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Alabdely MH, Alolayan AS, Almaghrabi RS, Al-Abdely HM. Cerebral phaeohyphomycosis at a tertiary healthcare center in Saudi Arabia. Neurosciences (Riyadh) 2023; 28:136-142. [PMID: 37045456 PMCID: PMC10155477 DOI: 10.17712/nsj.2023.2.20220118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/15/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To report cases of cerebral phaeohyphomycosis at a tertiary hospital in Riyadh, Saudi Arabia. Phaeohyphomycetes are a widely distributed group of fungi whose cell walls contain 1,8 dihydroxynaphthalene-melanin. Cerebral infections caused by these fungi are uncommon and primarily associated with neurotrophic phaeohyphomycetes. METHODS In January of 2020 we looked back to identify cases of culture-positive cerebral phaeohyphomycosis from our medical records at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. Data on demographics, potential risk factors, clinical presentation, treatment, and outcomes were analyzed. RESULTS Twelve cases of cerebral phaeohyphomycosis were identified, of which 4 were caused by Rhinocladiella mackenziei and the other 8 were caused by various phaeohyphomycetes. There were 2 cases caused by Neoscytalidium dimidiatum, and one case each caused by the following: Acrophialophora fusispora, Chaetomium atrobrunneum, Exophiala dermatitidis, Exerohilum rostratum, Fonsecaea pedrosoi, and Cladophialophora bantiana. Most patients (10 of 12) had underlying immunosuppression. R. mackenziei caused a brain-only infection manifesting as abscess formation. Four patients survived for more than a year after therapy. Surgical evacuation and triazole therapy with posaconazole or itraconazole, alone or in combination with other antifungal agents, were associated with success. CONCLUSION Cerebral phaeohyphomycosis is an uncommon fungal infection that primarily affects immunocompromised patients and is associated with poor prognosis. R. mackenziei is the most prevalent fungus in our facility and has been linked to a universal mortality.
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Affiliation(s)
- Mayyadah H Alabdely
- From the Department of Critical Care (Alolayan), Department of Medicine (Almaghrabi, Al-Abdely), King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah S Alolayan
- From the Department of Critical Care (Alolayan), Department of Medicine (Almaghrabi, Al-Abdely), King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Reem S Almaghrabi
- From the Department of Critical Care (Alolayan), Department of Medicine (Almaghrabi, Al-Abdely), King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Hail M Al-Abdely
- From the Department of Critical Care (Alolayan), Department of Medicine (Almaghrabi, Al-Abdely), King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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Kanj SS, Omrani AS, Al-Abdely HM, Subhi A, Fakih RE, Abosoudah I, Kanj H, Dimopoulos G. Survival Outcome of Empirical Antifungal Therapy and the Value of Early Initiation: A Review of the Last Decade. J Fungi (Basel) 2022; 8:1146. [PMID: 36354913 PMCID: PMC9695378 DOI: 10.3390/jof8111146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 10/03/2023] Open
Abstract
AIM This rapid systematic review aimed to collect the evidence published over the last decade on the effect of empirical antifungal therapy and its early initiation on survival rates. METHODS A systematic search was conducted in PubMed, Cochrane, Medline, Scopus, and Embase, in addition to a hand search and experts' suggestions. RESULTS Fourteen cohort studies and two randomized clinical trials reporting the survival outcome of empirical antifungal therapy were included in this review. Two studies reported the association between early empirical antifungal therapy (EAFT) and survival rates in a hematological cancer setting, and fourteen studies reported the outcome in patients in intensive care units (ICU). Six studies reported that appropriate EAFT decreases hospital mortality significantly; ten studies could not demonstrate a statistically significant association with mortality rates. DISCUSSION The inconsistency of the results in the literature can be attributed to the studies' small sample size and their heterogeneity. Many patients who may potentially benefit from such strategies were excluded from these studies. CONCLUSION While EAFT is practiced in many settings, current evidence is conflicting, and high-quality studies are needed to demonstrate the true value of this approach. Meanwhile, insights from experts in the field can help guide clinicians to initiate EAFT when indicated.
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Affiliation(s)
- Souha S. Kanj
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, Beirut P.O. Box 11-0236, Lebanon
| | - Ali S. Omrani
- Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
- College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar
| | - Hail M. Al-Abdely
- Division of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ahmad Subhi
- Division of Infectious Disease, Al-Qassimi Hospital, Emirates Health Services, Sharjah 61313, United Arab Emirates
| | - Riad El Fakih
- Department of Hematology, Stem Cell Transplant & Cellular Therapy, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Ibraheem Abosoudah
- Department of Oncology, King Faisal Specialist Hospital and Research Center, MBC J-64, Jeddah 21499, Saudi Arabia
| | - Hazar Kanj
- Faculty of Medicine, American University of Beirut Medical Center, Beirut P.O. Box 11-0236, Lebanon
| | - George Dimopoulos
- Department of Critical Care, “EVGENIDIO” Hospital, National and Kapodistrian University of Athens (NKUA), 10679 Athens, Greece
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Rosenthal VD, Duszynska W, Ider BE, Gurskis V, Al-Ruzzieh MA, Myatra SN, Gupta D, Belkebir S, Upadhyay N, Zand F, Todi SK, Kharbanda M, Nair PK, Mishra S, Chaparro G, Mehta Y, Zala D, Janc J, Aguirre-Avalos G, Aguilar-De-Morós D, Hernandez-Chena BE, Gün E, Oztoprak-Cuvalci N, Yildizdas D, Abdelhalim MM, Ozturk-Deniz SS, Gan CS, Hung NV, Joudi H, Omar AA, Gikas A, El-Kholy AA, Barkat A, Koirala A, Cerero-Gudiño A, Bouziri A, Gomez-Nieto K, Fisher D, Medeiros EA, Salgado-Yepez E, Horhat F, Agha HMM, Vimercati JC, Villanueva V, Jayatilleke K, Nguyet LTT, Raka L, Miranda-Novales MG, Petrov MM, Apisarnthanarak A, Tayyab N, Elahi N, Mejia N, Morfin-Otero R, Al-Khawaja S, Anguseva T, Gupta U, Belskii VA, Mat WRW, Chapeta-Parada EG, Guanche-Garcell H, Barahona-Guzmán N, Mathew A, Raja K, Pattnaik SK, Pandya N, Poojary AA, Chawla R, Mahfouz T, Kanj SS, Mioljevic V, Hlinkova S, Mrazova M, Al-Abdely HM, Guclu E, Ozgultekin A, Baytas V, Tekin R, Yalçın AN, Erben N. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2013-2018, Adult and Pediatric Units, Device-associated Module. Am J Infect Control 2021; 49:1267-1274. [PMID: 33901588 DOI: 10.1016/j.ajic.2021.04.077] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific. METHODS Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied. RESULTS We collected data from 428,847 patients, for an aggregate of 2,815,402 bed-days, 1,468,216 central line (CL)-days, 1,053,330 mechanical ventilator (MV)-days, 1,740,776 urinary catheter (UC)-days. We found 7,785 CL-associated bloodstream infections (CLAB), 12,085 ventilator-associated events (VAE), and 5,509 UC-associated urinary tract infections (CAUTI). Pooled DA-HAI rates were 5.91% and 9.01 DA-HAIs/1,000 bed-days. Pooled CLAB rate was 5.30/1,000 CL-days; VAE rate was 11.47/1,000 MV-days, and CAUTI rate was 3.16/1,000 UC-days. P aeruginosa was non-susceptible (NS) to imipenem in 52.72% of cases; to colistin in 10.38%; to ceftazidime in 50%; to ciprofloxacin in 40.28%; and to amikacin in 34.05%. Klebsiella spp was NS to imipenem in 49.16%; to ceftazidime in 78.01%; to ciprofloxacin in 66.26%; and to amikacin in 42.45%. coagulase-negative Staphylococci and S aureus were NS to oxacillin in 91.44% and 56.03%, respectively. Enterococcus spp was NS to vancomycin in 42.31% of the cases. CONCLUSIONS DA-HAI rates and bacterial resistance are high and continuous efforts are needed to reduce them.
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Somily A, Balkhy HH, Enani MAS, Althawadi SI, Alawi M, Al Johani SM, Al Jindan R, AlBarrak A, AlAjlan H, AlAgeel AA, Roushdy HM, Dada HM, Al-Abdely HM. Antimicrobial resistance trends of non-fermenter Gram negative bacteria in Saudi Arabia: A six-year national study. J Infect Public Health 2021; 14:1144-1150. [PMID: 34358816 DOI: 10.1016/j.jiph.2021.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) of non-fermenting Gram-negative bacteria (NFGNB) is increasingly recognized as urgent healthcare threat. Trend data on AMR of NFGNB in Saudi Arabia are either old or limited. The objective was to estimate the prevalence and resistance trends of isolated NFGNB in Saudi Arabia. METHODS A retrospective multicenter study involving seven tertiary care hospitals in Saudi Arabia was conducted between 2011 and 2016. Susceptibility testing for non-duplicate isolates was performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines in College of American Pathologists accredited diagnostic microbiology laboratories in the participating hospitals. RESULTS Out of 461,274 isolates, 100,132 (21.7%) were NFGNB which represented 30% of gram-negative pathogens. Pseudomonas aeruginosa was the most common (73.6%), followed by Acinetobacter baumannii (21.0%) and Stenotrophomonas maltophilia (5.3%). Resistance trends of P. aeruginosa were increasing for aztreonam (absolute increase during the study was 17.3%), imipenem (12.3%), and meropenem (11.6%). A. baumannii was fully resistant to several beta lactam drugs, and resistance trends were increasing for potential treatments such as tigecycline (25.1%) and tobramycin (15.5%). S. maltophilia was >90% resistant to trimethoprim/ sulfamethoxazole and ciprofloxacin by the end of the study. CONCLUSION We are reporting high and/or increasing resistance of NFGNB to common treatment options. The current findings call for urgent actions to combat the increasing resistance of NFGNB. Large scale sharing of AMR data collected at different hospitals with the Saudi AMR committee would be critical to set priorities and monitor progress.
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Affiliation(s)
- Ali Somily
- Department of Pathology and Laboratory Medicine/Microbiology, College of Medicine, King Saud University, King Saud University Medical City, Riyadh 11461, Saudi Arabia.
| | | | - Mushira A S Enani
- Medical Specialties Department and Infectious Diseases Section, King Fahad Medical City, Riyadh, 12231, Saudi Arabia
| | - Sahar I Althawadi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Maha Alawi
- Infection Control & Environmental Health Unit, Department of Medical Microbiology & Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sameera M Al Johani
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Reem Al Jindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali AlBarrak
- Department of Internal Medicine, Infectious Diseases Unit, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | - Abdulaziz A AlAgeel
- Microbiology Department, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Hala M Roushdy
- Medical Microbiology, General Directorate of Infection Prevention and Control, Ministry of Health, Saudi Arabia
| | - Hebah M Dada
- National Antimicrobial Resistance Department, Public Health Authority, Riyadh, Saudi Arabia
| | - Hail M Al-Abdely
- Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Alharbi NK, Ibrahim OH, Alhafufi A, Kasem S, Aldowerij A, Albrahim R, Abu-Obaidah A, Alkarar A, Bayoumi FA, Almansour AM, Aldubaib M, Al-Abdely HM, Balkhy HH, Qasim I. Challenge infection model for MERS-CoV based on naturally infected camels. Virol J 2020; 17:77. [PMID: 32552831 PMCID: PMC7298446 DOI: 10.1186/s12985-020-01347-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background Middle East Respiratory Syndrome coronavirus (MERS-CoV) is an emerging virus that infects humans and camels with no approved antiviral therapy or vaccine. Some vaccines are in development for camels as a one-health intervention where vaccinating camels is proposed to reduce human viral exposure. This intervention will require an understanding of the prior exposure of camels to the virus and appropriate vaccine efficacy studies in camels. Methods We conducted a cross sectional seroprevalence study in young dromedary camels to determine the rate of MERS-CoV seropositivity in young camels. Next, we utilised naturally infected camels as a natural challenge model that can be used by co-housing these camels with healthy naive camels in a ratio of 1 to 2. This model is aimed to support studies on natural virus transmission as well as evaluating drug and vaccine efficacy. Results We found that 90% of the screened camels have pre-existing antibodies for MERS-CoV. In addition, the challenge model resulted in MERS-CoV transmission within 48 h with infections that continued for 14 days post challenge. Conclusions Our finding suggests that the majority of young dromedary camels in Saudi Arabia are seropositive and that naturally infected camels can serve as a challenge model to assess transmission, therapeutics, and vaccine efficacy.
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Affiliation(s)
- Naif Khalaf Alharbi
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. .,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Osman H Ibrahim
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Ali Alhafufi
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Samy Kasem
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia.,Department of Virology, Faculty of Veterinary Medicine, Kafrelsheikh University, El Geish Street, Kafrelsheikh, 33516, Egypt
| | - Ali Aldowerij
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Raed Albrahim
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Ali Abu-Obaidah
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Ali Alkarar
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | | | | | - Musaad Aldubaib
- College of Agriculture and Veterinary Medicine, Qassim University, Qassim, Saudi Arabia
| | - Hail M Al-Abdely
- Ministry of Health, Riyadh, Saudi Arabia.,Internal Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hanan H Balkhy
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Infection Prevention and Control, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ibrahim Qasim
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Al-Abdely HM, Midgley CM, Alkhamis AM, Abedi GR, Lu X, Binder AM, Alanazi KH, Tamin A, Banjar WM, Lester S, Abdalla O, Dahl RM, Mohammed M, Trivedi S, Algarni HS, Sakthivel SK, Algwizani A, Bafaqeeh F, Alzahrani A, Alsharef AA, Alhakeem RF, Jokhdar HAA, Ghazal SS, Thornburg NJ, Erdman DD, Assiri AM, Watson JT, Gerber SI. Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia. Emerg Infect Dis 2019; 25:753-766. [PMID: 30882305 PMCID: PMC6433025 DOI: 10.3201/eid2504.181595] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) shedding and antibody responses are not fully understood, particularly in relation to underlying medical conditions, clinical manifestations, and mortality. We enrolled MERS-CoV–positive patients at a hospital in Saudi Arabia and periodically collected specimens from multiple sites for real-time reverse transcription PCR and serologic testing. We conducted interviews and chart abstractions to collect clinical, epidemiologic, and laboratory information. We found that diabetes mellitus among survivors was associated with prolonged MERS-CoV RNA detection in the respiratory tract. Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance. Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness. These findings should be considered in the development of infection control policies, vaccines, and antibody therapeutics.
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Lester S, Harcourt J, Whitt M, Al-Abdely HM, Midgley CM, Alkhamis AM, Aziz Jokhdar HA, Assiri AM, Tamin A, Thornburg N. Middle East respiratory coronavirus (MERS-CoV) spike (S) protein vesicular stomatitis virus pseudoparticle neutralization assays offer a reliable alternative to the conventional neutralization assay in human seroepidemiological studies. Access Microbiol 2019; 1:e000057. [PMID: 32974558 PMCID: PMC7472544 DOI: 10.1099/acmi.0.000057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 12/15/2022] Open
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel zoonotic coronavirus that was identified in 2012. MERS-CoV infection in humans can result in an acute, severe respiratory disease and in some cases multi-organ failure; the global mortality rate is approximately 35 %. The MERS-CoV spike (S) protein is a major target for neutralizing antibodies in infected patients. The MERS-CoV microneutralization test (MNt) is the gold standard method for demonstrating prior infection. However, this method requires the use of live MERS-CoV in biosafety level 3 (BSL-3) containment. The present work describes the generation and validation of S protein-bearing vesicular stomatitis virus (VSV) pseudotype particles (VSV-MERS-CoV-S) in which the VSV glycoprotein G gene has been replaced by the luciferase reporter gene, followed by the establishment of a pseudoparticle-based neutralization test to detect MERS-CoV neutralizing antibodies under BSL-2 conditions. Using a panel of human sera from confirmed MERS-CoV patients, the VSV-MERS-CoV particle neutralization assay produced results that were highly comparable to those of the microneutralization test using live MERS-CoV. The results suggest that the VSV-MERS-CoV-S pseudotype neutralization assay offers a highly specific, sensitive and safer alternative method to detect MERS-CoV neutralizing antibodies in human sera.
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Affiliation(s)
- Sandra Lester
- Synergy America, Inc., Duluth, GA, USA
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
- *Correspondence: Sandra Lester,
| | - Jennifer Harcourt
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Michael Whitt
- The University of Tennessee Health Science Center, Microbiology, Immunology, and Biochemistry, Memphis, TN, USA
| | | | - Claire M. Midgley
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | | | | | | | - Azaibi Tamin
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Natalie Thornburg
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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Alanazi KH, Killerby ME, Biggs HM, Abedi GR, Jokhdar H, Alsharef AA, Mohammed M, Abdalla O, Almari A, Bereagesh S, Tawfik S, Alresheedi H, Alhakeem RF, Hakawi A, Alfalah H, Amer H, Thornburg NJ, Tamin A, Trivedi S, Tong S, Lu X, Queen K, Li Y, Sakthivel SK, Tao Y, Zhang J, Paden CR, Al-Abdely HM, Assiri AM, Gerber SI, Watson JT. Scope and extent of healthcare-associated Middle East respiratory syndrome coronavirus transmission during two contemporaneous outbreaks in Riyadh, Saudi Arabia, 2017. Infect Control Hosp Epidemiol 2019; 40:79-88. [PMID: 30595141 PMCID: PMC7108661 DOI: 10.1017/ice.2018.290] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/16/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications. DESIGN Outbreak investigation. SETTING Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit. METHODS Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases. RESULTS In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive. CONCLUSIONS We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
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Affiliation(s)
| | - Marie E. Killerby
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- King Saud Medical City, Riyadh, Saudi Arabia
| | - Holly M. Biggs
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Glen R. Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | | | | | | | | | | | | | | | | | | | | | - Hala Amer
- King Saud Medical City, Riyadh, Saudi Arabia
- Department of Community Medicine, National Research Center, Cairo, Egypt
| | - Natalie J. Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Azaibi Tamin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Suvang Trivedi
- IHRC, contractor to National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Xiaoyan Lu
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Krista Queen
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Yan Li
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Senthilkumar K. Sakthivel
- Batelle, contractor to National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ying Tao
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Jing Zhang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Clinton R. Paden
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | | | - Susan I. Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - John T. Watson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
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Al-Abdely HM, Khidir Mohammed Y, Rosenthal VD, Orellano PW, ALazhary M, Kaid E, Al-Attas A, Hawsawi G, Kelany A, Hussein B, Esam B, Altowerqi R, Alkamaly MA, Tawfic NA, Cruzpero E, Al Rashidi RM, Thomas R, Molano AM, Al Enazy HA, Al Adwani FM, Casuyon Pahilanga AM, Alatawi S, Nakhla R, Al Adwani FM, Gasmin Aromin R, Balon Ubalde E, Hanafy Diab H, Kader NA, Hassan Assiry IY, Sawan FA, Ammari HE, Mashiakhy AM, Santiago EB, Chua CM, Dalis IM, Arishi HM, Lozada R, Al-Zaydani Asiri IA, Ahmed H, Jarie A, Al-Qathani AS, Al-Alkami HY, AlDalaton M, Alih SJ, Alaliany MJ, Helali NJ, Sindayen G, Malificio AA, Al Dossari HB, Algethami AG, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar SM, Rushdi H, Fernandez J, Hussain WM, Rajavel RD, Bukhari SZ, Turkistani AA, Mushtaq JJ, Albeladi E, Aboushoushah S, Qushmaq N, Shyrine L, Philipose J, Raees M, AbdulKhalik NS, Madco M, Abdulghany M, Manao A, Acostan C, Safwat R, Halwani M, Abdul Aal NA, Thomas A, Abdulatif SM, Ariola NC, Mutwalli AH, Ariola N, Bohlega E, Simon S, Damlig E, Elsherbini SG, Krishne IT, Abraham S, Ali Karrar MA, Gosn NA, Al Hindi AA, Jaha RN, AlQahtani SM, Abdul Aziz AO, Demaisip NL, Laungayan Cortez E, Cabato AF, Gonzales Celiz JM, Al Raey MA, Al Darani SA, Aziz MR, Manea BA, Samy E, Briones S, Krishnan R, Raees SS, Tabassum K, Ghalilah KM, Alradady M, Al Qatri A, Chaouali M, Elsisi M, Aldossary HA, Al-Suliman S, Al Talib AA, Albaghly N, Haqlre Mia ME, Al-Gethamy MM, Alamri DM, Al-Saadi AS, Ayugat EP, Al Hazazi NA, Al Hussain MI, Caminade Y, Santos AJ, Abdulwahab MH, Al-Garni BT. Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia. J Infect Public Health 2018; 11:677-684. [DOI: 10.1016/j.jiph.2018.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 01/09/2018] [Accepted: 06/05/2018] [Indexed: 01/30/2023] Open
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11
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Al-Abdely HM, Midgley CM, Alkhamis AM, Abedi GR, Tamin A, Binder AM, Alanazi K, Lu X, Abdalla O, Sakthivel SK, Mohammed M, Queen K, Algarni HS, Li Y, Trivedi S, Algwizani A, Alhakeem RF, Thornburg NJ, Tong S, Ghazal SS, Erdman DD, Assiri AM, Gerber SI, Watson JT. Infectious MERS-CoV Isolated From a Mildly Ill Patient, Saudi Arabia. Open Forum Infect Dis 2018; 5:ofy111. [PMID: 30294617 PMCID: PMC6016420 DOI: 10.1093/ofid/ofy111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 05/11/2018] [Indexed: 01/01/2023] Open
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with a wide range of clinical presentations, from asymptomatic or mildly ill to severe respiratory illness including death. We describe isolation of infectious MERS-CoV from the upper respiratory tract of a mildly ill 27-year-old female in Saudi Arabia 15 days after illness onset.
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Affiliation(s)
| | - Claire M Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Glen R Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Azaibi Tamin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alison M Binder
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Xiaoyan Lu
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Senthilkumar K Sakthivel
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Krista Queen
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Yan Li
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suvang Trivedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Natalie J Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sameeh S Ghazal
- Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Dean D Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John T Watson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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12
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Alshukairi AN, Khalid I, Ahmed WA, Dada AM, Bayumi DT, Malic LS, Althawadi S, Ignacio K, Alsalmi HS, Al-Abdely HM, Wali GY, Qushmaq IA, Alraddadi BM, Perlman S. Antibody Response and Disease Severity in Healthcare Worker MERS Survivors. Emerg Infect Dis 2018; 22. [PMID: 27192543 PMCID: PMC4880093 DOI: 10.3201/eid2206.160010] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We studied antibody response in 9 healthcare workers in Jeddah, Saudi Arabia, who survived Middle East respiratory syndrome, by using serial ELISA and indirect immunofluorescence assay testing. Among patients who had experienced severe pneumonia, antibody was detected for >18 months after infection. Antibody longevity was more variable in patients who had experienced milder disease.
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Abstract
Mucormycosis is a rare opportunistic fungal infection that occurs in certain immunocompromised patients. We present 2 cases of invasive mucormycosis due to Rhizopus spp. in patients with chronic granulomatous disease (CGD) and discuss their clinical presentation, management challenges, and outcomes.
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Alhamlan FS, Majumder MS, Brownstein JS, Hawkins J, Al-Abdely HM, Alzahrani A, Obaid DA, Al-Ahdal MN, BinSaeed A. Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. BMJ Open 2017; 7:e011865. [PMID: 28082362 PMCID: PMC5253590 DOI: 10.1136/bmjopen-2016-011865] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. DESIGN Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. RESULTS A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). CONCLUSIONS To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed.
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Affiliation(s)
- F S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - M S Majumder
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - J Hawkins
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - H M Al-Abdely
- Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia
| | - A Alzahrani
- Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia
| | - D A Obaid
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - M N Al-Ahdal
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - A BinSaeed
- Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia
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Al-Abdely HM, Alshehri AD, Rosenthal VD, Mohammed YK, Banjar W, Orellano PW, Assiri AM, Kader NMA, Enizy HAA, Mohammed DA, Al-Awadi DK, Cabato AF, Wasbourne M, Saliya R, Aromin RG, Ubalde EB, Diab HH, Alkamaly MA, Alanazi NM, Hassan Assiry IY, Molano AM, Flores Baldonado C, Al-Azhary M, Al Atawi S, Molano AM, Al Adwani FM, Casuyon Pahilanga AM, Nakhla R, Al Adwani FM, Nair DS, Sindayen G, Malificio AA, Helali NJ, Al Dossari HB, Kelany A, Algethami AG, Yanne L, Tan A, Babu S, Abduljabbar SM, Bukhari SZ, Basri RH, Mushtaq JJ, Rushdi H, Turkistani AA, Gonzales Celiz JM, Al Raey MA, Al-Zaydani Asiri IAM, Aldarani SA, Laungayan Cortez E, Demaisip NL, Aziz MR, Omer Abdul Aziz A, Al Manea B, Samy E, Al-Dalaton M, Alaliany MJ. Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection. J Infect Prev 2017; 18:25-34. [PMID: 28989500 PMCID: PMC5298378 DOI: 10.1177/1757177416669424] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 08/11/2016] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. DESIGN Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (1) a bundle of infection prevention practice interventions; (2) education; (3) outcome surveillance; (4) process surveillance; (5) feedback on CLABSI rates and consequences; and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed. RESULTS During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28-0.72; P = 0.001). CONCLUSIONS Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia.
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Affiliation(s)
- Hail M Al-Abdely
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
- Assir Central Hospital, Assir, Saudi Arabia
| | - Areej Dhafer Alshehri
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Yassir Khidir Mohammed
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
- Assir Central Hospital, Assir, Saudi Arabia
| | - Weam Banjar
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
| | - Pablo Wenceslao Orellano
- International Nosocomial Infection Control Consortium (INICC), Buenos Aires, Argentina
- Universidad Tecnológica Nacional, Facultad Regional San Nicolás and Consejo Nacional de Investigaciones Científicas y Técnicas, San Nicolás, Argentina
| | - Abdullah Mufareh Assiri
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
| | | | | | | | | | | | - Maria Wasbourne
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
| | - Randa Saliya
- General Directorate of Prevention and Infection Control, Ministry of Health, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Mohamed Al-Azhary
- King Khalid Hospital, Najran, Saudi Arabia
- Assir Central Hospital, Assir, Saudi Arabia
| | | | | | | | | | | | | | | | | | | | | | | | - Ashraf Kelany
- King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | | | - Leigh Yanne
- King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | - Avigail Tan
- King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | - Sheema Babu
- King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Eslam Samy
- Assir Central Hospital, Assir, Saudi Arabia
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Rosenthal VD, Al-Abdely HM, El-Kholy AA, AlKhawaja SAA, Leblebicioglu H, Mehta Y, Rai V, Hung NV, Kanj SS, Salama MF, Salgado-Yepez E, Elahi N, Morfin Otero R, Apisarnthanarak A, De Carvalho BM, Ider BE, Fisher D, Buenaflor MCS, Petrov MM, Quesada-Mora AM, Zand F, Gurskis V, Anguseva T, Ikram A, Aguilar de Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di Silvestre G, Furova K, Ramos-Ortiz GY, Gamar Elanbya MO, Satari HI, Gupta U, Dendane T, Raka L, Guanche-Garcell H, Hu B, Padgett D, Jayatilleke K, Ben Jaballah N, Apostolopoulou E, Prudencio Leon WE, Sepulveda-Chavez A, Telechea HM, Trotter A, Alvarez-Moreno C, Kushner-Davalos L, Desse J, Maurizi D, Montanini A, Chaparro G, Stagnaro J, Romani A, Bianchi A, Álvarez G, Palaoro A, Bernan M, Cabrera-Montesino R, Domínguez C, Rodríguez C, Silva C, Bogdanowicz E, Riera F, Benchetrit G, Perez I, Vimercati J, Marcos L, Ramasco L, Caridi M, Oyola M, Rodríguez M, Spadaro M, Olivieri M, Saul P, Juarez P, Pérez R, Botta P, Quintana D, Ríos A, Stagnaro J, Chediack V, Chilon W, Alsayegh AI, Yaseen FH, Hani LF, Sowar SF, Magray TA, Medeiros E, Alves De Oliveira A, Romario-Mendes A, Fernandes-Valente C, Santos C, Escudeiro D, Azevedo-Ferreira Lima D, Azevedo-Pereira D, Onzi-Siliprandi E, Serpa-Maia F, Aguiar-Leitao F, Assuncao-Ponte G, Dos Anjos-Lima J, Olszewski J, Harten Pinto Coelho K, Alves De Lima L, Mendonca M, Maciel-Canuto Amaral M, Tenorio M, Gerah S, Andrade-Oliveira-Reis M, Moreira M, Ximenes-Rocha Batista M, Campos-Uchoa R, Rocha-Vasconcelos Carneiro R, Amaral De Moraes R, Do Nascimento S, Moreira-Matos T, Lima-De Barros Araujo T, De Jesus Pinheiro-Bandeira T, Machado-Silva V, Santos Monteiro W, Hristozova E, Kostadinov E, Angelova K, Velinova V, Dicheva V, Guo X, Ye G, Li R, Song L, Liu K, Liu T, Song G, Wang C, Yang X, Yu H, Yang Y, Martínez A, Vargas-García A, Lagares-Guzmán A, González A, Linares C, Ávila-Acosta C, Santofimio D, Yepes-Gomez D, Marin-Tobar D, Mazo-Elorza D, Chapeta-Parada E, Camacho-Moreno G, Roncancio-Vill G, Valderrama-Marquez I, Ruiz-Gallardo J, Ospina-Martínez J, Osorio J, Marín-Uribe J, López J, Gualtero S, Rojas J, Gomez-Nieto K, Rincon L, Meneses-Ovallos L, Canas-Giraldo L, Burgos-Florez L, Amaral-Almeida Costa M, Rodriguez M, Barahona-Guzmán N, Mancera-Paez O, Rios-Arana P, Ortega R, Romero-Torres S, Pulido-Leon S, Valderrama S, Moreno-Mejia V, Raigoza-Martinez W, Villamil-Gomez W, Pardo-Lopez Y, Argüello-Ruiz A, Solano-Chinchilla A, Muñoz-Gutierrez G, Calvo-Hernández I, Maroto-Vargas L, Zuniga M, Valverde-Hernandez M, Chavarria-Ugalde O, Herrera B, Díaz C, Bovera M, Cevallos C, Pelaez C, Jara E, Delgado V, Coello-Gordon E, Picoita F, Guerrero-Toapant F, Valencia F, Santacruz G, Gonzalez H, Pazmino L, Garcia M, Arboleda M, Lascano M, Alquinga N, Ramírez V, Yousef RH, Moustafa AEM, Ahmed A, Elansary A, Ali AM, Hasanin A, Messih AA, Ramadan A, El Awady B, Hassan D, Abd El Aziz D, Hamza H, Agha HM, Ghazi IA, ElKholy J, Fattah MA, Elanany M, Mansour M, Haleim M, Fouda R, El-Sherif RH, Bekeit S, Bayani V, Elkholy Y, Abdelhamid Y, Salah Z, Rivera D, Chawla A, Manked A, Azim A, Mubarak A, Thakur A, Dharan A, Patil A, Sasidharan A, Bilolikar AK, Anirban Karmakar A, Mathew A, Kulkarni A, Agarwal A, Sriram A, Dwivedy A, Dasgupta A, Bhakta A, Suganya AR, Poojary A, Mani AK, Sakle A, Abraham BK, Padmini B, Ramachandran B, Ray B, Pati BK, Chaudhury BN, Mishra BM, Biswas S, Saibala MB, Jawadwala BQ, Rodrigues C, Modi C, Patel C, Khanna D, Devaprasad D, Divekar D, Aggarwal DG, Divatia J, Zala D, Pathrose E, Abubakar F, Chacko F, Gehlot G, Khanna G, Sale H, Roy I, Shelgaonkar J, Sorabjee J, Eappen J, Mathew J, Pal J, Varma K, Joshi KL, Sandhu K, Kelkar R, Ranganathan L, Pushparaj L, Lavate M, Latha M, Suryawanshi M, Bhattacharyya M, Kavathekar M, Agarwal MK, Patel M, Shah M, Sivakumar M, Kharbanda M, Bej M, Potdar M, Chakravarthy M, Karpagam M, Myatra S, Gita N, Rao N, Sen N, Ramakrishnan N, Jaggi N, Saini N, Pawar N, Modi N, Pandya N, Mohanty N, Thakkar P, Joshi P, Sahoo PK, Nair PK, Kumar PS, Patil P, Mukherjee P, Mathur P, Shah P, Sukanya R, Arjun R, Chawla R, Gopalakrishnan R, Venkataraman R, Raut S, Krupanandan R, Tejam R, Misra R, Debroy R, Saranya S, Narayanan S, Mishra S, Saseedharan S, Sengupta S, Patnaik S, Sinha S, Blessymole S, Rohra S, Rajagopal S, Mukherjee S, Sengupta S, John S, Bhattacharya S, Sijo, Bhattacharyya S, Singh S, Sohanlal T, Vadi S, Dalal S, Todi S, Kumar S, Kansal S, Misra S, Bhattacharyya S, Nirkhiwale S, Purkayastha SK, Mukherjee S, Singh S, Sahu S, Sharma S, Kumar S, Basu S, Shetty S, Shah S, Singhal T, Francis T, Anand T, Venkateshwar V, Thomas V, Kothari V, Velupandi, Kantroo V, Sitohang G, Kadarsih R, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Alebouyeh M, Sherafat SJ, Mohamed YK, Al Khamis A, Alsaadi AS, Al-Jarie AA, Mutwalli AH, Rillorta A, Thomas A, Kelany A, Manao A, Alamri DM, Santiago E, Cruzpero E, Sawan FA, Al Qasmah FA, Alabdaly H, Al-Dossary HA, Ahmed H, Roshdi H, Al-Alkami HY, Hanafi H, Ammari HE, Hani HMA, Asiri IAA, Mendoza JA, Philipose J, Selga JO, Kehkashan, Ghalilah KM, Redito LS, Josph L, Al-Alawi M, Al-Gethamy MM, Madco M, Manuel M, Girvan M, Aldalaton M, De Guzman M, Alkhamaly M, Masfar M, Karrar MAA, Al Azmi MM, Quisai ML, Torres MM, Al-Abdullah N, Tawfic NA, Elsayed N, Abdulkhalik NS, Bugis NA, Ariola NC, Gad N, Alghosn N, Tashkandi N, Zharani NA, De Vera P, Krishnan R, Al Shehri RH, Jaha RNA, Thomas R, Cresencia RL, Penuliar R, Lozada R, Al Qahtani S, Twfik S, Al Faraj SH, El-Sherbiny S, Alih SJB, Briones S, Bukhari SZ, Alotaibi TSA, Gopal U, Nair U, Abdulatif WA, Hussain WM, Demotica WM, Spahija G, Baftiu N, Gashi A, Omar AA, Mohamed A, Rebello F, Almousa HH, Abdo NM, George S, Khamis S, Thomas S, Ahmad Zaatari A, Anwar Al Souheil A, Ayash H, Zeid I, Tannous J, Zahreddine N, Ahmadieh R, Mahfouz T, Kardas T, Tanzi V, Kanafani Z, Hammoud Z, Dagys A, Grinkeviciute D, Kevalas R, Kondratas T, Petrovska M, Popovska K, Mitrev Z, Miteva ZB, Jankovska K, Guroska ST, Gan CS, Othman AA, Yusof AM, Abidin ASZ, Aziz FA, Weng FK, Zainol H, Bakar KBA, Lum LCS, Mansor M, Zaman MK, Jamaluddin MFH, Hasan MS, Rahman RA, Zaini RHM, Zhazali R, Sri Ponnampala SSL, Chuah SL, Shukeri WFWM, Hassan WNW, Yusoff WNW, Mat WRW, Cureno-Diaz M, Aguirre-Avalos G, Flores-Alvarado A, Cerero-Gudino A, Zamores-Pedroza A, Cano-Munoz B, Hernandez-Chena B, Carreon-Martinez C, Coronado-Magana H, Corona-Jimenez F, Rodriguez-Noriega E, Alcala-Martinez E, Gonzalez-Diaz E, Guerra-Infante F, Arteaga-Troncoso G, Martinez-Falcon G, Leon-Garnica G, Delgado-Aguirre H, Perez-Gomez H, Sosa-Gonzalez I, Galindo-Olmeda J, Ayala-Gaytan J, Rodriguez-Pacheco J, Zamorano-Flores L, Lopez-Pulgarin J, Miranda-Novales M, Ramírez M, Lopez-Hurtado M, Lozano M, Gomez M, Sanchez-Castuera M, Kasten-Monges M, Gonzalez-Martinez M, Sanchez-Vargas M, Culebro-Burguet M, Altuzar-Figueroa M, Mijangos-Mendez J, Ramires O, Espinosa O, De Leon-Escobedo R, Salas-Flores R, Ruiz-Rendon R, Petersen-Morfin S, Aguirre-Diaz S, Esparza-Ahumada S, Vega-Gonzalez S, Gaona-Flores V, Monroy-Colin V, Cruz-Rivera Z, Bat-Erdene A, Narankhuu B, Choijamts B, Tuvdennyam B, Batkhuu B, Chuluunchimeg K, Enkhtsetseg D, Batjargal G, Bayasgalan G, Dorj M, Mendsaikhan N, Baatar O, Suvderdene P, Baigalmaa S, Khajidmaa T, Begzjav T, Tsuyanga, Ariyasuren Z, Zeggwagh A, Berechid K, Abidi K, Madani N, Abouqal R, Koirala A, Giri R, Sainju S, Acharya SP, Ahmed A, Raza A, Parveen A, Sultan F, Khan M, Paul N, Daud N, Yusuf S, Nizamuddin S, Garcia-Mayorca E, Castaño E, Moreno-Castillo J, Ballinas-Aquino J, Lara L, Vargas M, Rojas-Bonilla M, Ramos S, Mapp T, De Iturrado V, La Hoz Vergara C, Linares-Calderon C, Moreno D, Ramirez E, Ramírez Wong F, Montenegro-Orrego G, Sandoval-Castillo H, Pichilingue-Chagray J, Mueras-Quevedo J, Aibar-Yaranga K, Castillo-Bravo L, Santivanez-Monge L, Mayorga-Espichan M, Rosario-Tueros M, Changano-Rodriguez M, Salazar-Ramirez N, Marquez-Mondalgo V, Tajanlangit ALN, Tamayo AS, Llames CMJP, Labro E, Dy AP, Fortin J, Bergosa L, Salvio L, Bermudez V, Sg-Buenaflor M, Trajano M, Mendoza M, Javellana O, Maglente R, Arreza-Galapia Y, Navoa-Ng J, Kubler A, Barteczko-Grajek B, Dragan B, Zurawska M, Mikaszewska-Sokolewicz M, Zielinska M, Ramos-Ortiz G, Florin-Rogobete A, Vlad CD, Muntean D, Sandesc D, Papurica M, Licker M, Bedreag OH, Popescu R, Grecu S, Dumitrascu V, Molkov A, Galishevskiy D, Furman M, Simic A, Lekic D, Ristic G, Eremija J, Kojovic J, Nikolic L, Bjelovic M, Lesnakova A, Hlinkova S, Gamar-Elanbya M, Supa N, Prasan P, Pimathai R, Wanitanukool S, Somabutr S, Ben-Jaballah N, Borgi A, Bouziri A, Dilek A, Oncul A, Kaya A, Demiroz AP, Gunduz A, Ozgultekin A, Inan A, Yalcin A, Ramazanoglu A, Engin A, Willke A, Meco BC, Aygun C, Bulut C, Uzun C, Becerik C, Hatipoglu CA, Guclu CY, Ozdemir D, Yildizdas D, Ugurcan D, Azak E, Guclu E, Yilmaz EM, Sebnem-Erdinc F, Sirmatel F, Ulger F, Sari F, Kizilates F, Usluer G, Ceylan G, Ersoz G, Kaya G, Ertem GT, Senol G, Agin H, Cabadak H, Yilmaz H, Sungurtekin H, Zengin H, Turgut H, Ozgunes I, Devrim I, Erdem I, Işcanlı IGE, Bakir MM, Geyik M, Oral M, Meric M, Cengiz M, Ozcelik M, Altindis M, Sunbul M, Elaldi N, Kuyucu N, Unal N, Oztoprak N, Yasar N, Erben N, Bayram N, Dursun O, Karabay O, Coskun O, Horoz OO, Turhan O, Sandal OS, Tekin R, Esen S, Erdogan SY, Unal S, Karacorlu S, Sen S, Sen S, Sacar S, Yarar V, Oruc Y, Sahip Y, Kaya Z, Philip A, Elhoufi A, Alrahma H, Sachez E, Perez F, Empaire G, Vidal H, Montes-Bravo L, Guzman Siritt M, Orozco N, Navarrete N, Ruiz Y, De Anez ZDG, Van Trang DT, Minh DQ, Co DX, Anh DPP, Thu LTA, Tuyet LTD, Nguyet LTT, Chau NU, Binh NG, Tien NP, Anh NQ, Hang PT, Hanh TTM, Hang TTT, Thu TA, Thoa VTH. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module. Am J Infect Control 2016; 44:1495-1504. [PMID: 27742143 DOI: 10.1016/j.ajic.2016.08.007] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 08/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. CONCLUSIONS Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically.
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Alhakeem RF, Midgley CM, Assiri AM, Alessa M, Al Hawaj H, Saeed AB, Almasri MM, Lu X, Abedi GR, Abdalla O, Mohammed M, Algarni HS, Al-Abdely HM, Alsharef AA, Nooh R, Erdman DD, Gerber SI, Watson JT. Exposures among MERS Case-Patients, Saudi Arabia, January-February 2016. Emerg Infect Dis 2016; 22:2020-2022. [PMID: 27606432 PMCID: PMC5088020 DOI: 10.3201/eid2211.161042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Assiri AM, Biggs HM, Abedi GR, Lu X, Bin Saeed A, Abdalla O, Mohammed M, Al-Abdely HM, Algarni HS, Alhakeem RF, Almasri MM, Alsharef AA, Nooh R, Erdman DD, Gerber SI, Watson JT. Increase in Middle East Respiratory Syndrome-Coronavirus Cases in Saudi Arabia Linked to Hospital Outbreak With Continued Circulation of Recombinant Virus, July 1-August 31, 2015. Open Forum Infect Dis 2016; 3:ofw165. [PMID: 27704019 PMCID: PMC5047409 DOI: 10.1093/ofid/ofw165] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/25/2016] [Indexed: 12/31/2022] Open
Abstract
During July–August 2015, the number of cases of Middle East respiratory syndrome (MERS) reported from Saudi Arabia increased dramatically. We reviewed the 143 confirmed cases from this period and classified each based upon likely transmission source. We found that the surge in cases resulted predominantly (90%) from secondary transmission largely attributable to an outbreak at a single healthcare facility in Riyadh. Genome sequencing of MERS coronavirus from 6 cases demonstrated continued circulation of the recently described recombinant virus. A single unique frameshift deletion in open reading frame 5 was detected in the viral sequence from 1 case.
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Affiliation(s)
| | - Holly M Biggs
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Glen R Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Xiaoyan Lu
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Abdulaziz Bin Saeed
- Ministry of Health, Riyadh, Saudi Arabia; Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | - Randa Nooh
- Ministry of Health , Riyadh , Saudi Arabia
| | - Dean D Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - John T Watson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
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Abstract
[No Abstract Available].
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Affiliation(s)
- Hail M Al-Abdely
- General Directorate of Infection Prevention and Control, Ministry of Health, Kingdom of Saudi Arabia. E-mail.
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Assiri AM, Midgley CM, Abedi GR, Bin Saeed A, Almasri MM, Lu X, Al-Abdely HM, Abdalla O, Mohammed M, Algarni HS, Alhakeem RF, Sakthivel SK, Nooh R, Alshayab Z, Alessa M, Srinivasamoorthy G, AlQahtani SY, Kheyami A, HajOmar WH, Banaser TM, Esmaeel A, Hall AJ, Curns AT, Tamin A, Alsharef AA, Erdman D, Watson JT, Gerber SI. Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia. J Infect Dis 2016; 214:712-21. [PMID: 27302191 PMCID: PMC5712457 DOI: 10.1093/infdis/jiw236] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/25/2016] [Indexed: 01/17/2023] Open
Abstract
Background. Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe respiratory illness in humans. Fundamental questions about circulating viruses and transmission routes remain. Methods. We assessed routinely collected epidemiologic data for MERS-CoV cases reported in Saudi Arabia during 1 January–30 June 2015 and conducted a more detailed investigation of cases reported during February 2015. Available respiratory specimens were obtained for sequencing. Results. During the study period, 216 MERS-CoV cases were reported. Full genome (n = 17) or spike gene sequences (n = 82) were obtained from 99 individuals. Most sequences (72 of 99 [73%]) formed a discrete, novel recombinant subclade (NRC-2015), which was detected in 6 regions and became predominant by June 2015. No clinical differences were noted between clades. Among 87 cases reported during February 2015, 13 had no recognized risks for secondary acquisition; 12 of these 13 also denied camel contact. Most viruses (8 of 9) from these 13 individuals belonged to NRC-2015. Discussions. Our findings document the spread and eventual predominance of NRC-2015 in humans in Saudi Arabia during the first half of 2015. Our identification of cases without recognized risk factors but with similar virus sequences indicates the need for better understanding of risk factors for MERS-CoV transmission.
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Affiliation(s)
| | - Claire M Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Glen R Abedi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Abdulaziz Bin Saeed
- Ministry of Health Department of Family and Community Medicine, King Saud Medical City
| | | | - Xiaoyan Lu
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | | | | | | | | | | | | | - Randa Nooh
- Ministry of Health Field Epidemiology Training Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Zainab Alshayab
- Ministry of Health Field Epidemiology Training Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Mohammad Alessa
- Ministry of Health Field Epidemiology Training Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | | | | | | | - Aron J Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Aaron T Curns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Azaibi Tamin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | | | - Dean Erdman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - John T Watson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Susan I Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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Balkhy HH, Alenazi TH, Alshamrani MM, Baffoe-Bonnie H, Al-Abdely HM, El-Saed A, Al Arbash HA, Al Mayahi ZK, Assiri AM, Bin Saeed A. Notes from the Field: Nosocomial Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital--Riyadh, Saudi Arabia, 2015. MMWR Morb Mortal Wkly Rep 2016; 65:163-4. [PMID: 26890816 DOI: 10.15585/mmwr.mm6506a5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Since the first diagnosis of Middle East respiratory syndrome (MERS) caused by the MERS coronavirus (MERS-CoV) in the Kingdom of Saudi Arabia in 2012, sporadic cases and clusters have occurred throughout the country (1). During June-August, 2015, a large MERS outbreak occurred at King Abulaziz Medical City, a 1,200-bed tertiary-care hospital that includes a 150-bed emergency department that registers 250,000 visits per year.
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22
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Alkabab YM, Al-Abdely HM, Heysell SK. Diabetes-related tuberculosis in the Middle East: an urgent need for regional research. Int J Infect Dis 2015; 40:64-70. [PMID: 26409203 PMCID: PMC4863943 DOI: 10.1016/j.ijid.2015.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/21/2015] [Accepted: 09/16/2015] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Diabetes mellitus (DM) triples the risk of tuberculosis (TB) disease, complicates TB treatment, and increases the risk of a poor TB outcome. As DM prevalence is increasing across the Middle East, this review was performed to identify regional gaps in knowledge and research priorities for DM/TB. METHODS Online databases were searched for studies published from Middle East countries on DM and TB and the studies summarized based on topic and major findings. Studies included had a principle hypothesis related to both diseases, or described TB patients with individual data on DM. RESULTS Fifty-nine studies from 10 countries met search criteria. No published studies were found from Lebanon, Bahrain, Syria, Jordan, Cyprus, or the United Arab Emirates. DM prevalence among TB patients was high, but varied considerably across studies. The vast majority of studies were not specifically designed to compare DM/TB and non-DM/TB patients, but many suggested worse treatment outcomes for DM/TB, in accordance with reports from other regions. CONCLUSIONS Opportunity exists for the regional study of bidirectional screening, management strategies for both DM and TB diseases, and whether such efforts could take place through the integration of services.
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Affiliation(s)
- Yosra M Alkabab
- Division of Infectious Diseases, King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - Hail M Al-Abdely
- Division of Infectious Diseases, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Scott K Heysell
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
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Alhuraiji A, Alqaraawi A, Alaraj A, Al-Abdely HM, Alrajhi AA. PHOTO QUIZ. Chronic abdominal pain and intestinal obstruction in a 24-year-old woman. Clin Infect Dis 2014; 58:990, 1035-6. [PMID: 24627560 DOI: 10.1093/cid/cit944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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24
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Al-Abdely HM, Alothman AF, Salman JA, Al-Musawi T, Almaslamani M, Butt AA, Al Thaqafi AO, Raghubir N, Morsi WE, Yared NA. Clinical practice guidelines for the treatment of invasive Aspergillus infections in adults in the Middle East region: Expert panel recommendations. J Infect Public Health 2014; 7:20-31. [DOI: 10.1016/j.jiph.2013.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 08/05/2013] [Accepted: 08/12/2013] [Indexed: 10/26/2022] Open
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25
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Al-Mozaini MA, Mansour MK, Al-Hokail AA, Mohmed MA, Daham MAB, Al-Abdely HM, Frayha HH, Al-Rabiah FA, Alhajjar SH, Keshavjee S, Adra CN, Alrajhi AA. HIV-Care Outcome in Saudi Arabia; a Longitudinal Cohort. ACTA ACUST UNITED AC 2014; 5. [PMID: 25750760 PMCID: PMC4350238 DOI: 10.4172/2155-6113.1000370] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Clinical characteristics of HIV-1 infection in people inhabiting Western, Sub-Saharan African, and South-East Asian countries are well recognized. However, very little information is available with regard to HIV-1 infection and treatment outcome in MENA countries including the Gulf Cooperation Council (GCC) states. Methods Clinical, demographic and epidemiologic characteristics of 602 HIV-1 infected patients followed in the adult Infectious Diseases Clinic of King Faisal Specialist Hospital and Research Centre, in Riyadh, Kingdom of Saudi Arabia a tertiary referral center were longitudinally collected from 1989 to 2010. Results Of the 602 HIV-1 infected patients in this observation period, 70% were male. The major mode of HIV-1 transmission was heterosexual contact (55%). At diagnosis, opportunistic infections were found in 49% of patients, most commonly being pneumocysitis. AIDS associated neoplasia was also noted in 6% of patients. A hundred and forty-seven patients (24%) died from the cohort by the end of the observation period. The mortality rate peaked in 1992 at 90 deaths per 1000 person-year, whereas the mortality rate gradually decreased to <1% from 1993-2010. In 2010, 71% of the patients were receiving highly active retroviral therapy. Conclusions These data describe the clinical characteristic of HIV-1-infected patients at a major tertiary referral hospital in KSA over a 20-year period. Initiation of antiretroviral therapy resulted in a significant reduction in both morbidity and mortality. Future studies are needed in the design and implementation of targeted treatment and prevention strategies for HIV-1 infection in KSA.
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Affiliation(s)
- Maha A Al-Mozaini
- Immunocompromised Host Research, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Michael K Mansour
- Immunocompromised Host Research, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia ; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Abdullah A Al-Hokail
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Magid A Mohmed
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Munirah A Bin Daham
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Hail M Al-Abdely
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Husn H Frayha
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Fahad A Al-Rabiah
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Sami H Alhajjar
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Chaker N Adra
- Immunocompromised Host Research, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrahman A Alrajhi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
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Alothman AF, Al-Musawi T, Al-Abdely HM, Salman JA, Almaslamani M, Yared N, Butt AA, Raghubir N, Morsi WE, Al Thaqafi AO. Clinical practice guidelines for the management of invasive Candida infections in adults in the Middle East region: Expert panel recommendations. J Infect Public Health 2013; 7:6-19. [PMID: 24035607 DOI: 10.1016/j.jiph.2013.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/05/2013] [Accepted: 08/12/2013] [Indexed: 11/26/2022] Open
Abstract
Invasive Candida infections contribute to significant morbidity and mortality in patients with healthcare-associated infections. They represent a major burden on the public health system, and are challenging to diagnose and treat. A multidisciplinary expert panel critically reviewed available evidence to provide consensus recommendations for the management of invasive Candida infections in the Middle East. Based on diagnosis, recommendations were provided for the management of Candida infections in non-neutropenic and neutropenic patients. Polyenes (amphotericin B-deoxycholate [AmB-d] and lipid formulations amphotericin B [LFAmB]), triazoles (fluconazole, itraconazole and voriconazole), echinocandins (caspofungin, anidulafungin, and micafungin) and flucytosine are the recommended categories of antifungal agents for treatment of Candida infections. Echinocandins are preferred for treatment of proven and suspected Candida infections, especially in critically ill patients or those with previous exposure to azoles. Recommendations were also provided for infections caused by specific Candida species as well as management of different disease conditions. The experts highlighted that the guidelines should be used along with clinical judgment. Given the paucity of published data from the region, research in the form of randomized clinical trials should be given priority.
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Affiliation(s)
- Adel F Alothman
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | | | - Hail M Al-Abdely
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | | | - Muna Almaslamani
- Hamad Medical Corporation (HMC), Weill Cornell Medical College, Qatar, State of Qatar.
| | - Nadine Yared
- Lebanese University, Faculty of Medical Sciences, Beirut, Lebanon.
| | - Adeel A Butt
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
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Al-Tawfiq JA, Al-Abdely HM. Vertebral osteomyelitis due toAspergillus fumigatusin a patient with chronic granulomatous disease successfully treated with antifungal agents and interferon-gamma. Med Mycol 2010; 48:537-41. [DOI: 10.3109/13693780903325290] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Clinical presentation, CD4+ T lymphocyte count at diagnosis, and reasons for HIV-1 testing reflect the attitudes towards HIV testing and also the ability of the health-care system to diagnose HIV early. In a cross-sectional study from the HIV database in a large HIV-referral centre in Saudi Arabia, all 410 HIV-infected patients were included, 276 men and 134 women. Women were younger at diagnosis (mean age 25.5 compared with 29 years for men, P < 0.04) and had higher CD4+ T lymphocytes (mean 461 for women and 223 for men, P < 0.001). Out of 276 men, 90 (33%) were identified as HIV infected when they presented with AIDS. Fifty-five percent of the infected women were tested for HIV-1 because of contact with an infected person compared with 8% of the infected men, odds ratio (OR) 13.8 (95% confidence interval [CI]: 7.7-24.9). AIDS remains the main presentation for HIV-infected men. Women are diagnosed earlier and younger than men.
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Affiliation(s)
- A A Alrajhi
- Section of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Al-Abdely HM, Najvar LK, Bocanegra R, Graybill JR. Antifungal therapy of experimental cerebral phaeohyphomycosis due to Cladophialophora bantiana. Antimicrob Agents Chemother 2005; 49:1701-7. [PMID: 15855484 PMCID: PMC1087650 DOI: 10.1128/aac.49.5.1701-1707.2005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cladophialophora bantiana is associated with central nervous system infection and a poor outcome. C. bantiana tends to be resistant to amphotericin B. Accordingly, we evaluated amphotericin B and three triazoles--posaconazole, itraconazole, and fluconazole--for treatment of C. bantiana infection in mice. In immunosuppressed ICR mice infected intravenously, posaconazole, itraconazole, and amphotericin B prolonged survival. This improvement in survival corresponded with a reduction in brain fungal concentrations for mice which were given itraconazole and posaconazole, but not amphotericin B. In nonimmunosuppressed BALB/c mice infected intracerebrally, posaconazole showed dose-dependent responses in survival and reduction of brain tissue counts. These responses were observed for short, delayed, and prolonged therapy. Although posaconazole prolonged the survival of mice with reductions in brain fungal counts, it did not sterilize brain tissue with continuous therapy for 8 weeks. We concluded that posaconazole shows promise for the treatment of C. bantiana brain infections.
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Affiliation(s)
- Hail M Al-Abdely
- Division of Infectious Diseases, Department of Medicine, The University of Texas Health Science Center at San Antonio, Texas, USA.
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Bukhary Z, Mahmood W, Al-Khani A, Al-Abdely HM. Treatment of nosocomial meningitis due to a multidrug resistant Acinetobacter baumannii with intraventricular colistin. Saudi Med J 2005; 26:656-8. [PMID: 15900379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
We report a case of serious nosocomial meningitis due to a multidrug-resistant Acinetobacter baumannii in a 23-year-old woman who had a posterior fossa craniotomy with upper cervical laminectomy for excision of a meningioma at the level of foramen magnum. Post-operatively, she had neck pain with continuous fever and deterioration in the level of consciousness and convulsions. The CSF was turbid and had neutrophil pleocytosis. A multidrug-resistant Acinetobacter baumannii was isolated from the blood and CSF. The patient failed high doses of imipenem, ciprofloxacin and systemic colistin but responded well to intraventricular injections of colistin 125,000 units twice daily for 3 weeks. No apparent side effects were noticed. We have reviewed other similar cases reported in the literature.
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Affiliation(s)
- Zakeya Bukhary
- Section of Infectious Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
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Al-Abdely HM, Alkhunaizi AM, Al-Tawfiq JA, Hassounah M, Rinaldi MG, Sutton DA. Successful therapy of cerebral phaeohyphomycosis due toRamichloridium mackenzieiwith the new triazole posaconazole. Med Mycol 2005; 43:91-5. [PMID: 15712614 DOI: 10.1080/13693780400011104] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Cerebral phaeohyphomycosis caused by Ramichloridium mackenziei is universally fatal. All reported cases with long-term follow-up have indicated 100% mortality despite antifungal therapy and surgical intervention. We describe the case of a 62-year-old patient who underwent renal transplantation and had a cerebral abscess caused by R. mackenziei. The infection progressed despite surgical evacuation and therapy with liposomal amphotericin B, itraconazole, and 5-flucytosine. The patient was subsequently treated with the investigational triazole posaconazole oral suspension, 800 mg/day, in divided doses. Treatment with posaconazole resulted in progressive clinical and radiologic improvement. The patient is alive four years after diagnosis and maintained on posaconazole therapy. This case supports the potential role of this extended-spectrum azole in the treatment of this serious fungal infection of the central nervous system.
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Affiliation(s)
- H M Al-Abdely
- Section of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
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Abstract
PURPOSE OF REVIEW Fungal infections caused by rare fungi have increased in recent years. This may be due to the increase in the number of immunocompromised patients. Some rare fungi are geographically restricted, but with globalization and travel these infections are seen worldwide. The aim of this review is to address recent advances in the management of some uncommon fungal infections. RECENT FINDINGS Dematiaceous fungi (Phaeohyphomycetes) have been reported in both immunocompromised and immunocompetent individuals. Cerebral involvement and disseminated disease are associated with high mortality rates. Surgical excision and broad-spectrum triazole antifungal therapy are associated with better outcomes. Mucormycosis in diabetic and immune-suppressed patients is associated with high mortality. Early radical surgical debridement and amphotericin B-based regimens are a key to success. Basidiobolomycosis has recently been reported to cause chronic granulomatous infection of the gastrointestinal tract. Treatment with itraconazole and surgical resection is associated with favourable outcomes. Invasive fusariosis in cancer patients is typically resistant to most antifungal agents, but recent data have suggested a response to voriconazole. Voriconazole also demonstrated activity against Scedosporium apiospermum, but was less active against Scedosporium prolificans. Amphotericin B and itraconazole are currently the treatments of choice for the southeast Asian fungus, Penicillium marneffie. SUMMARY Parallel to the increased number of patients susceptible to invasive infections has been an increase in the number of broad-spectrum antifungal agents allowing for better therapeutic options. High-quality data are lacking because of the rarity of such infections. In future, new triazoles and echinocandins will probably replace amphotericin B as the first therapeutic choice for many uncommon fungal infections.
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Affiliation(s)
- Hail M Al-Abdely
- Section of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Center, Saudi Arabia.
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Abstract
The mode of HIV-1 transmission was determined for 410 Saudi patients. Heterosexual transmission occurred in 189 patients (46%), blood product transfusion in 107 (26%), and perinatal transmission in 47 (12%). Men who have sex with men and injection drug users represented 5% and 2%,respectively. Sixty-three of 65 heterosexually infected women acquired HIV-1 from their spouses, whereas 111 of 124 heterosexually infected men acquired the virus from commercial sex workers. Heterosexual transmission is the main mode in Saudi patients.
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Affiliation(s)
- Abdulrahman A Alrajhi
- Department of Medicine, King Faisal Specialist Hospitaltal and Research Centre, Riyadh, Saudi Arabia
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Alrajhi AA, Abdulwahab S, Almodovar E, Al-Abdely HM. Risk factors for drug-resistant Mycobacterium tuberculosis in Saudi Arabia. Neurosciences (Riyadh) 2002; 7:99-104. [PMID: 23978918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To identify rates of primary and secondary drug-resistant Mycobacterium tuberculosis and their risk factors from a tertiary-care center in the Kingdom of Saudi Arabia. METHODS Review of microbiological and clinical data of all patients with positive isolates of Mycobacterium tuberculosis between 1995 and 2000 at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia. RESULTS Susceptibility to antituberculosis agents was tested in 320 isolates from 320 patients. The median age was 50 years. Pulmonary tuberculosis was diagnosed in 106 (33%) patients, extrapulmonary in 183 (57%), and both in 31 (10%) patients. Two hundred forty-six isolates were sensitive to all 5 first line agents. Resistance to at least one of the first line agents was documented in 36 (11.3%) isolates. For the year 2000, resistance rates increased to 17.6%. Monoresistance was noted in 20 isolates (6.3%) and polyresistance in 16 isolates (5.0%) including 9 multidrug-resistant Mycobacterium tuberculosis isolates (2.8%). Resistance rates for antituberculosis agents are: Isoniazid, 9.1%; Rifampin, 2.8%; Ethambutol, 1.6%; Streptomycin, 5%; Pyrazinamide, 3.6%. Seventy-eight percent of the resistant isolates are considered primary resistance. History of antituberculosis therapy was the only risk factor associated with drug resistant Mycobacterium tuberculosis, odds ratio 19.9 (P< 0.00001). The mean age of patients with resistant isolates was 42 years compared to 49 years in patients with susceptible isolates (P= 0.047). CONCLUSION In a population of mostly Saudi patients, primary and secondary drug-resistant Mycobacterium tuberculosis is relatively low but has increased lately. Previous history of antituberculosis chemotherapy and young age are risk factors identified.
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Affiliation(s)
- Abdulrahman A Alrajhi
- Department of Medicine, MBC 46, King Faisal Specialist Hospital & Research Centre, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia. Tel. +966 (1) 4427494 Fax. +966 (1) 4427499. E-mail:
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35
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Alrajhi AA, Abdulwahab S, Almodovar E, Al-Abdely HM. Risk factors for drug-resistant Mycobacterium tuberculosis in Saudi Arabia. Saudi Med J 2002; 23:305-10. [PMID: 11938422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To identify rates of primary and secondary drug-resistant Mycobacterium tuberculosis and their risk factors from a tertiary-care center in the Kingdom of Saudi Arabia. METHODS Review of microbiological and clinical data of all patients with positive isolates of Mycobacterium tuberculosis between 1995 and 2000 at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia. RESULTS Susceptibility to antituberculosis agents was tested in 320 isolates from 320 patients. The median age was 50 years. Pulmonary tuberculosis was diagnosed in 106 (33%) patients, extrapulmonary in 183 (57%), and both in 31 (10%) patients. Two hundred forty-six isolates were sensitive to all 5 first line agents. Resistance to at least one of the first line agents was documented in 36 (11.3%) isolates. For the year 2000, resistance rates increased to 17.6%. Monoresistance was noted in 20 isolates (6.3%) and polyresistance in 16 isolates (5.0%) including 9 multidrug-resistant Mycobacterium tuberculosis isolates (2.8%). Resistance rates for antituberculosis agents are: Isoniazid, 9.1%; Rifampin, 2.8%; Ethambutol, 1.6%; Streptomycin, 5%; Pyrazinamide, 3.6%. Seventy-eight percent of the resistant isolates are considered primary resistance. History of antituberculosis therapy was the only risk factor associated with drug resistant Mycobacterium tuberculosis, odds ratio 19.9 (P< 0.00001). The mean age of patients with resistant isolates was 42 years compared to 49 years in patients with susceptible isolates (P= 0.047). CONCLUSION In a population of mostly Saudi patients, primary and secondary drug-resistant Mycobacterium tuberculosis is relatively low but has increased lately. Previous history of antituberculosis chemotherapy and young age are risk factors identified.
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Affiliation(s)
- Abdulrahman A Alrajhi
- Section of Infectious Diseases, Department of Pathology & Laboratory Services, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia.
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Abstract
OBJECTIVES To report our experience with disseminated Mycobacterium simiae disease in patients with AIDS, and review other cases reported in the literature. METHODS We retrospectively reviewed all cases of M. simiae that were isolated from sterile body sites over a 9-year period at the University Health System Hospital at San Antonio, Texas, U.S.A. Data included patient demographics, clinical features, other accompanying opportunistic infections, in vitro susceptibility, therapy and outcome. RESULTS Ten cases of M. simiae disseminated disease were identified. All of them were inpatients with AIDS. Another nine cases of disseminated infection in AIDS patients were reported in the literature. Advanced AIDS with absolute CD4 counts of less than 50 and an associated AIDS-defining illness characterized all cases. Persistent fever and debilitation without localizing signs were the most common clinical features. Our patients responded poorly to antimycobacterial drugs and died within 6 months of diagnosis. The only reported successful therapy was in patients who responded well to highly active antiretroviral therapy and antimycobacterial regimens containing clarithromycin, ethambutol and ciprofloxacin. CONCLUSIONS Clinical presentation of M. simiae infection mimics Mycobacterium avium complex, with fever and progressive debilitation, but is less responsive to therapy. Immuno-reconstitution with potent antiretroviral therapy may be the best therapy for such resistant disease.
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Affiliation(s)
- H M Al-Abdely
- Department of Medicine, Division of Infectious Diseases, The University of Texas Health Science Centre at San Antonio, 7703 Floyd Curl, San Antonio, Texas 78284, USA
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Al-Abdely HM, Najvar L, Bocanegra R, Fothergill A, Loebenberg D, Rinaldi MG, Graybill JR. SCH 56592, amphotericin B, or itraconazole therapy of experimental murine cerebral phaeohyphomycosis due to Ramichloridium obovoideum ("Ramichloridium mackenziei"). Antimicrob Agents Chemother 2000; 44:1159-62. [PMID: 10770745 PMCID: PMC89838 DOI: 10.1128/aac.44.5.1159-1162.2000] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Ramichloridium obovoideum ("Ramichloridium makenziei") is a rare cause of lethal cerebral phaeohyphomycosis. It has been, so far, geographically restricted to the Middle East. BALB/c mice were inoculated with two strains of R. obovoideum intracranially. Therapy with amphotericin B, itraconazole, or the investigational triazole SCH 56592 was conducted for 10 days. Half the mice were monitored for survival and half were killed for determination of the fungal load in brain tissue. Recipients of SCH 56592 had significantly prolonged survival and lower brain fungal burden, and this result was found for mice infected with both of the fungal strains tested. Itraconazole reduced the brain fungal load in mice infected with one strain but not the other, while amphotericin B had no effect on brain fungal concentrations. This study indicates a possible role of SCH 56592 in the treatment of the serious cerebral phaeohyphomycosis due to R. obovoideum.
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Affiliation(s)
- H M Al-Abdely
- Division of Infectious Diseases, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284, USA.
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Al-Abdely HM, Graybill JR, Loebenberg D, Melby PC. Efficacy of the triazole SCH 56592 against Leishmania amazonensis and Leishmania donovani in experimental murine cutaneous and visceral leishmaniases. Antimicrob Agents Chemother 1999; 43:2910-4. [PMID: 10582881 PMCID: PMC89586 DOI: 10.1128/aac.43.12.2910] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Current therapy for leishmaniasis is unsatisfactory. Efficacious and safe oral therapy would be ideal. We examined the efficacy of SCH 56592, an investigational triazole antifungal agent, against cutaneous infection with Leishmania amazonensis and visceral infection with Leishmania donovani in BALB/c mice. Mice were infected in the ear pinna and tail with L. amazonensis promastigotes and were treated with oral SCH 56592 or intraperitoneal amphotericin B for 21 days. At doses of 60 and 30 mg/kg/day, SCH 56592 was highly efficacious in treating cutaneous disease, and at a dose of 60 mg/kg/day, it was superior to amphotericin B at a dose of 1 mg/kg/day. The means of tail lesion sizes were 0.32 +/- 0.12, 0.11 +/- 0.06, 0.17 +/- 0.07, and 0.19 +/- 0.08 mm for controls, SCH 56592 at 60 and 30 mg/kg/day, and amphotericin B recipients, respectively (P = 0.0003, 0.005, and 0.01, respectively). Parasite burden in draining lymph nodes confirmed these efficacy findings. In visceral leishmaniasis due to L. donovani infection, mice treated with SCH 56592 showed a 0.5- to 1-log-unit reduction in parasite burdens in the liver and the spleen compared to untreated mice. Amphotericin B at 1 mg/kg/day was superior to SCH 56592 in the treatment of visceral infection, with a 2-log-unit reduction in parasite burdens in both the liver and spleen. These studies indicate very good activity of SCH 56592 against cutaneous leishmaniasis due to L. amazonensis infection and, to a lesser degree, against visceral leishmaniasis due to L. donovani infection in susceptible BALB/c mice.
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Affiliation(s)
- H M Al-Abdely
- Medical Service, Audie Murphy Veterans Administration Hospital, San Antonio, Texas 78284, USA.
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Al-Abdely HM, Graybill JR, Bocanegra R, Najvar L, Montalbo E, Regen SL, Melby PC. Efficacies of KY62 against Leishmania amazonensis and Leishmania donovani in experimental murine cutaneous leishmaniasis and visceral leishmaniasis. Antimicrob Agents Chemother 1998; 42:2542-8. [PMID: 9756753 PMCID: PMC105886 DOI: 10.1128/aac.42.10.2542] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Current therapy for leishmaniasis is unsatisfactory because parenteral antimonial salts and pentamidine are associated with significant toxicity and failure rates. We examined the efficacy of KY62, a new, water-soluble, polyene antifungal, against cutaneous infection with Leishmania amazonensis and against visceral infection with Leishmania donovani in susceptible BALB/c mice. Mice were infected with L. amazonensis promastigotes in the ear pinna and in the tail and were treated with KY62 or amphotericin B. The cutaneous lesions showed a remarkable response to therapy with KY62 at a dose of 30 mg per kg of body weight per day. At this dose, the efficacy of KY62 was equivalent to or better than that of amphotericin B at 1 to 5 mg/kg/day. Mice infected intravenously with 10(7) L. donovani promastigotes and treated with KY62 showed a 4-log reduction in the parasite burden in the liver and spleen compared to untreated mice. These studies indicate potent activity of KY62 against experimental cutaneous leishmaniasis caused by L. amazoniensis and against experimental visceral leishmaniasis caused by L. donovani.
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Affiliation(s)
- H M Al-Abdely
- Division of Infectious Diseases, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284, USA.
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