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Hasan T, Lynch M, King C, Wehbe C, Plymoth M, Islam MS, Iannuzzi T, Dao A, Lai J, Martiniuk A, Desai S, Sheel M. Vaccine-Preventable Disease Outbreaks among Healthcare Workers: A Scoping Review. Clin Infect Dis 2024:ciae209. [PMID: 38630638 DOI: 10.1093/cid/ciae209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2023] [Revised: 03/19/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Outbreaks of vaccine preventable diseases (VPDs) in health care workers (HCWs) can result in morbidity and mortality and cause significant disruptions to health care services, patients and visitors as well as an added burden on the health system. This scoping review is aimed to describe the epidemiology of VPD outbreaks in HCW, caused by diseases which are prevented by the ten vaccines recommended by World Health Organization (WHO) for HCWs. METHODS In April 2022 CINAHL, MEDLINE, Global Health and EMBASE were searched for all articles reporting on VPD outbreaks in HCWs since the year 2000. Articles were included regardless of language and study type. Clinical and epidemiological characteristics of VPD outbreaks were described. RESULTS Our search found 9363 articles, of which 216 met inclusion criteria. Studies describing six of the ten VPDs were found: influenza, measles, varicella, tuberculosis, pertussis and rubella. Most articles (93%) were from high- and upper middle-income countries. While most outbreaks occurred in hospitals, several influenza outbreaks were reported in long term care facilities. Based on available data, vaccination rates amongst HCWs were rarely reported. CONCLUSION We describe several VPD outbreaks in HCWs from 2000 to April 2022. The review emphasises the need to understand the factors influencing outbreaks in HCWs and highlight importance of vaccination amongst HCWs.
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Affiliation(s)
- Tasnim Hasan
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
- Western Sydney Local Health District, New South Wales, Australia
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
| | - Michelle Lynch
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Catherine King
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia
| | - Charbel Wehbe
- Western Sydney Local Health District, New South Wales, Australia
| | - Martin Plymoth
- Western Sydney Local Health District, New South Wales, Australia
| | - Md Saiful Islam
- School of Population Health, University of New South Wales, Australia
| | | | - Aiken Dao
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Jana Lai
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia
| | - Alexandra Martiniuk
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
- Dalla Lana School of Public Health, the University of Toronto, Canada
| | - Shalini Desai
- Immunization, Vaccines and Biologicals Department, The World Health Organization, Geneva, Switzerland
| | - Meru Sheel
- Sydney Infectious Disease Institute, Faculty of Medicine and Health, University of Sydney, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
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Chong H, Liu X, Fang S, Yang X, Zhang Y, Wang T, Liu L, Kan Y, Zhao Y, Fan H, Zhang J, Wang X, Yao H, Yang Y, Gao Y, Zhao Q, Li S, Plymoth M, Xi J, Zhang Y, Wang C, Pang H. Organo-Pt ii Complexes for Potent Photodynamic Inactivation of Multi-Drug Resistant Bacteria and the Influence of Configuration. Adv Sci (Weinh) 2024; 11:e2306936. [PMID: 38298088 PMCID: PMC11005693 DOI: 10.1002/advs.202306936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Indexed: 02/02/2024]
Abstract
PtII based organometallic photosensitizers (PSs) have emerged as novel potent photodynamic inactivation (PDI) reagents through their enhanced intersystem crossing (ISC) processes. Currently, few PtII PSs have been investigated as antibacterial materials, with relatively poor performances reported and with structure-activity relationships not well described. Herein, a pair of configurational isomers are reported of Bis-BODIPY (4,4-difluoro-boradizaindacene) embedded PtII PSs. The cis-isomer (cis-BBP) displayed enhanced 1O2 generation and better bacterial membrane anchoring capability as compared to the trans-isomer (trans-BBP). The effective PDI concentrations (efficiency > 99.9%) for cis-BBP in Acinetobacter baumannii (multi-drug resistant (MDR)) and Staphylococcus aureus are 400 nM (12 J cm-2) and 100 nM (18 J cm-2), respectively; corresponding concentrations and light doses for trans-BBP in the two bacteria are 2.50 µM (30 J cm-2) and 1.50 µM (18 J cm-2), respectively. The 50% and 90% minimum inhibitory concentration (MIC50 and MIC90) ratio of trans-BBP to cis-BBP is 22.22 and 24.02 in A. baumannii (MDR); 21.29 and 22.36 in methicillin resistant S. aureus (MRSA), respectively. Furthermore, cis-BBP displays superior in vivo antibacterial performance, with acceptable dark and photoinduced cytotoxicity. These results demonstrate cis-BBP is a robust light-assisted antibacterial reagent at sub-micromolecular concentrations. More importantly, configuration of PtII PSs should be an important issue to be considered in further PDI reagents design.
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Affiliation(s)
- Hui Chong
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Xuanwei Liu
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Siyu Fang
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Xiaofei Yang
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Yuefei Zhang
- Department of EmergencyAffiliated Hospital of Yangzhou UniversityYangzhouJiangsu225000China
| | - Tianyi Wang
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Lin Liu
- School of NursingYangzhou UniversityYangzhou225009P. R. China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention andTreatment of Senile DiseasesNo. 88 South University Rd.Yangzhou225009P. R. China
| | - Yinshi Kan
- School of NursingYangzhou UniversityYangzhou225009P. R. China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention andTreatment of Senile DiseasesNo. 88 South University Rd.Yangzhou225009P. R. China
| | - Yueqi Zhao
- School of NursingYangzhou UniversityYangzhou225009P. R. China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention andTreatment of Senile DiseasesNo. 88 South University Rd.Yangzhou225009P. R. China
| | - Hongying Fan
- Testing Center of Yangzhou UniversityNo. 48 Wenhui East Rd.Yangzhou225009P. R. China
| | - Jingqi Zhang
- School of Materials Science and EngineeringUniversity of Science and Technology BeijingBeijing100083P. R. China
| | - Xiaoyu Wang
- School of Materials Science and EngineeringUniversity of Science and Technology BeijingBeijing100083P. R. China
| | - Hang Yao
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Yi Yang
- Center LaboratoryAffiliated Hospital of Yangzhou UniversityYangzhou225009P. R. China
| | - Yijian Gao
- College of Pharmaceutical SciencesSoochow UniversitySuzhou215123P. R. China
| | - Qi Zhao
- College of Pharmaceutical SciencesSoochow UniversitySuzhou215123P. R. China
| | - Shengliang Li
- College of Pharmaceutical SciencesSoochow UniversitySuzhou215123P. R. China
| | - Martin Plymoth
- Westmead hospitalSydneyNSW 2145Australia
- Department of Clinical MicrobiologyUmeå UniversityUmeå90187Sweden
| | - Juqun Xi
- Department of PharmacologyInstitute of Translational MedicineSchool of MedicineYangzhou UniversityYangzhou225009P. R. China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention andTreatment of Senile DiseasesYangzhou225009P. R. China
| | - Yu Zhang
- School of NursingYangzhou UniversityYangzhou225009P. R. China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention andTreatment of Senile DiseasesNo. 88 South University Rd.Yangzhou225009P. R. China
| | - Chengyin Wang
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
| | - Huan Pang
- Department of Chemical and Chemical EngineeringYangzhou UniversityNo. 180, Si‐Wang‐Ting Rd.YangzhouJiangsu225009P. R. China
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Plymoth M, Lundquist R, Nystedt A, Sjöstedt A, Gustafsson TN. Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes from an 11-year Retrospective Observational Cohort in Northern Sweden. Clin Infect Dis 2024:ciae098. [PMID: 38393822 DOI: 10.1093/cid/ciae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/17/2023] [Revised: 01/25/2024] [Accepted: 02/21/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Tularemia is an important re-emerging disease with a multimodal transmission-pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden. METHODS Data from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011-2021 were collected through review of electronic medical records and participant questionnaires; with 415 out of 784 accepting participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or PCR). A multivariable logistic regression model was used to investigate variables associated with re-treatment. RESULTS Median age of participants was 54 years (IQR 41.5-65) and 49.2% were female. While ulceroglandular tularemia was the predominant form (n=215, 65.7%), there were several cases of pulmonary tularemia (n=40; 12.2%). Inflammatory markers were largely non-specific, with monocytosis frequently observed (n=36/75; 48%). Tularemia was often misdiagnosed upon presentation (n=158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics, and 102 (31.2%) re-treated. Persistent lymphadenopathy was infrequent (n=22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with re-treatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR 3.25-20.75] vs. 7 [IQR 4-11.25] days; adjusted p=0.076), and doxycycline-based treatment regimen (vs. ciprofloxacin; adjusted p=0.084), although not significant after correction for multiple comparisons. CONCLUSION We comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis and timely commencement of treatment for an appropriate duration.
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Affiliation(s)
- Martin Plymoth
- Department of Clinical Microbiology, Sunderby Research Unit, Umeå University, Umeå, Sweden
- Westmead Hospital, Sydney, New South Wales, Australia
| | - Robert Lundquist
- Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Anders Nystedt
- Department of Communicable Disease Control, County Counsel of Norrbotten, Luleå, Sweden
| | - Anders Sjöstedt
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Tomas N Gustafsson
- Department of Clinical Microbiology, Sunderby Research Unit, Umeå University, Umeå, Sweden
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Plymoth M, Mogessie YG, Mohammed I, Mengesha D, Wang M, Musa SS, Bekele BK, Tatere HY, Musa MB, Lucero-Prisno, III DE. Conflict, community, and COVID-19: response and implications in Ethiopia. J Public Health Afr 2022; 13:1957. [PMID: 36277946 PMCID: PMC9585601 DOI: 10.4081/jphia.2022.1957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 04/25/2022] [Indexed: 11/23/2022] Open
Abstract
Community transmission of COVID-19 is currently on the rise in Ethiopia, while availability of diagnostic and treatment services remains limited. Impaired access to essential services is affected by the pandemic’s strain on the health system, and as a consequence of the country’s public health response. The ongoing conflict in the Tigray Region provides another obstacle to accessing and providing care for the local population; and has displaced large numbers of people both within and outside the country. In this commentary we discuss the impact of the conflict on essential services and argue that a coordinated holistic response is essential to mitigate both short and long-term consequences of the conflict, including increased COVID-19 transmission, acute malnutrition, disruption of education services, displacement of people, and food insecurities. We highlight the important role of community engagement in prevention and early detection of these challenges, and the need for comprehensive interventions in the region.
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Plymoth M, Sanders EJ, Van Der Elst EM, Medstrand P, Tesfaye F, Winqvist N, Balcha T, Björkman P. Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia. PLoS One 2020; 15:e0244066. [PMID: 33320900 PMCID: PMC7737988 DOI: 10.1371/journal.pone.0244066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/17/2020] [Accepted: 12/02/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction The potential impact of socio-economic condition on virological suppression during antiretroviral treatment (ART) in sub-Saharan Africa is largely unknown. In this case-control study, we compared socio-economic factors among Ethiopian ART recipients with lack of virological suppression to those with undetectable viral load (VL). Methods Cases (VL>1000 copies/ml) and controls (VL<150 copies/ml) aged ≥15years, with ART for >6 months and with available VL results within the last 3 months, were identified from registries at public ART clinics in Central Ethiopia. Questionnaire-based interviews on socio-economic characteristics, health condition and transmission risk behavior were conducted. Univariate variables associated with VL>1000 copies/ml (p<0.25) were added to a multivariable logistic regression model. Results Among 307 participants (155 cases, 152 controls), 61.2% were female, and the median age was 38 years (IQR 32–46). Median HIV-RNA load among cases was 6,904 copies/ml (IQR 2,843–26,789). Compared to controls, cases were younger (median 36 vs. 39 years; p = 0.004), more likely to be male (46.5% vs. 30.9%; p = 0.005) and had lower pre-ART CD4 cell counts (170 vs. 220 cells/μl; p = 0.009). In multivariable analysis of urban residents (94.8%), VL>1000 copies/ml was associated with lower relative wealth (adjusted odds ratio [aOR] 2.98; 95% CI 1.49–5.94; p = 0.016), geographic work mobility (aOR 6.27, 95% CI 1.82–21.6; p = 0.016), younger age (aOR 0.94 [year], 95% CI 0.91–0.98; p = 0.011), longer duration of ART (aOR 1.19 [year], 95% CI 1.07–1.33; p = 0.020), and suboptimal (aOR 3.83, 95% CI 1.33–10.2; p = 0.048) or poor self-perceived wellbeing (aOR 9.75, 95% CI 2.85–33.4; p = 0.012), after correction for multiple comparisons. High-risk sexual behavior and substance use was not associated with lack of virological suppression. Conclusion Geographic work mobility and lower relative wealth were associated with lack of virological suppression among Ethiopian ART recipients in this predominantly urban population. These characteristics indicate increased risk of treatment failure and the need for targeted interventions for persons with these risk factors.
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Affiliation(s)
- Martin Plymoth
- Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
- * E-mail: ,
| | - Eduard J. Sanders
- Centre for Geographic Medicine Research, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Nuffield Department of Clinical Medicine, University of Oxford, Headington, United Kingdom
| | - Elise M. Van Der Elst
- Centre for Geographic Medicine Research, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
| | - Patrik Medstrand
- Clinical Virology, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Fregenet Tesfaye
- Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Niclas Winqvist
- Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Taye Balcha
- Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Per Björkman
- Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Infectious Diseases, Skåne University Hospital, Malmö, Sweden
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Wang M, Keighley C, Watts M, Plymoth M, McGee TM. Preventing Early-Onset Group B Streptococcus neonatal infection and reducing antibiotic exposure using a rapid PCR test in term prelabour rupture of membranes. Aust N Z J Obstet Gynaecol 2020; 60:753-759. [PMID: 32291755 DOI: 10.1111/ajo.13159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/12/2019] [Accepted: 03/07/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND How best to target intrapartum antibiotic prophylaxis (IAP) to minimise both Early-Onset Group B Streptococcus (EOGBS) neonatal infection and maternal/fetal antibiotic exposure is uncertain, with both routine-screening and risk-factor approaches available. AIMS This retrospective cohort study was undertaken to examine the outcomes of a hybrid risk-and-screen approach to EOGBS prevention using GBS polymerase chain reaction (PCR). The target population was women with term prelabour rupture of membranes (TermPROM) having the risk factor of prolonged rupture of membranes (ROM) ≥18 h. MATERIALS AND METHODS Non-labouring TermPROM women had rapid GBS PCR testing at presentation. GBS screen-positive women proceeded to induction of labour and received IAP. GBS screen-negative women were allowed home to await spontaneous labour and not given IAP regardless of duration of ROM, unless other risk factors developed. For all other women, the risk-factor approach was followed. RESULTS From 2009 to 2018, there were 20 cases of culture-positive EOGBS, a rate of 0.36/1000 live births (95% CI 0.22-0.56/1000), comparable to other recent reports. Over 2010-2018 when laboratory data were available, 1120 TermPROM women with ROM ≥18 h avoided antibiotics because they were GBS PCR-negative (2.3% of all births, 3.6% of vaginal births) while 338 TermPROM women with ROM <18 h received targeted antibiotics for being GBS-positive. No cases of EOGBS occurred in TermPROM women, those with ROM ≥18 h, or due to protocol-compliance failure. CONCLUSIONS A hybrid approach involving risk-factor-based IAP and intrapartum GBS PCR screening of non-labouring TermPROM women delivers acceptably low rates of EOGBS while minimising and better targeting antibiotic exposure.
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Affiliation(s)
- Mandy Wang
- Department of Women's and Newborn Health, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin Keighley
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology Public Health, Institute for Clinical Pathology and Medical Research-New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Matthew Watts
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology Public Health, Institute for Clinical Pathology and Medical Research-New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | | | - Therese M McGee
- Department of Women's and Newborn Health, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
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