level of its use and compliance with current jurisdictional guidelines which were amended in 2010, is unknown. We determined the level of palivizumab use in a cohort of high-risk infants in Western Australia. METHODS Using probabilistically linked administrative data, we conducted a birth cohort study within tertiary neonatal intensive care units (NICUs) born between 2002 and 2013. We described palivizumab use by patient characteristics, eligibility criteria according to guidelines over the period of study and identified predictors of its use. RESULTS Of 24,329 infants admitted to tertiary NICUs, 271 (1.1%) were dispensed 744 palivizumab doses with 62.5% being dispensed to infants born 2010-2013. The median number of doses received was 2. A total of 2679 infants met at least one of three criteria for palivizumab (criteria 1: gestational age at birth < 28 weeks and chronic lung disease; criteria 2: gestational age < 28 weeks and Aboriginal; criteria 3: congenital heart disease not otherwise in criteria 1 or 2). The extent of palivizumab use differed across the 3 groups. Of 803 infants meeting criteria 1, 21.8% received at least 1 dose of palivizumab; 52.8% from 2010 onwards. From 174 infants meeting criteria 2, 14.4% received at least 1 dose; 43.1% from 2010 onwards and from 1804 births meeting criteria 3, only 3.7% received at least 1 dose; 5.4% from year of birth 2010 onwards). In adjusted analyses, being born after 2010, being extreme preterm, chronic lung disease, congenital lung disease and being born in autumn or winter were independent predictors of palivizumab use. CONCLUSION In this high-risk setting and notwithstanding the limitations of our data sources, the level of compliance of palivizumab use against current guidelines was low. Most doses were dispensed to infants meeting at least one high-risk criterion. Evidence of incomplete dosing is an important finding in light of recent developments of single dose monoclonal antibodies offering longer protection.
Collapse
Affiliation(s)
- Ruomei Xu
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia
| | - Tobias Strunk
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia
- Neonatal Directorate, King Edward Memorial Hospital, Perth, WA, Australia
| | - Nicholas de Klerk
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia
| | - Thomas L Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia
- Departments of Immunology and General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Peter C Richmond
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia
- Departments of Immunology and General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, WA, Australia
| | | | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box 855, Crawley, WA, 6872, Australia.
| |
Collapse
|
41
|
RSV prophylaxis use in high-risk infants in Western Australia, 2002-2013: a record linkage cohort study. BMC Pediatr 2020. [PMID: 33092566 DOI: 10.1186/s12887‐020‐02390‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The monoclonal antibody, palivizumab is licensed for use in high-risk infants to prevent severe illness caused by respiratory syncytial virus (RSV). The level of its use and compliance with current jurisdictional guidelines which were amended in 2010, is unknown. We determined the level of palivizumab use in a cohort of high-risk infants in Western Australia. METHODS Using probabilistically linked administrative data, we conducted a birth cohort study within tertiary neonatal intensive care units (NICUs) born between 2002 and 2013. We described palivizumab use by patient characteristics, eligibility criteria according to guidelines over the period of study and identified predictors of its use. RESULTS Of 24,329 infants admitted to tertiary NICUs, 271 (1.1%) were dispensed 744 palivizumab doses with 62.5% being dispensed to infants born 2010-2013. The median number of doses received was 2. A total of 2679 infants met at least one of three criteria for palivizumab (criteria 1: gestational age at birth < 28 weeks and chronic lung disease; criteria 2: gestational age < 28 weeks and Aboriginal; criteria 3: congenital heart disease not otherwise in criteria 1 or 2). The extent of palivizumab use differed across the 3 groups. Of 803 infants meeting criteria 1, 21.8% received at least 1 dose of palivizumab; 52.8% from 2010 onwards. From 174 infants meeting criteria 2, 14.4% received at least 1 dose; 43.1% from 2010 onwards and from 1804 births meeting criteria 3, only 3.7% received at least 1 dose; 5.4% from year of birth 2010 onwards). In adjusted analyses, being born after 2010, being extreme preterm, chronic lung disease, congenital lung disease and being born in autumn or winter were independent predictors of palivizumab use. CONCLUSION In this high-risk setting and notwithstanding the limitations of our data sources, the level of compliance of palivizumab use against current guidelines was low. Most doses were dispensed to infants meeting at least one high-risk criterion. Evidence of incomplete dosing is an important finding in light of recent developments of single dose monoclonal antibodies offering longer protection.
Collapse
|
42
|
|
43
|
Britton PN, Hu N, Saravanos G, Shrapnel J, Davis J, Snelling T, Dalby-Payne J, Kesson AM, Wood N, Macartney K, McCullagh C, Lingam R. COVID-19 public health measures and respiratory syncytial virus. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:e42-e43. [PMID: 32956616 PMCID: PMC7500894 DOI: 10.1016/s2352-4642(20)30307-2] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Philip N Britton
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
| | - Nan Hu
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Gemma Saravanos
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jane Shrapnel
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Management Support and Analysis Unit, Directorate of Clinical Integration, Sydney Children's Hospitals Network, Sydney, NSW, Australia
| | - Jake Davis
- Management Support and Analysis Unit, Directorate of Clinical Integration, Sydney Children's Hospitals Network, Sydney, NSW, Australia
| | - Tom Snelling
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, NSW, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jacqui Dalby-Payne
- Department of General Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Alison M Kesson
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Nicholas Wood
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Department of General Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Kristine Macartney
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, NSW, Australia; National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Cheryl McCullagh
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Management Support and Analysis Unit, Directorate of Clinical Integration, Sydney Children's Hospitals Network, Sydney, NSW, Australia
| | - Raghu Lingam
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia; Department of Community Paediatrics, Sydney Children's Hospital, Randwick, NSW, Australia
| |
Collapse
|
44
|
Allen AJ, Gonzalez-Ciscar A, Lendrem C, Suklan J, Allen K, Bell A, Baxter F, Crulley S, Fairlie L, Hardy D, Johnston L, McKenna J, Richards N, Shovlin G, Simmister C, Waugh S, Woodsford P, Graziadio S, Power M, Simpson AJ, Kumar P, Eastham K, Brodlie M. Diagnostic and economic evaluation of a point-of-care test for respiratory syncytial virus. ERJ Open Res 2020; 6:00018-2020. [PMID: 32832529 PMCID: PMC7430145 DOI: 10.1183/23120541.00018-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/22/2020] [Indexed: 12/27/2022] Open
Abstract
Respiratory syncytial virus is a common cause of bronchiolitis. Historically, point-of-care tests have involved antigen detection technology with limited sensitivity. The aim of this study was to prospectively evaluate the diagnostic accuracy and model the economic impact of the Roche cobas® Liat® point-of-care influenza A/B and respiratory syncytial virus test. The “DEC-RSV” study was a multi-centre, prospective, observational study in children under 2 years presenting with viral respiratory symptoms. A nasopharyngeal aspirate sample was tested using the point-of-care test and standard laboratory-based procedures. The primary outcome was accuracy of respiratory syncytial virus detection. The cost implications of adopting a point-of-care test were modelled using study data. A total of 186 participants were recruited, with both tests performed on 177 samples. The point-of-care test was invalid for 16 samples (diagnostic yield 91%) leaving 161 available for primary analysis. After resolving discrepancies, the cobas® Liat® respiratory syncytial virus test had 100.00% (95% CI 96.07%–100.00%) sensitivity and 98.53% (95% CI 92.08%–99.96%) specificity. Median time to result was 0.6 h (interquartile range (IQR) 0.5–1) for point-of-care testing and 28.9 h (IQR 26.3–48.1) for standard laboratory testing. Estimated non-diagnostic cost savings for 1000 patients, based on isolation decision-making on point-of-care test result, were £57 010, which would increase to £94 847 when cohort nursing is used. In young children the cobas® Liat® point-of-care respiratory syncytial virus test has high diagnostic accuracy using nasopharyngeal aspirates (currently an off-licence sample type). Time to result is clinically important and was favourable compared to laboratory-based testing. The potential exists for cost savings when adopting the point-of-care test. This prospective evaluation of the cobas Liat point-of-care RSV test in children demonstrated high diagnostic accuracy using nasopharyngeal aspirate samples, with favourable time to result compared to usual laboratory-based testing procedureshttps://bit.ly/2yKKmUB
Collapse
Affiliation(s)
- A Joy Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Andrea Gonzalez-Ciscar
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Clare Lendrem
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jana Suklan
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Karen Allen
- Paediatric Research Unit, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ashley Bell
- Paediatric Research Unit, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Frances Baxter
- Paediatric Research Unit, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stephen Crulley
- Paediatric Research Unit, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Louise Fairlie
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Danielle Hardy
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Louise Johnston
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Joanne McKenna
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Nicole Richards
- Pathology Dept, Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Gavin Shovlin
- Pathology Dept, Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Clare Simmister
- Paediatric Research Unit, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sheila Waugh
- Microbiology and Virology Dept, Freeman Hospital, Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle upon Tyne, UK
| | - Philip Woodsford
- Paediatric Research Unit, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sara Graziadio
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Power
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A John Simpson
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Prashant Kumar
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | | | - Malcolm Brodlie
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
45
|
Aikphaibul P, Theerawit T, Sophonphan J, Wacharachaisurapol N, Jitrungruengnij N, Puthanakit T. Risk factors of severe hospitalized respiratory syncytial virus infection in tertiary care center in Thailand. Influenza Other Respir Viruses 2020; 15:64-71. [PMID: 32783380 PMCID: PMC7767956 DOI: 10.1111/irv.12793] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 01/21/2023] Open
Abstract
AIM To determine factors associated with severe hospitalized Respiratory syncytial virus (RSV)-associated LRTI and to describe management in tertiary care center. METHODS Retrospective medical record review was conducted among children under 5 years old hospitalized with RSV-associated LRTI at King Chulalongkorn Memorial Hospital. Severe RSV-associated LRTI was defined as death, mechanical ventilator, or positive pressure ventilation use, prolonged hospitalization >7 days. Factors associated with severe RSV were analyzed using univariate and multivariate logistic regression. RESULTS From January 2011 to December 2016, 427 children were hospitalized. Median age was 10 months (IQR 4.2-23.0). One hundred seventy-four (41%) patients had severe RSV (11 deaths, 56 mechanical ventilators, 19 positive pressure ventilation, and 88 prolonged hospitalization). Factors associated with severe RSV were chronic lung disease (aOR 15.16 [4.26-53.91]), cirrhosis/biliary atresia (aOR 15.01 [3.21-70.32]), congenital heart disease (aOR 5.11 [1.97-13.23]), chemotherapy (aOR 4.7 [1.34-16.56]), and pre-term (aOR 2.03 [1.13-3.67]). Oxygen therapy was mainly low flow oxygen delivery. 88% of cases received bronchodilator. Parenteral antibiotics were prescribed in 37.9% of cases. CONCLUSIONS Children with co-morbidities have higher risk of severe RSV-associated LRTI. More than two-third of patients received bronchodilator, of which was not recommended by American Academy of Pediatrics. The specific treatment and prevention for RSV are urgently needed.
Collapse
Affiliation(s)
- Puneyavee Aikphaibul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tuangtip Theerawit
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jiratchaya Sophonphan
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Noppadol Wacharachaisurapol
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nattapong Jitrungruengnij
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
46
|
The efficacy of PPE for COVID-19-type respiratory illnesses in primary and community care staff. Br J Gen Pract 2020; 70:413-416. [PMID: 32661012 DOI: 10.3399/bjgp20x710969] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
47
|
Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections. Curr Opin Infect Dis 2020; 33:312-318. [PMID: 32657968 DOI: 10.1097/qco.0000000000000655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Prevention of nosocomial transmission of respiratory viruses is a priority in all healthcare settings and often achieved with the use of personal protective equipment. Several adjunctive infection prevention methods are in common use but their effectiveness in reducing healthcare-associated respiratory viral infections is unclear. In this review, recent advances regarding the effectiveness of several adjunctive infection prevention methods to reduce healthcare-associated respiratory viral infections are discussed. RECENT FINDINGS Training and education on hand hygiene guidelines, mandatory influenza vaccination for healthcare personnel, access to paid sick leave to reduce ill presenteeism, cohorting of patients with the same infection or clinical syndrome, neuraminidase inhibitor chemoprophylaxis during influenza outbreaks, and enhanced visitor restrictions in pediatric hospitals all have shown some degree of effectiveness in observational or quasi-experimental studies. SUMMARY Most of the studies evaluating the effect of adjunctive infection prevention methods on healthcare-associated respiratory viral infections are observational or quasi-experimental and are often combined with other interventions. Therefore, it is difficult to determine the precise effectiveness or efficacy of these interventions and more controlled trials are needed. Multimodal infection prevention policies are likely to be most effective in reducing healthcare-associated respiratory viral infections.
Collapse
|
48
|
Hasan J, Xu Y, Yarlagadda T, Schuetz M, Spann K, Yarlagadda PK. Antiviral and Antibacterial Nanostructured Surfaces with Excellent Mechanical Properties for Hospital Applications. ACS Biomater Sci Eng 2020; 6:3608-3618. [PMID: 33463169 DOI: 10.1021/acsbiomaterials.0c00348] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
With the rise of bacterial and viral infections including the recent outbreak of coronavirus, the requirement for novel antimicrobial strategies is also rising with urgency. To solve this problem, we have used a wet etching technique to fabricate 23 nm wide nanostructures randomly aligned as ridges on aluminum (Al) 6063 alloy surfaces. The surfaces were etched for 0.5, 1, and 3 h. The surfaces were characterized using scanning electron microscopy, energy-dispersive X-ray spectroscopy, contact angle goniometry, nanoindentation and atomic force microscopy. Strains of the Gram negative bacteria Pseudomonas aeruginosa and the Gram positive bacteria Staphylococcus aureus were used to evaluate the bacterial attachment behavior. For the first time, common respiratory viruses, respiratory syncytial virus (RSV) and rhinovirus (RV), were investigated for antiviral activity on nanostructured surfaces. It was found that the etched Al surfaces were hydrophilic and the nanoscale roughness enhanced with the etching time with Rrms ranging from 69.9 to 995 nm. Both bacterial cells of P. aeruginosa and S. aureus were physically deformed and were nonviable upon attachment after 3 h on the etched Al 6063 surface. This nanoscale surface topography inactivated 92 and 87% of the attached P. aeruginosa and S. aureus cells, respectively. The recovery of infectious RSV was also reduced significantly within 2 h of exposure to the nanostructured surfaces compared to the smooth Al control surfaces. There was a 3-4 log10 reduction in the viability counts of rhinovirus after 24 h on the nanostructured surfaces. The nanostructured surfaces exhibited excellent durability as the surfaces sustained 1000 cycles of 2000 μN load without any damage. This is the first report that has shown the combined antibacterial and antiviral property of the nanostructured surface with excellent nanomechanical properties that could be potentially significant for use in hospital environments to stop the spread of infections arising from physical surfaces.
Collapse
Affiliation(s)
- Jafar Hasan
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland 4000, Australia
| | - Yanan Xu
- Institute for Future Environments, Queensland University of Technology, Brisbane, Queensland 4000, Australia
| | - Tejasri Yarlagadda
- Institute of Health Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4000, Australia.,School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland 4000, Australia
| | - Michael Schuetz
- Institute of Health Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4000, Australia.,Jamieson Trauma Institute, Metro North Hospital and Health Service, Herston, Queensland 4029, Australia
| | - Kirsten Spann
- Institute of Health Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4000, Australia.,School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland 4000, Australia
| | - Prasad Kdv Yarlagadda
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland 4000, Australia
| |
Collapse
|
49
|
Thomas JP, Srinivasan A, Wickramarachchi CS, Dhesi PK, Hung YM, Kamath AV. Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic. Clin Med (Lond) 2020; 20:242-247. [PMID: 32357976 PMCID: PMC7354042 DOI: 10.7861/clinmed.2020-0143] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tragically, many of the infections and deaths recorded in the global coronavirus disease 2019 (COVID-19) pandemic have occurred in healthcare workers. Some have attributed this to inadequate provision of personal protective equipment (PPE). In the UK, several organisations have voiced their concerns that the national PPE guidance issued by Public Health England is inadequate. Despite recent revisions to these guidelines, concerns remain that they offer insufficient protection to frontline NHS healthcare workers. In this report, we evaluate whether these concerns are merited, through critical appraisal of the available evidence, review of international PPE guidance, and consideration of the ethical implications.
Collapse
Affiliation(s)
- John P Thomas
- Norfolk and Norwich University Hospital, Norwich, UK
| | | | | | | | - Yat Ma Hung
- Norfolk and Norwich University Hospital, Norwich, UK
| | - Ajay V Kamath
- Norfolk and Norwich University Hospital, Norwich, UK
| |
Collapse
|
50
|
Fine LS. Non-ventilator health care-associated pneumonia (NV-HAP): Pathogenesis and microbiology of NV-HAP. Am J Infect Control 2020; 48:A7-A9. [PMID: 32331565 DOI: 10.1016/j.ajic.2020.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/27/2022]
Abstract
Studies demonstrate that those at risk for developing nonventilator associated pneumonia (NV-HAP) include the very young and the very old, as well as persons with compromised immune systems cardiovascular and/or pulmonary disease. This section includes a review of the pathogenesis and microbiology of NV-HAP, including bacterial as well as viral and fungal pathogens. Etiology, modes of transmission, and specific prevention strategies associated with various causative microorganisms are highlighted.
Collapse
|