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Advani SD, Turner NA, North R, Moehring RW, Vaughn VM, Scales CD, Siddiqui NY, Schmader KE, Anderson DJ. Proposing the "Continuum of UTI" for a Nuanced Approach to Diagnosis and Management of Urinary Tract Infections. J Urol 2024; 211:690-698. [PMID: 38330392 PMCID: PMC11003824 DOI: 10.1097/ju.0000000000003874] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Patients with suspected UTIs are categorized into 3 clinical phenotypes based on current guidelines: no UTI, asymptomatic bacteriuria (ASB), or UTI. However, all patients may not fit neatly into these groups. Our objective was to characterize clinical presentations of patients who receive urine tests using the "continuum of UTI" approach. MATERIALS AND METHODS This was a retrospective cohort study of a random sample of adult noncatheterized inpatient and emergency department encounters with paired urinalysis and urine cultures from 5 hospitals in 3 states between January 01, 2017, and December 31, 2019. Trained abstractors collected clinical (eg, symptom) and demographic data. A focus group discussion with multidisciplinary experts was conducted to define the continuum of UTI, a 5-level classification scheme that includes 2 new categories: lower urinary tract symptoms/other urologic symptoms and bacteriuria of unclear significance. The newly defined continuum of UTI categories were compared to the current UTI classification scheme. RESULTS Of 220,531 encounters, 3392 randomly selected encounters were reviewed. Based on the current classification scheme, 32.1% (n = 704) had ASB and 53% (n = 1614) did not have a UTI. When applying the continuum of UTI categories, 68% of patients (n = 478) with ASB were reclassified as bacteriuria of unclear significance and 29% of patients (n = 467) with "no UTI" were reclassified to lower urinary tract symptoms/other urologic symptoms. CONCLUSIONS Our data suggest the need to reframe our conceptual model of UTI vs ASB to reflect the full spectrum of clinical presentations, acknowledge the diagnostic uncertainty faced by frontline clinicians, and promote a nuanced approach to diagnosis and management of UTIs.
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Affiliation(s)
- Sonali D Advani
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Nicholas A Turner
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Rebecca North
- Duke Aging Center, Duke University School of Medicine, Durham, North Carolina
| | - Rebekah W Moehring
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Valerie M Vaughn
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Charles D Scales
- Department of Urology, Duke University School of Medicine, Durham, North Carolina
- Department Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | - Nazema Y Siddiqui
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina
| | - Kenneth E Schmader
- Duke Aging Center, Duke University School of Medicine, Durham, North Carolina
- Durham VA Medical Center, Durham, North Carolina
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
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Hackett C, Frank L, Heldt-Werle L, Loosier PS. Provider-Reported Barriers in Sexual Health Care Services for Women With Upstream Barriers: The Case of Syphilis and Congenital Syphilis in Southern Colorado, 2022. Sex Transm Dis 2024; 51:337-341. [PMID: 38301636 PMCID: PMC11018457 DOI: 10.1097/olq.0000000000001936] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Syphilis and congenital syphilis rates have increased sharply in Colorado in the past 5 years. Congenital syphilis is passed during pregnancy in utero and can cause lifelong physical, developmental, and neurologic problems for the child, or can lead to miscarriage, stillbirth, or early infant death. Congenital syphilis is easily prevented if the mother receives timely testing, treatment, and prenatal care. Providers can play a key role in preventing congenital syphilis for women with social vulnerabilities, who have a higher likelihood of syphilis and/or congenital syphilis infection. METHODS We surveyed 23 and interviewed 4 health care providers in southern Colorado in 2022 to record their experiences in providing sexual health care services. We asked providers with direct care experience about perceived barriers in effectively treating syphilis. RESULTS The most significant barriers reported in the survey were the cost of treatment (26%) and the loss to follow-up (22%). Interviews revealed further challenges, including discretionary testing procedures, delays in screening results, treatment referral issues, and stigma around substance use and sexual activity. CONCLUSIONS Elevated syphilis and congenital syphilis rates pose significant public health challenges. Coordinated interventions are necessary to effectively reduce the transmission of syphilis and congenital syphilis among women with upstream barriers. Potential care solutions include expanding rapid, point-of care testing and treatment options, supporting bicillin delivery or web-based inventory systems, offering anti-stigma training for providers, offering mental and behavioral health resources at providers' clinics, and expanding partnerships with syringe access programs.
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Affiliation(s)
- Colleen Hackett
- From the Department of Criminology and Criminal Justice, Northern Arizona University, Flagstaff, AZ
| | - Leslie Frank
- Office of STI, HIV and Viral Hepatitis Colorado Department of Public Health and Environment, Denver, CO
| | - Lindsey Heldt-Werle
- Office of STI, HIV and Viral Hepatitis Colorado Department of Public Health and Environment, Denver, CO
| | - Penny S Loosier
- Division of STD Prevention Centers for Disease Control and Prevention, Atlanta, GA
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Taylor-Salmon E, Hill V, Paul LM, Koch RT, Breban MI, Chaguza C, Sodeinde A, Warren JL, Bunch S, Cano N, Cone M, Eysoldt S, Garcia A, Gilles N, Hagy A, Heberlein L, Jaber R, Kassens E, Colarusso P, Davis A, Baudin S, Rico E, Mejía-Echeverri Á, Scott B, Stanek D, Zimler R, Muñoz-Jordán JL, Santiago GA, Adams LE, Paz-Bailey G, Spillane M, Katebi V, Paulino-Ramírez R, Mueses S, Peguero A, Sánchez N, Norman FF, Galán JC, Huits R, Hamer DH, Vogels CBF, Morrison A, Michael SF, Grubaugh ND. Travel surveillance uncovers dengue virus dynamics and introductions in the Caribbean. Nat Commun 2024; 15:3508. [PMID: 38664380 PMCID: PMC11045810 DOI: 10.1038/s41467-024-47774-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Dengue is the most prevalent mosquito-borne viral disease in humans, and cases are continuing to rise globally. In particular, islands in the Caribbean have experienced more frequent outbreaks, and all four dengue virus (DENV) serotypes have been reported in the region, leading to hyperendemicity and increased rates of severe disease. However, there is significant variability regarding virus surveillance and reporting between islands, making it difficult to obtain an accurate understanding of the epidemiological patterns in the Caribbean. To investigate this, we used travel surveillance and genomic epidemiology to reconstruct outbreak dynamics, DENV serotype turnover, and patterns of spread within the region from 2009-2022. We uncovered two recent DENV-3 introductions from Asia, one of which resulted in a large outbreak in Cuba, which was previously under-reported. We also show that while outbreaks can be synchronized between islands, they are often caused by different serotypes. Our study highlights the importance of surveillance of infected travelers to provide a snapshot of local introductions and transmission in areas with limited local surveillance and suggests that the recent DENV-3 introductions may pose a major public health threat in the region.
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Affiliation(s)
- Emma Taylor-Salmon
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
| | - Verity Hill
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Lauren M Paul
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Robert T Koch
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Mallery I Breban
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Afeez Sodeinde
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
- Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, USA
| | - Sylvia Bunch
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Natalia Cano
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Marshall Cone
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Sarah Eysoldt
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Alezaundra Garcia
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Nicadia Gilles
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Andrew Hagy
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Lea Heberlein
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Rayah Jaber
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Elizabeth Kassens
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Pamela Colarusso
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, USA
| | - Amanda Davis
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, USA
| | - Samantha Baudin
- Florida Department of Health in Miami-Dade County, Miami, FL, USA
| | - Edhelene Rico
- Florida Department of Health in Miami-Dade County, Miami, FL, USA
| | | | - Blake Scott
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA
| | - Danielle Stanek
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA
| | - Rebecca Zimler
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA
| | - Jorge L Muñoz-Jordán
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gilberto A Santiago
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Laura E Adams
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Melanie Spillane
- Office of Data, Analytics, and Technology, Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Bureau for Global Health, United States Agency for International Development, Arlington, VA, USA
| | - Volha Katebi
- Office of Data, Analytics, and Technology, Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert Paulino-Ramírez
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana, UNIBE Research Hub, Santo Domingo, Dominican Republic
| | - Sayira Mueses
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana, UNIBE Research Hub, Santo Domingo, Dominican Republic
| | - Armando Peguero
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana, UNIBE Research Hub, Santo Domingo, Dominican Republic
| | - Nelissa Sánchez
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana, UNIBE Research Hub, Santo Domingo, Dominican Republic
| | - Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, CIBER de Enfermedades Infecciosas, IRYCIS, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - Juan-Carlos Galán
- Microbiology Department, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER de Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
| | - Ralph Huits
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Section of Infectious Diseases, Boston University School of Medicine, Center for Emerging Infectious Disease Policy and Research, Boston University, and National Emerging Infectious Disease Laboratory, Boston, MA, USA
| | - Chantal B F Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Andrea Morrison
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA.
| | - Scott F Michael
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, FL, USA.
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
- Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, USA.
- Yale Institute for Global Health, Yale University, New Haven, CT, USA.
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA.
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Bell C, Goss M, Norton D, Barlow S, Temte E, He C, Hamer C, Walters S, Sabry A, Johnson K, Chen G, Uzicanin A, Temte J. Descriptive Epidemiology of Pathogens Associated with Acute Respiratory Infection in a Community-Based Study of K-12 School Children (2015-2023). Pathogens 2024; 13:340. [PMID: 38668295 PMCID: PMC11053468 DOI: 10.3390/pathogens13040340] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
School-based outbreaks often precede increased incidence of acute respiratory infections in the greater community. We conducted acute respiratory infection surveillance among children to elucidate commonly detected pathogens in school settings and their unique characteristics and epidemiological patterns. The ORegon CHild Absenteeism due to Respiratory Disease Study (ORCHARDS) is a longitudinal, laboratory-supported, school-based, acute respiratory illness (ARI) surveillance study designed to evaluate the utility of cause-specific student absenteeism monitoring for early detection of increased activity of influenza and other respiratory viruses in schools from kindergarten through 12th grade. Eligible participants with ARIs provided demographic, epidemiologic, and symptom data, along with a nasal swab or oropharyngeal specimen. Multipathogen testing using reverse-transcription polymerase chain reaction (RT-PCR) was performed on all specimens for 18 respiratory viruses and 2 atypical bacterial pathogens (Chlamydia pneumoniae and Mycoplasma pneumoniae). Between 5 January 2015 and 9 June 2023, 3498 children participated. Pathogens were detected in 2455 of 3498 (70%) specimens. Rhinovirus/enteroviruses (36%) and influenza viruses A/B (35%) were most commonly identified in positive specimens. Rhinovirus/enteroviruses and parainfluenza viruses occurred early in the academic year, followed by seasonal coronaviruses, RSV, influenza viruses A/B, and human metapneumovirus. Since its emergence in 2020, SARS-CoV-2 was detected year-round and had a higher median age than the other pathogens. A better understanding of the etiologies, presentations, and patterns of pediatric acute respiratory infections can help inform medical and public health system responses.
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Affiliation(s)
- Cristalyne Bell
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Maureen Goss
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Derek Norton
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (D.N.); (G.C.)
| | - Shari Barlow
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Emily Temte
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Cecilia He
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Caroline Hamer
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Sarah Walters
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Alea Sabry
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Kelly Johnson
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Guanhua Chen
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (D.N.); (G.C.)
| | - Amra Uzicanin
- Centers for Disease Control and Prevention, Atlanta, GA 30329, USA;
| | - Jonathan Temte
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
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Plumb ID, Briggs Hagen M, Wiegand R, Dumyati G, Myers C, Harland KK, Krishnadasan A, James Gist J, Abedi G, Fleming-Dutra KE, Chea N, Lee JE, Kellogg M, Edmundson A, Britton A, Wilson LE, Lovett SA, Ocampo V, Markus TM, Smithline HA, Hou PC, Lee LC, Mower W, Rwamwejo F, Steele MT, Lim SC, Schrading WA, Chinnock B, Beiser DG, Faine B, Haran JP, Nandi U, Chipman AK, LoVecchio F, Eucker S, Femling J, Fuller M, Rothman RE, Curlin ME, Talan DA, Mohr NM. Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022-May 2023. Vaccine 2024; 42:2543-2552. [PMID: 37973512 PMCID: PMC10994739 DOI: 10.1016/j.vaccine.2023.10.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Bivalent mRNA vaccines were recommended since September 2022. However, coverage with a recent vaccine dose has been limited, and there are few robust estimates of bivalent VE against symptomatic SARS-CoV-2 infection (COVID-19). We estimated VE of a bivalent mRNA vaccine dose against COVID-19 among eligible U.S. healthcare personnel who had previously received monovalent mRNA vaccine doses. METHODS We conducted a case-control study in 22 U.S. states, and enrolled healthcare personnel with COVID-19 (case-participants) or without COVID-19 (control-participants) during September 2022-May 2023. Participants were considered eligible for a bivalent mRNA dose if they had received 2-4 monovalent (ancestral-strain) mRNA vaccine doses, and were ≥67 days after the most recent vaccine dose. We estimated VE of a bivalent mRNA dose using conditional logistic regression, accounting for matching by region and four-week calendar period. We adjusted estimates for age group, sex, race and ethnicity, educational level, underlying health conditions, community COVID-19 exposure, prior SARS-CoV-2 infection, and days since the last monovalent mRNA dose. RESULTS Among 3,647 healthcare personnel, 1,528 were included as case-participants and 2,119 as control-participants. Participants received their last monovalent mRNA dose a median of 404 days previously; 1,234 (33.8%) also received a bivalent mRNA dose a median of 93 days previously. Overall, VE of a bivalent dose was 34.1% (95% CI, 22.6%-43.9%) against COVID-19 and was similar by product, days since last monovalent dose, number of prior doses, age group, and presence of underlying health conditions. However, VE declined from 54.8% (95% CI, 40.7%-65.6%) after 7-59 days to 21.6% (95% CI 5.6%-34.9%) after ≥60 days. CONCLUSIONS Bivalent mRNA COVID-19 vaccines initially conferred approximately 55% protection against COVID-19 among U.S. healthcare personnel. However, protection waned after two months. These findings indicate moderate initial protection against symptomatic SARS-CoV-2 infection by remaining up-to-date with COVID-19 vaccines.
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Affiliation(s)
- Ian D Plumb
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA.
| | - Melissa Briggs Hagen
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Ryan Wiegand
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Ghinwa Dumyati
- University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | - Jade James Gist
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Glen Abedi
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Katherine E Fleming-Dutra
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Nora Chea
- National Center for Emerging and Zoonotic Diseases, Centers for Disease Control & Prevention, USA
| | - Jane E Lee
- California Emerging Infections Program, Oakland, CA, USA
| | | | - Alexandra Edmundson
- Connecticut Emerging Infections Program, Yale School of Public Health, CT, USA
| | - Amber Britton
- Georgia Emerging Infections Program and Emory University School of Medicine, Atlanta, GA, USA
| | - Lucy E Wilson
- Maryland Emerging Infections Program, Maryland Department of Health and University of Maryland, Baltimore, MD, USA
| | | | - Valerie Ocampo
- Public Health Division, Oregon Health Authority, OR, USA
| | | | | | - Peter C Hou
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Mark T Steele
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Stephen C Lim
- University Medical Center New Orleans, LSU Health Sciences Center, New Orleans, LA, USA
| | | | | | | | | | - John P Haran
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Utsav Nandi
- University of Mississippi Medical Center, Jackson, MS, USA
| | | | | | | | - Jon Femling
- University of New Mexico Health Science Center, USA
| | | | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
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Pell ME, Blankenship HM, Gaddy JA, Davies HD, Manning SD. Intrapartum antibiotic prophylaxis selects for mutators in group B streptococci among persistently colonized patients. bioRxiv 2024:2024.04.01.587590. [PMID: 38617326 PMCID: PMC11014637 DOI: 10.1101/2024.04.01.587590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Through vaginal colonization, GBS causes severe pregnancy outcomes including neonatal sepsis and meningitis. Although intrapartum antibiotic prophylaxis (IAP) has reduced early-onset disease rates, persistent GBS colonization has been observed in patients following prophylaxis. To determine whether IAP selects for genomic signatures that enhance GBS survival and persistence in the vaginal tract, whole-genome sequencing was performed on 97 isolates from 58 patients before (prenatal) and after (postpartum) IAP/childbirth. Core-gene mutation analysis identified 7,025 mutations between the paired isolates. Three postpartum isolates accounted for 98% of mutations and were classified as "mutators" because of point mutations within DNA repair systems. In vitro assays revealed stronger biofilms in two mutators. These findings suggest that antibiotics select for mutations that promote survival in vivo, which increases the likelihood of transmission to neonates. They also demonstrate how mutators can provide a reservoir of beneficial mutations that enhance fitness and genetic diversity in the GBS population.
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Affiliation(s)
- Macy E Pell
- Michigan State University, Department of Microbiology, Genetics, and Immunology (MGI), E. Lansing, MI
| | - Heather M Blankenship
- Michigan Department of Health and Human Services, Bureau of Laboratories, Division of Infectious Diseases, Lansing, MI
| | - Jennifer A Gaddy
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
- Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, TN
| | | | - Shannon D Manning
- Michigan State University, Department of Microbiology, Genetics, and Immunology (MGI), E. Lansing, MI
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Kamali A, Ferguson D, Dowless H, Ortiz N, Mukhopadhyay R, Schember C, Lunsford R, Hutchinson J, Scherer M, Crandall J, Bauer H, Yu A, Kimura A. Outbreak of Invasive Serratia marcescens among Persons Incarcerated in a State Prison, California, USA, March 2020-December 2022. Emerg Infect Dis 2024; 30:S41-S48. [PMID: 38561639 PMCID: PMC10986826 DOI: 10.3201/eid3013.230801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Serratia marcescens is an environmental gram-negative bacterium that causes invasive disease in rare cases. During 2020-2022, an outbreak of 21 invasive Serratia infections occurred in a prison in California, USA. Most (95%) patients had a history of recent injection drug use (IDU). We performed whole-genome sequencing and found isolates from 8 patients and 2 pieces of IDU equipment were closely related. We also identified social interactions among patients. We recovered S. marcescens from multiple environmental samples throughout the prison, including personal containers storing Cell Block 64 (CB64), a quaternary ammonium disinfectant solution. CB64 preparation and storage conditions were suboptimal for S. marcescens disinfection. The outbreak was likely caused by contaminated CB64 and propagated by shared IDU equipment and social connections. Ensuring appropriate preparation, storage, and availability of disinfectants and enacting interventions to counteract disease spread through IDU can reduce risks for invasive Serratia infections in California prisons.
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Nickel KB, Durkin MJ, Olsen MA, Sahrmann JM, Neuner E, O’Neil CA, Butler AM. Utilization of broad- versus narrow-spectrum antibiotics for the treatment of outpatient community-acquired pneumonia among adults in the United States. Pharmacoepidemiol Drug Saf 2024; 33:e5779. [PMID: 38511244 PMCID: PMC11016291 DOI: 10.1002/pds.5779] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/22/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To characterize antibiotic utilization for outpatient community-acquired pneumonia (CAP) in the United States. METHODS We conducted a cohort study among adults 18-64 years diagnosed with outpatient CAP and a same-day guideline-recommended oral antibiotic fill in the MarketScan® Commercial Database (2008-2019). We excluded patients coded for chronic lung disease or immunosuppressive disease; recent hospitalization or frequent healthcare exposure (e.g., home wound care, patients with cancer); recent antibiotics; or recent infection. We characterized utilization of broad-spectrum antibiotics (respiratory fluoroquinolone, β-lactam + macrolide, β-lactam + doxycycline) versus narrow-spectrum antibiotics (macrolide, doxycycline) overall and by patient- and provider-level characteristics. Per 2007 IDSA/ATS guidelines, we stratified analyses by otherwise healthy patients and patients with comorbidities (coded for diabetes; chronic heart, liver, or renal disease; etc.). RESULTS Among 263 914 otherwise healthy CAP patients, 35% received broad-spectrum antibiotics (not recommended); among 37 161 CAP patients with comorbidities, 44% received broad-spectrum antibiotics (recommended). Ten-day antibiotic treatment durations were the most common for all antibiotic classes except macrolides. From 2008 to 2019, broad-spectrum antibiotic use substantially decreased from 45% to 19% in otherwise healthy patients (average annual percentage change [AAPC], -7.5% [95% CI -9.2%, -5.9%]), and from 55% to 29% in patients with comorbidities (AAPC, -5.8% [95% CI -8.8%, -2.6%]). In subgroup analyses, broad-spectrum antibiotic use varied by age, geographic region, provider specialty, and provider location. CONCLUSIONS Real-world use of broad-spectrum antibiotics for outpatient CAP declined over time but remained common, irrespective of comorbidity status. Prolonged duration of therapy was common. Antimicrobial stewardship is needed to aid selection according to comorbidity status and to promote shorter courses.
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Affiliation(s)
- Katelin B. Nickel
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael J. Durkin
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Margaret A. Olsen
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - John M. Sahrmann
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Elizabeth Neuner
- Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Caroline A. O’Neil
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M. Butler
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
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9
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Carrel M, Shi Q, Clore GS, Hasegawa S, Smith M, Perencevich EN, Goto M. Assessing the potential for improved predictive capacity of antimicrobial resistance in outpatient Staphylococcus aureus isolates using seasonal and spatial antibiograms. Antimicrob Resist Infect Control 2024; 13:34. [PMID: 38519975 PMCID: PMC10960453 DOI: 10.1186/s13756-024-01388-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND While the use of cumulative susceptibility reports, antibiograms, is recommended for improved empiric therapy and antibiotic stewardship, the predictive ability of antibiograms has not been well-studied. While enhanced antibiograms have been shown to better capture variation in susceptibility profiles by characteristics such as infection site or patient age, the potential for seasonal or spatial variation in susceptibility has not been assessed as important in predicting likelihood of susceptibility. METHODS Utilizing Staphylococcus aureus isolates obtained in outpatient settings from a nationwide provider of care, the Veterans Health Administration, and a local provider of care, the University of Iowa Hospitals and Clinics, standard, seasonal and spatial antibiograms were created for five commonly used antibiotic classes: cephalosporins, clindamycin, macrolides, tetracycline, trimethoprim/sulfamethoxazole. RESULTS A total of 338,681 S. aureus isolates obtained in VHA outpatient settings from 2010 to 2019 and 6,817 isolates obtained in UIHC outpatient settings from 2014 to 2019 were used to generate and test antibiograms. Logistic regression modeling determined the capacity of these antibiograms to predict isolate resistance to each antibiotic class. All models had low predictive capacity, with areas under the curve of < 0.7. CONCLUSIONS Standard antibiograms are poor in predicting S. aureus susceptibility to antibiotics often chosen by clinicians, and seasonal and spatial antibiograms do not provide an improved tool in anticipating non-susceptibility. These findings suggest that further refinements to antibiograms may be necessary to improve their utility in informing choice of effective antibiotic therapy.
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Affiliation(s)
- Margaret Carrel
- Department of Geographical & Sustainability Sciences, University of Iowa, Iowa City, IA, USA.
- , Iowa City, USA.
| | - Qianyi Shi
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Gosia S Clore
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Shinya Hasegawa
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Matthew Smith
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Eli N Perencevich
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Michihiko Goto
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
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10
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Lange RE, Prusinski MA, Dupuis AP, Ciota AT. Direct Evidence of Powassan Virus Vertical Transmission in Ixodes scapularis in Nature. Viruses 2024; 16:456. [PMID: 38543821 PMCID: PMC10974323 DOI: 10.3390/v16030456] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/01/2024] Open
Abstract
Powassan virus (POWV) is a tick-borne flavivirus endemic in North America and Russia. Experimental infections with POWV have confirmed horizontal, transstadial, vertical, and cofeeding transmission routes for potential virus maintenance. In the field, vertical transmission has never been observed. During New York State tick-borne pathogen surveillance, POWV RNA and/or infectious POWV was detected in five pools of questing Ixodes scapularis larvae. Additionally, engorged female I. scapularis adults were collected from hunter-harvested white-tailed deer (Odocoileus virginianus) in a region with relatively high tick infection rates of POWV and allowed to oviposit under laboratory conditions. POWV RNA was detected in three female adult husks and one pool of larvae from a positive female. Infectious virus was isolated from all three RNA-positive females and the single positive larval pool. The detection of RNA and infectious virus in unfed questing larvae from the field and larvae from replete females collected from the primary tick host implicates vertical transmission as a potential mechanism for the maintenance of POWV in I. scapularis in nature, and elucidates the potential epidemiological significance of larval ticks in the transmission of POWV to humans.
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Affiliation(s)
- Rachel E. Lange
- Department of Biomedical Sciences, School of Public Health, State University of New York, Albany, NY 12144, USA; (R.E.L.)
- The Arbovirus Laboratory, New York State Department of Health, Wadsworth Center, Slingerlands, NY 12159, USA
| | - Melissa A. Prusinski
- Vector Ecology Laboratory, New York State Department of Health, Bureau of Communicable Disease Control, Albany, NY 12237, USA;
| | - Alan P. Dupuis
- Department of Biomedical Sciences, School of Public Health, State University of New York, Albany, NY 12144, USA; (R.E.L.)
- The Arbovirus Laboratory, New York State Department of Health, Wadsworth Center, Slingerlands, NY 12159, USA
| | - Alexander T. Ciota
- Department of Biomedical Sciences, School of Public Health, State University of New York, Albany, NY 12144, USA; (R.E.L.)
- The Arbovirus Laboratory, New York State Department of Health, Wadsworth Center, Slingerlands, NY 12159, USA
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Oladapo-Shittu O, Cosgrove SE, Rock C, Hsu YJ, Klein E, Harris AD, Mejia Chew C, Saunders H, Ching PR, Gadala A, Mayoryk S, Pineles L, Maragakis L, Salinas A, Helsel T, Keller SC. Characterizing Patients Presenting on Hospital Admission with Central Line-Associated Bloodstream Infections: A Multicenter Study. Clin Infect Dis 2024:ciae144. [PMID: 38483930 DOI: 10.1093/cid/ciae144] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/05/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND There are no systematic measures of central line-associated bloodstream infections (CLABSIs) in patients maintaining central venous catheters (CVCs) outside acute care hospitals. To improve understanding of the burden of CLABSIs outside acute care hospitals, we characterized patients with CLABSI present on hospital admission (POA). METHODS Retrospective cross-sectional analysis of patients with CLABSI-POA in three health systems covering eleven hospitals across Maryland, Washington DC, and Missouri from November 2020 to October 2021. CLABSI-POA was defined using an adaptation of the acute care CLABSI definition. Patient demographics, clinical characteristics, and outcomes were collected via chart review. Cox proportional hazard analysis was used to assess factors associated with all-cause mortality within 30 days. RESULTS 461 patients were identified as having CLABSI-POA. CVCs were most commonly maintained in home infusion therapy (32.8%) or oncology clinics (31.2%). Enterobacterales were the most common etiologic agent (29.2%). Recurrent CLABSIs occurred in a quarter of patients (25%). Eleven percent of patients died during the hospital admission. Among CLABSI-POA patients, mortality risk increased with age (versus ages <20: ages 20-44 years: HR: 11.21, 95% CI: 1.46-86.22; ages 45-64: HR: 20.88, 95% CI: 2.84-153.58; at least 65 years of age: HR: 22.50, 95% CI: 2.98-169.93), and lack of insurance (HR: 2.46; 95% CI: 1.08-5.59), and decreased with CVC removal (HR: 0.57, 95% CI: 0.39-0.84). CONCLUSION CLABSI-POA is associated with significant in-hospital mortality. Surveillance is required to understand the burden of CLABSI in the community to identify targets for CLABSI prevention initiatives outside acute care settings.
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Affiliation(s)
| | - Sara E Cosgrove
- Johns Hopkins University School of Medicine, Baltimore, MD USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Clare Rock
- Johns Hopkins University School of Medicine, Baltimore, MD USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Yea-Jen Hsu
- Johns Hopkins University School of Medicine, Baltimore, MD USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Eili Klein
- Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Anthony D Harris
- University of Maryland School of Medicine, Baltimore, MD USA
- University of Maryland School of Public Health, Baltimore, MD USA
| | | | | | - Patrick R Ching
- Washington University School of Medicine, St. Louis, MO, USA
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Avi Gadala
- Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Stephanie Mayoryk
- University of Maryland School of Medicine, Baltimore, MD USA
- University of Maryland School of Public Health, Baltimore, MD USA
| | - Lisa Pineles
- University of Maryland School of Medicine, Baltimore, MD USA
- University of Maryland School of Public Health, Baltimore, MD USA
| | - Lisa Maragakis
- Johns Hopkins University School of Medicine, Baltimore, MD USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | | | - Taylor Helsel
- Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Sara C Keller
- Johns Hopkins University School of Medicine, Baltimore, MD USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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12
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O’Connor C, Prusinski MA, Aldstadt J, Falco RC, Oliver J, Haight J, Tober K, Sporn LA, White J, Brisson D, Backenson PB. Assessing the impact of areal unit selection and the modifiable areal unit problem on associative statistics between cases of tick-borne disease and entomological indices. J Med Entomol 2024; 61:331-344. [PMID: 38157309 PMCID: PMC10936173 DOI: 10.1093/jme/tjad157] [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: 06/10/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
The modifiable areal unit problem (MAUP) is a cause of statistical and visual bias when aggregating data according to spatial units, particularly when spatial units may be changed arbitrarily. The MAUP is a concern in vector-borne disease research when entomological metrics gathered from point-level sampling data are related to epidemiological data aggregated to administrative units like counties or ZIP Codes. Here, we assess the statistical impact of the MAUP when calculating correlations between randomly aggregated cases of anaplasmosis in New York State during 2017 and a geostatistical layer of an entomological risk index for Anaplasma phagocytophilum in blacklegged ticks (Ixodes scapularis Say, Acari: Ixodidae) collected during the fall of 2017. Correlations were also calculated using various administrative boundaries for comparison. We also demonstrate the impact of the MAUP on data visualization using choropleth maps and offer pycnophylactic interpolation as an alternative. Polygon simulations indicate that increasing the number of polygons decreases correlation coefficients and their variability. Correlation coefficients calculated using ZIP Code tabulation area and Census tract polygons were beyond 4 standard deviations from the mean of the simulated correlation coefficients. These results indicate that using smaller polygons may not best incorporate the geographical context of the tick-borne disease system, despite the tendency of researchers to strive for more granular spatial data and associations.
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Affiliation(s)
- Collin O’Connor
- New York State Department of Health, Bureau of Communicable Disease Control, Buffalo, NY, USA
- Department of Geography, State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Melissa A Prusinski
- New York State Department of Health, Bureau of Communicable Disease Control, Albany, NY, USA
| | - Jared Aldstadt
- Department of Geography, State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Richard C Falco
- New York State Department of Health, Vector Ecology Laboratory, Fordham University, Armonk, NY, USA
| | - JoAnne Oliver
- New York State Department of Health, Bureau of Communicable Disease Control, Syracuse, NY, USA
| | - Jamie Haight
- New York State Department of Health, Bureau of Communicable Disease Control, Falconer, NY, USA
| | - Keith Tober
- New York State Department of Health, Bureau of Communicable Disease Control, Buffalo, NY, USA
| | - Lee Ann Sporn
- Natural Science Department, Paul Smith’s College, Paul Smiths, NY, USA
| | - Jennifer White
- New York State Department of Health, Bureau of Communicable Disease Control, Albany, NY, USA
| | - Dustin Brisson
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - P Bryon Backenson
- New York State Department of Health, Bureau of Communicable Disease Control, Albany, NY, USA
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13
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Ensor KB, Schedler JC, Sun T, Schneider R, Mulenga A, Wu J, Stadler LB, Hopkins L. Online trend estimation and detection of trend deviations in sub-sewershed time series of SARS-CoV-2 RNA measured in wastewater. Sci Rep 2024; 14:5575. [PMID: 38448481 PMCID: PMC10918082 DOI: 10.1038/s41598-024-56175-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/03/2024] [Indexed: 03/08/2024] Open
Abstract
Wastewater surveillance has proven a cost-effective key public health tool to understand a wide range of community health diseases and has been a strong source of information on community levels and spread for health departments throughout the SARS- CoV-2 pandemic. Studies spanning the globe demonstrate the strong association between virus levels observed in wastewater and quality clinical case information of the population served by the sewershed. Few of these studies incorporate the temporal dependence present in sampling over time, which can lead to estimation issues which in turn impact conclusions. We contribute to the literature for this important public health science by putting forward time series methods coupled with statistical process control that (1) capture the evolving trend of a disease in the population; (2) separate the uncertainty in the population disease trend from the uncertainty due to sampling and measurement; and (3) support comparison of sub-sewershed population disease dynamics with those of the population represented by the larger downstream treatment plant. Our statistical methods incorporate the fact that measurements are over time, ensuring correct statistical conclusions. We provide a retrospective example of how sub-sewersheds virus levels compare to the upstream wastewater treatment plant virus levels. An on-line algorithm supports real-time statistical assessment of deviations of virus level in a population represented by a sub-sewershed to the virus level in the corresponding larger downstream wastewater treatment plant. This information supports public health decisions by spotlighting segments of the population where outbreaks may be occurring.
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Affiliation(s)
- Katherine B Ensor
- Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA.
| | - Julia C Schedler
- Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA
| | - Thomas Sun
- Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA
| | - Rebecca Schneider
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, 77054, USA
| | - Anthony Mulenga
- Houston Health Department, 8000 N. Stadium Dr., Houston, TX, 77054, USA
| | - Jingjing Wu
- Department of Civil and Environment Engineering, Rice University, 6100 Main St, Houston, TX, 77005, USA
| | - Lauren B Stadler
- Department of Civil and Environment Engineering, Rice University, 6100 Main St, Houston, TX, 77005, USA
| | - Loren Hopkins
- Houston Health Department and Department of Statistics, Rice University, 6100 Main St., Houston, TX, 77005, USA
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14
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Lehane Á, Parker-Crockett C, Norris E, Wheeler SS, Harrington LC. Measuring insecticide resistance in a vacuum: exploring next steps to link resistance data with mosquito control efficacy. J Med Entomol 2024:tjae029. [PMID: 38427792 DOI: 10.1093/jme/tjae029] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/28/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
Insecticide resistance is a great challenge facing mosquito operational control agencies across the United States, where few active ingredients with unique modes of action are available for use, increasing resistance pressure and further hampering resistance management strategies. Emergence and expansion of insecticide resistance in mosquitoes can be detected by resistance monitoring programs; however, there are gaps in our knowledge regarding the link between resistance bioassay results and operational control outcomes. Here, we review both public health and agricultural studies on pesticide resistance bioassays and control outcomes. A discussion on the main gaps in our knowledge of insecticide resistance and a review of resistance management practices is also presented. We conclude with research questions that can advance our understanding of resistance monitoring and control.
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Affiliation(s)
- Áine Lehane
- Department of Entomology, Cornell University, Ithaca, NY 14850, USA
| | | | - Edmund Norris
- United States Department of Agriculture-Agriculture Research Service Center for Medical, Agricultural, and Veterinary Entomology, Gainesville, FL 32608, USA
| | - Sarah S Wheeler
- Sacramento-Yolo Mosquito and Vector Control District, 8631 Bond Road, Elk Grove, CA 95624, USA
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15
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Woodworth KR, Newton SM, Tannis A, Reynolds MR, Olsen EO, Sizemore L, Wingate H, Orkis L, Reynolds B, Longcore N, Thomas N, Kim SY, Panagiotakopoulos L, Wester C, Delman DM, Gilboa SM, Tong VT. Birth Outcomes Among People with Hepatitis C in Pregnancy - Three U.S. States, 2018-2021. Matern Child Health J 2024:10.1007/s10995-024-03917-3. [PMID: 38416334 DOI: 10.1007/s10995-024-03917-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION There are limited and conflicting data regarding the impact of hepatitis C in pregnancy on adverse birth outcomes. METHODS Using the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET), a large surveillance cohort, we describe birth outcomes among a cohort of people with HCV in pregnancy in total and by reported substance use. RESULTS Among 1418 infants, 89% were born to people with reported substance use during pregnancy. The proportion born preterm was 20%, 13% were small-for-gestational age and 34% of term infants required intensive care. CONCLUSIONS Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes.
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Affiliation(s)
- Kate R Woodworth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Suzanne M Newton
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ayzsa Tannis
- Eagle Global Scientific, LLC, San Antonio, TX, USA
| | - Megan R Reynolds
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily O Olsen
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Lauren Orkis
- Pennsylvania Department of Health, Pittsburgh, PA, USA
| | | | | | - Nadia Thomas
- New York State Department of Health, Albany, NY, USA
| | - Shin Y Kim
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lakshmi Panagiotakopoulos
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carolyn Wester
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Meaney Delman
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suzanne M Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Van T Tong
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Kim D, DeBriere TJ, Eastmond BH, Alomar AA, Yaren O, McCarter J, Bradley KM, Benner SA, Alto BW, Burkett-Cadena ND. Rapid detection of West Nile and Dengue viruses from mosquito saliva by loop-mediated isothermal amplification and displaced probes. PLoS One 2024; 19:e0298805. [PMID: 38394282 PMCID: PMC10889885 DOI: 10.1371/journal.pone.0298805] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Arthropod-borne viruses are major causes of human and animal disease, especially in endemic low- and middle-income countries. Mosquito-borne pathogen surveillance is essential for risk assessment and vector control responses. Sentinel chicken serosurveillance (antibody testing) and mosquito pool screening (by RT-qPCR or virus isolation) are currently used to monitor arbovirus transmission, however substantial time lags of seroconversion and/or laborious mosquito identification and RNA extraction steps sacrifice their early warning value. As a consequence, timely vector control responses are compromised. Here, we report on development of a rapid arbovirus detection system whereby adding sucrose to reagents of loop-mediated isothermal amplification with displaced probes (DP-LAMP) elicits infectious mosquitoes to feed directly upon the reagent mix and expectorate viruses into the reagents during feeding. We demonstrate that RNA from pathogenic arboviruses (West Nile and Dengue viruses) transmitted in the infectious mosquito saliva was detectable rapidly (within 45 minutes) without RNA extraction. Sucrose stabilized viral RNA at field temperatures for at least 48 hours, important for transition of this system to practical use. After thermal treatment, the DP-LAMP could be reliably visualized by a simple optical image sensor to distinguish between positive and negative samples based on fluorescence intensity. Field application of this technology could fundamentally change conventional arbovirus surveillance methods by eliminating laborious RNA extraction steps, permitting arbovirus monitoring from additional sites, and substantially reducing time needed to detect circulating pathogens.
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Affiliation(s)
- Dongmin Kim
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, Florida, United States of America
| | | | - Bradley H. Eastmond
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, Florida, United States of America
| | - Abdullah A. Alomar
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, Florida, United States of America
| | - Ozlem Yaren
- Firebird Biomolecular Sciences LLC, Alachua, Florida, United States of America
- Foundation for Applied Molecular Evolution, Alachua, Florida, United States of America
| | - Jacquelyn McCarter
- Firebird Biomolecular Sciences LLC, Alachua, Florida, United States of America
- Foundation for Applied Molecular Evolution, Alachua, Florida, United States of America
| | - Kevin M. Bradley
- Foundation for Applied Molecular Evolution, Alachua, Florida, United States of America
| | - Steven A. Benner
- Firebird Biomolecular Sciences LLC, Alachua, Florida, United States of America
- Foundation for Applied Molecular Evolution, Alachua, Florida, United States of America
| | - Barry W. Alto
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, Florida, United States of America
| | - Nathan D. Burkett-Cadena
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, Florida, United States of America
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17
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He K, Foerster S, Vora NM, Blaney K, Keeley C, Hendricks L, Varma JK, Long T, Shaman J, Pei S. Evaluating completion rates of COVID-19 contact tracing surveys in New York City. BMC Public Health 2024; 24:414. [PMID: 38331772 PMCID: PMC10854191 DOI: 10.1186/s12889-024-17920-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
IMPORTANCE Contact tracing is the process of identifying people who have recently been in contact with someone diagnosed with an infectious disease. During an outbreak, data collected from contact tracing can inform interventions to reduce the spread of infectious diseases. Understanding factors associated with completion rates of contact tracing surveys can help design improved interview protocols for ongoing and future programs. OBJECTIVE To identify factors associated with completion rates of COVID-19 contact tracing surveys in New York City (NYC) and evaluate the utility of a predictive model to improve completion rates, we analyze laboratory-confirmed and probable COVID-19 cases and their self-reported contacts in NYC from October 1st 2020 to May 10th 2021. METHODS We analyzed 742,807 case investigation calls made during the study period. Using a log-binomial regression model, we examined the impact of age, time of day of phone call, and zip code-level demographic and socioeconomic factors on interview completion rates. We further developed a random forest model to predict the best phone call time and performed a counterfactual analysis to evaluate the change of completion rates if the predicative model were used. RESULTS The percentage of contact tracing surveys that were completed was 79.4%, with substantial variations across ZIP code areas. Using a log-binomial regression model, we found that the age of index case (an individual who has tested positive through PCR or antigen testing and is thus subjected to a case investigation) had a significant effect on the completion of case investigation - compared with young adults (the reference group,24 years old < age < = 65 years old), the completion rate for seniors (age > 65 years old) were lower by 12.1% (95%CI: 11.1% - 13.3%), and the completion rate for youth group (age < = 24 years old) were lower by 1.6% (95%CI: 0.6% -2.6%). In addition, phone calls made from 6 to 9 pm had a 4.1% (95% CI: 1.8% - 6.3%) higher completion rate compared with the reference group of phone calls attempted from 12 and 3 pm. We further used a random forest algorithm to assess its potential utility for selecting the time of day of phone call. In counterfactual simulations, the overall completion rate in NYC was marginally improved by 1.2%; however, certain ZIP code areas had improvements up to 7.8%. CONCLUSION These findings suggest that age and time of day of phone call were associated with completion rates of case investigations. It is possible to develop predictive models to estimate better phone call time for improving completion rates in certain communities.
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Affiliation(s)
- Kaiyu He
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Steffen Foerster
- New York City Department of Health and Mental Hygiene (DOHMH), Long Island City, NY, 11001, USA
| | - Neil M Vora
- New York City Department of Health and Mental Hygiene (DOHMH), Long Island City, NY, 11001, USA
| | - Kathleen Blaney
- New York City Department of Health and Mental Hygiene (DOHMH), Long Island City, NY, 11001, USA
| | | | | | - Jay K Varma
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, 10065, USA
| | - Theodore Long
- NYC Health + Hospitals, New York, NY, USA
- Department of Population Health, New York University, New York, NY, 10016, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- Columbia Climate School, Columbia University, New York, NY, 10025, USA
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
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18
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Cahill ME, Lozoya SB, Griffin MA, Blackstock A, Stockdale K, Cowman S, Graff R, Spear C, Carter K. Observed face mask use outside retail chain stores during the COVID-19 pandemic in two cities in the state of Idaho, USA. J Community Health 2024; 49:26-33. [PMID: 37314630 PMCID: PMC10719412 DOI: 10.1007/s10900-023-01241-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
During the COVID-19 pandemic, public health authorities have encouraged the use of face masks to minimize transmission within the community. To assess mask wear during a COVID-19 surge and guide public health response efforts, including public messaging on mask recommendations, we compared observed mask use in the largest city in each of Idaho's 2 most populous counties, both without a current mask mandate. We recorded mask usage by every third person exiting stores of 5 retail chains in Boise and Nampa during November 8-December 5, 2021. Observations were conducted during three time periods (morning, afternoon, and evening) on weekday and weekend days. A multivariable model with city, retail chain, and city-chain interaction was used to assess mask wear differences by city for each chain. Of 3021 observed persons, 22.0% wore masks. In Boise, 31.3% (430/1376) of observed persons wore masks; in Nampa, 14.3% (236/1645) wore masks. Among all persons wearing masks, > 94% wore masks correctly; cloth and surgical masks were most common. By retail chain, observed individuals at Boise locations were 2.3-5.7 times as likely to wear masks than persons at respective Nampa locations. This study provided a rapid, nonconfrontational assessment of public use of mitigation measures in 2 Idaho cities during a COVID-19 surge.
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Affiliation(s)
- Megan E Cahill
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA.
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sujeith Barraza Lozoya
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
- Public Health Associate Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle A Griffin
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
| | - Anna Blackstock
- Epidemiology Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Robert Graff
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
| | | | - Kris Carter
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
- Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
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19
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Schinkel M, Boerman A, Carroll K, Cosgrove SE, Hsu YJ, Klein E, Nanayakkara P, Schade R, Wiersinga WJ, Fabre V. Impact of Blood Culture Contamination on Antibiotic Use, Resource Utilization, and Clinical Outcomes: A Retrospective Cohort Study in Dutch and US Hospitals. Open Forum Infect Dis 2024; 11:ofad644. [PMID: 38312218 PMCID: PMC10836193 DOI: 10.1093/ofid/ofad644] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/20/2023] [Indexed: 02/06/2024] Open
Abstract
Background Blood culture contamination (BCC) has been associated with prolonged antibiotic use (AU) and increased health care utilization; however, this has not been widely reevaluated in the era of increased attention to antibiotic stewardship. We evaluated the impact of BCC on AU, resource utilization, and length of stay in Dutch and US patients. Methods This retrospective observational study examined adults admitted to 2 hospitals in the Netherlands and 5 hospitals in the United States undergoing ≥2 blood culture (BC) sets. Exclusion criteria included neutropenia, no hospital admission, or death within 48 hours of hospitalization. The impact of BCC on clinical outcomes-overall inpatient days of antibiotic therapy, test utilization, length of stay, and mortality-was determined via a multivariable regression model. Results An overall 22 927 patient admissions were evaluated: 650 (4.1%) and 339 (4.8%) with BCC and 11 437 (71.8%) and 4648 (66.3%) with negative BC results from the Netherlands and the United States, respectively. Dutch and US patients with BCC had a mean ± SE 1.74 ± 0.27 (P < .001) and 1.58 ± 0.45 (P < .001) more days of antibiotic therapy than patients with negative BC results. They also had 0.6 ± 0.1 (P < .001) more BCs drawn. Dutch but not US patients with BCC had longer hospital stays (3.36 days; P < .001). There was no difference in mortality between groups in either cohort. AU remained higher in US but not Dutch patients with BCC in a subanalysis limited to BC obtained within the first 24 hours of admission. Conclusions BCC remains associated with higher inpatient AU and health care utilization as compared with patients with negative BC results, although the impact on these outcomes differs by country.
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Affiliation(s)
- Michiel Schinkel
- Center for Experimental and Molecular Medicine, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
- Division of Acute Medicine, Department of Internal Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anneroos Boerman
- Division of Acute Medicine, Department of Internal Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Karen Carroll
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sara E Cosgrove
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yea-Jen Hsu
- Department of Health Policy and Management, Johns Hopkins Bloomberg of School of Public Health, Baltimore, Maryland, USA
| | - Eili Klein
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Disease Dynamics, Economics & Policy, Washington, DC, USA
| | - Prabath Nanayakkara
- Division of Acute Medicine, Department of Internal Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rogier Schade
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Amsterdam, the Netherlands
| | - W Joost Wiersinga
- Center for Experimental and Molecular Medicine, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Valeria Fabre
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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20
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Matias WR, Fulcher IR, Sauer SM, Nolan CP, Guillaume Y, Zhu J, Molano FJ, Uceta E, Collins S, Slater DM, Sánchez VM, Moheed S, Harris JB, Charles RC, Paxton RM, Gonsalves SF, Franke MF, Ivers LC. Disparities in SARS-CoV-2 Infection by Race, Ethnicity, Language, and Social Vulnerability: Evidence from a Citywide Seroprevalence Study in Massachusetts, USA. J Racial Ethn Health Disparities 2024; 11:110-120. [PMID: 36652163 PMCID: PMC9847437 DOI: 10.1007/s40615-022-01502-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Uncovering and addressing disparities in infectious disease outbreaks require a rapid, methodical understanding of local epidemiology. We conducted a seroprevalence study of SARS-CoV-2 infection in Holyoke, Massachusetts, a majority Hispanic city with high levels of socio-economic disadvantage to estimate seroprevalence and identify disparities in SARS-CoV-2 infection. METHODS We invited 2000 randomly sampled households between 11/5/2020 and 12/31/2020 to complete questionnaires and provide dried blood spots for SARS-CoV-2 antibody testing. We calculated seroprevalence based on the presence of IgG antibodies using a weighted Bayesian procedure that incorporated uncertainty in antibody test sensitivity and specificity and accounted for household clustering. RESULTS Two hundred eighty households including 472 individuals were enrolled. Three hundred twenty-eight individuals underwent antibody testing. Citywide seroprevalence of SARS-CoV-2 IgG was 13.1% (95% CI 6.9-22.3) compared to 9.8% of the population infected based on publicly reported cases. Seroprevalence was 16.1% (95% CI 6.2-31.8) among Hispanic individuals compared to 9.4% (95% CI 4.6-16.4) among non-Hispanic white individuals. Seroprevalence was higher among Spanish-speaking households (21.9%; 95% CI 8.3-43.9) compared to English-speaking households (10.2%; 95% CI 5.2-18.0) and among individuals in high social vulnerability index (SVI) areas based on the CDC SVI (14.4%; 95% CI 7.1-25.5) compared to low SVI areas (8.2%; 95% CI 3.1-16.9). CONCLUSIONS The SARS-CoV-2 IgG seroprevalence in a city with high levels of social vulnerability was 13.1% during the pre-vaccination period of the COVID-19 pandemic. Hispanic individuals and individuals in communities characterized by high SVI were at the highest risk of infection. Public health interventions should be designed to ensure that individuals in high social vulnerability communities have access to the tools to combat COVID-19.
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Affiliation(s)
- Wilfredo R Matias
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA.
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.
| | - Isabel R Fulcher
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Harvard Data Science Initiative, Cambridge, MA, USA
| | - Sara M Sauer
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Cody P Nolan
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Yodeline Guillaume
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Jack Zhu
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Francisco J Molano
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth Uceta
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Shannon Collins
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Damien M Slater
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA
| | - Vanessa M Sánchez
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA
| | - Serina Moheed
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA
| | - Jason B Harris
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Richelle C Charles
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | - Molly F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Louise C Ivers
- Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, BUL-130, Boston, MA, 02114, USA
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Harvard Global Health Institute, Cambridge, MA, USA
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21
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Costa-da-Silva AL, Cabal S, Lopez K, Boloix J, Rodriguez BG, Marrero KM, Bellantuono AJ, DeGennaro M. Female Aedes aegypti mosquitoes use communal cues to manage population density at breeding sites. Commun Biol 2024; 7:143. [PMID: 38297108 PMCID: PMC10830494 DOI: 10.1038/s42003-024-05830-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
Where a female mosquito lays her eggs creates the conditions for reproductive success. Here we identify a communal behavior among ovipositing female mosquitoes. When choosing equal breeding sites, gravid Aedes aegypti aggregate more often than expected. This aggregation occurs when water contact is restricted and does not require the presence of eggs. Instead, the aggregation is regulated by the number of females present at the breeding site. Using assays with both occupied and empty oviposition sites, we show that the Orco olfactory co-receptor and a carbon dioxide receptor, Gr3, detect the presence of mosquitoes. orco mutants aggregate more often in empty sites, suggesting attractive olfactory cues influence females to associate with one another. Gr3 mutant females do not prefer either site, suggesting that the CO2 receptor is necessary to evaluate mosquito population density at breeding sites. Further, raising CO2 levels is sufficient to cause wild-type mosquitoes to avoid empty oviposition sites. Our results demonstrate that female mosquitoes can regulate their own population density at breeding sites using attractive and repellent communal cues.
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Affiliation(s)
- Andre Luis Costa-da-Silva
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Silvia Cabal
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Kristian Lopez
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Jean Boloix
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Brian Garcia Rodriguez
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Kaylee M Marrero
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Anthony J Bellantuono
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA
| | - Matthew DeGennaro
- Department of Biological Sciences, Florida International University, Miami, FL, 33199, USA.
- Biomolecular Sciences Institute, Florida International University, Miami, FL, 33199, USA.
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22
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Machoko MMP, Dong Y, Grozdani A, Hong H, Oliver E, Hyle EP, Ryan ET, Colubri A, LaRocque RC. Knowledge, attitudes and practices regarding the use of mobile travel health apps. J Travel Med 2024; 31:taad089. [PMID: 37410376 PMCID: PMC10823485 DOI: 10.1093/jtm/taad089] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
We performed a survey of US international travellers to evaluate their knowledge, attitudes and practices regarding mobile technologies related to health. We found that many international travellers carry smartphones and are interested in receiving health information from a mobile app when they travel abroad.
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Affiliation(s)
- Munashe M P Machoko
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Yinan Dong
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Hung Hong
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Elizabeth Oliver
- Travelers’ Advice and Immunization Center, Massachusetts General Hospital, Boston, MA, USA
| | - Emily P Hyle
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Edward T Ryan
- Travelers’ Advice and Immunization Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andrés Colubri
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Regina C LaRocque
- Travelers’ Advice and Immunization Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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23
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Robin TT, Cascante-Vega J, Shaman J, Pei S. System identifiability in a time-evolving agent-based model. PLoS One 2024; 19:e0290821. [PMID: 38271401 PMCID: PMC10810497 DOI: 10.1371/journal.pone.0290821] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/16/2023] [Indexed: 01/27/2024] Open
Abstract
Mathematical models are a valuable tool for studying and predicting the spread of infectious agents. The accuracy of model simulations and predictions invariably depends on the specification of model parameters. Estimation of these parameters is therefore extremely important; however, while some parameters can be derived from observational studies, the values of others are difficult to measure. Instead, models can be coupled with inference algorithms (i.e., data assimilation methods, or statistical filters), which fit model simulations to existing observations and estimate unobserved model state variables and parameters. Ideally, these inference algorithms should find the best fitting solution for a given model and set of observations; however, as those estimated quantities are unobserved, it is typically uncertain whether the correct parameters have been identified. Further, it is unclear what 'correct' really means for abstract parameters defined based on specific model forms. In this work, we explored the problem of non-identifiability in a stochastic system which, when overlooked, can significantly impede model prediction. We used a network, agent-based model to simulate the transmission of Methicillin-resistant staphylococcus aureus (MRSA) within hospital settings and attempted to infer key model parameters using the Ensemble Adjustment Kalman Filter, an efficient Bayesian inference algorithm. We show that even though the inference method converged and that simulations using the estimated parameters produced an agreement with observations, the true parameters are not fully identifiable. While the model-inference system can exclude a substantial area of parameter space that is unlikely to contain the true parameters, the estimated parameter range still included multiple parameter combinations that can fit observations equally well. We show that analyzing synthetic trajectories can support or contradict claims of identifiability. While we perform this on a specific model system, this approach can be generalized for a variety of stochastic representations of partially observable systems. We also suggest data manipulations intended to improve identifiability that might be applicable in many systems of interest.
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Affiliation(s)
- Tal T. Robin
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Jaime Cascante-Vega
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Columbia Climate School, Columbia University, New York, NY, United States of America
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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24
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Klein E, Saheed M, Irvin N, Balhara KS, Badaki-Makun O, Poleon S, Kelen G, Cosgrove SE, Hinson J. Racial and Socioeconomic Disparities Evident in Inappropriate Antibiotic Prescribing in the Emergency Department. Ann Emerg Med 2024:S0196-0644(23)01426-9. [PMID: 38260931 DOI: 10.1016/j.annemergmed.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024]
Abstract
STUDY OBJECTIVE Inappropriate antibiotic prescribing for acute respiratory tract infections is a common source of low-value care in the emergency department (ED). Racial and socioeconomic disparities have been noted in episodes of low-value care, particularly in children. We evaluated whether prescribing rates for acute respiratory tract infections when antibiotics would be inappropriate by guidelines differed by race and socioeconomics. METHODS A retrospective cross-sectional analysis of adult and pediatric patient encounters in the emergency department (ED) between 2015 and 2023 at 5 hospitals for acute respiratory tract infections that did not require antibiotics by guidelines. Multivariable regression was used to calculate the risk ratio between race, ethnicity, and area deprivation index and inappropriate antibiotic prescribing, controlling for patient age, sex, and relevant comorbidities. RESULTS A total of 147,401 ED encounters (55% pediatric, 45% adult) were included. At arrival, 4% patients identified as Asian, 50% as Black, 5% as Hispanic, and 23% as White. Inappropriate prescribing was noted in 7.6% of overall encounters, 8% for Asian patients, 6% for Black patients, 5% for Hispanic patients, and 12% for White patients. After adjusting for age, sex, comorbidities, and area deprivation index, White patients had a 1.32 (95% confidence interval, 1.26 to 1.38) higher likelihood of receiving a prescription compared with Black patients. Patients residing in areas of greater socioeconomic deprivation, regardless of race and ethnicity, had a 0.74 (95% confidence interval, 0.70 to 0.78) lower likelihood of receiving a prescription. CONCLUSION Our results suggest that although overall inappropriate prescribing was relatively low, White patients and patients from wealthier areas were more likely to receive an inappropriate antibiotic prescription.
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Affiliation(s)
- Eili Klein
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; OneHealthTrust, Washington, DC.
| | - Mustapha Saheed
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nathan Irvin
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kamna S Balhara
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Oluwakemi Badaki-Makun
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Division of Pediatric Emergency Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Gabor Kelen
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sara E Cosgrove
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jeremiah Hinson
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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25
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Wilke ABB, Vasquez C, Medina J, Unlu I, Beier JC, Ajelli M. Presence and abundance of malaria vector species in Miami-Dade County, Florida. Malar J 2024; 23:24. [PMID: 38238772 PMCID: PMC10797977 DOI: 10.1186/s12936-024-04847-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Malaria outbreaks have sporadically occurred in the United States, with Anopheles quadrimaculatus serving as the primary vector in the eastern region. Anopheles crucians, while considered a competent vector, has not been directly implicated in human transmission. Considering the locally acquired Plasmodium vivax cases in Sarasota County, Florida (7 confirmed cases), Cameron County, Texas (one confirmed case), and Maryland (one confirmed case) in the summer of 2023. The hypothesis of this study is that major cities in the United States harbour sufficient natural populations of Anopheles species vectors of malaria, that overlap with human populations that could support local transmission to humans. The objective of this study is to profile the most abundant Anopheles vector species in Miami-Dade County, Florida-An. crucians and An. quadrimaculatus. METHODS This study was based on high-resolution mosquito surveillance data from 2020 to 2022 in Miami-Dade County, Florida. Variations on the relative abundance of An. crucians and An. quadrimaculatus was assessed by dividing the total number of mosquitoes collected by each individual trap in 2022 by the number of mosquitoes collected by the same trap in 2020. In order to identify influential traps, the linear distance in meters between all traps in the surveillance system from 2020 to 2022 was calculated and used to create a 4 km buffer radius around each trap in the surveillance system. RESULTS A total of 36,589 An. crucians and 9943 An. quadrimaculatus were collected during this study by the surveillance system, consisting of 322 CO2-based traps. The findings reveal a highly heterogeneous spatiotemporal distribution of An. crucians and An. quadrimaculatus in Miami-Dade County, highlighting the presence of highly conducive environments in transition zones between natural/rural and urban areas. Anopheles quadrimaculatus, and to a lesser extent An. crucians, pose a considerable risk of malaria transmission during an outbreak, given their high abundance and proximity to humans. CONCLUSIONS Understanding the factors driving the proliferation, population dynamics, and spatial distribution of Anopheles vector species is vital for implementing effective mosquito control and reducing the risk of malaria outbreaks in the United States.
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Affiliation(s)
- André B B Wilke
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA.
| | | | - Johana Medina
- Miami-Dade County Mosquito Control Division, Miami, FL, USA
| | - Isik Unlu
- Miami-Dade County Mosquito Control Division, Miami, FL, USA
| | - John C Beier
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA.
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Abdullah O, Fall A, Klein E, Mostafa HH. Increased circulation of human adenovirus in 2023: an investigation of the circulating genotypes, upper respiratory viral loads, and hospital admissions in a large academic medical center. J Clin Microbiol 2024; 62:e0123723. [PMID: 38112530 PMCID: PMC10793258 DOI: 10.1128/jcm.01237-23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
IMPORTANCE The circulation of human adenoviruses (HAdV) increased in 2023. In this manuscript, we show that HAdV-B3 was predominant in 2023 in a cohort characterized by the Johns Hopkins Hospital System. We also show that HAdV-B3 was associated with an increase in viral loads in respiratory samples and provide a correlation with the clinical presentations and outcomes.
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Affiliation(s)
- Omar Abdullah
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Amary Fall
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Eili Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Center for Disease Dynamics, Economics, and Policy, Washington, DC, USA
| | - Heba H. Mostafa
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Shifflett SA, Ferreira FC, González J, Toledo A, Fonseca DM, Ellis VA. Diversity and host specificity of Borrelia burgdorferi's outer surface protein C ( ospC) alleles in synanthropic mammals, with a notable ospC allele U absence from mixed infections. Infect Immun 2024; 92:e0024423. [PMID: 38099660 PMCID: PMC10790820 DOI: 10.1128/iai.00244-23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/15/2023] [Indexed: 01/17/2024] Open
Abstract
Interactions among pathogen genotypes that vary in host specificity may affect overall transmission dynamics in multi-host systems. Borrelia burgdorferi, a bacterium that causes Lyme disease, is typically transmitted among wildlife by Ixodes ticks. Despite the existence of many alleles of B. burgdorferi's sensu stricto outer surface protein C (ospC) gene, most human infections are caused by a small number of ospC alleles ["human infectious alleles" (HIAs)], suggesting variation in host specificity associated with ospC. To characterize the wildlife host association of B. burgdorferi's ospC alleles, we used metagenomics to sequence ospC alleles from 68 infected individuals belonging to eight mammalian species trapped at three sites in suburban New Brunswick, New Jersey (USA). We found that multiple allele ("mixed") infections were common. HIAs were most common in mice (Peromyscus spp.) and only one HIA was detected at a site where mice were rarely captured. ospC allele U was exclusively found in chipmunks (Tamias striatus), and although a significant number of different alleles were observed in chipmunks, including HIAs, allele U never co-occurred with other alleles in mixed infections. Our results suggest that allele U may be excluding other alleles, thereby reducing the capacity of chipmunks to act as reservoirs for HIAs.
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Affiliation(s)
- Scarlet A. Shifflett
- Department of Entomology and Wildlife Ecology, University of Delaware, Newark, Delaware, USA
| | - Francisco C. Ferreira
- Center for Vector Biology, Department of Entomology, Rutgers University, New Brunswick, New Jersey, USA
| | - Julia González
- Center for Vector Biology, Department of Entomology, Rutgers University, New Brunswick, New Jersey, USA
| | - Alvaro Toledo
- Center for Vector Biology, Department of Entomology, Rutgers University, New Brunswick, New Jersey, USA
| | - Dina M. Fonseca
- Center for Vector Biology, Department of Entomology, Rutgers University, New Brunswick, New Jersey, USA
| | - Vincenzo A. Ellis
- Department of Entomology and Wildlife Ecology, University of Delaware, Newark, Delaware, USA
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Saraswati K, Tanganuchitcharnchai A, Ongchaikupt S, Mukaka M, Day NPJ, Baird JK, Antonjaya U, Myint KSA, Dewi YP, Yudhaputri FA, Haryanto S, Witari NPD, Blacksell SD. Scrub typhus in Indonesia: A cross-sectional analysis of archived fever studies samples. Trans R Soc Trop Med Hyg 2024:trad094. [PMID: 38205975 DOI: 10.1093/trstmh/trad094] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/06/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Scrub typhus is an understudied vector-borne bacterial infection. METHODS We tested archived fever samples for scrub typhus seropositivity to begin charting its geographic distribution in Indonesia. We analysed 1033 serum samples from three sites. IgM and IgG enzyme-linked immunosorbent assay (ELISA) against Orientia tsutsugamushi was performed using Karp, Kato, Gilliam, TA 716 antigens. To determine the cutoff in the absence of a presumed unexposed population and gold standard tests, we identified the visual inflection point, performed change point analysis, and used finite mixture models. RESULTS The optical density cutoff values used for IgM and IgG were 0.49 and 0.13, respectively. Across all sites, IgM seropositivity was 4.6% (95% CI: 3.4 to 6.0%) while IgG seropositivity was 4.4% (95% CI: 3.3 to 5.8%). The overall seropositivity across sites was 8.8% (95% CI: 8.1 to 11.7%). The overall seropositivity for Jambi, Denpasar, Tabanan were 9.7% (95% CI: 7.0 to 13.3%), 8.0% (95% CI: 5.7 to 11.0%), 9.0% (95% CI: 6.1 to 13.0%), respectively. CONCLUSIONS We conclude that O. tsutsugamushi exposure in humans occurred at all sites analysed and could be the cause of illness in some cases. Though it was not the main cause of acute fever in these locations, it is still important to consider scrub typhus in cases not responding to beta-lactam antibiotics. Future seroprevalence surveys and testing for scrub typhus in acute febrile illness studies will be essential to understand its distribution and burden in Indonesia.
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Affiliation(s)
- Kartika Saraswati
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, 10430 Jakarta, Indonesia
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 10400 Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, OX3 7LG Oxford, UK
| | - Ampai Tanganuchitcharnchai
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 10400 Bangkok, Thailand
| | - Sirada Ongchaikupt
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 10400 Bangkok, Thailand
| | - Mavuto Mukaka
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 10400 Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, OX3 7LG Oxford, UK
| | - Nicholas P J Day
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 10400 Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, OX3 7LG Oxford, UK
| | - J Kevin Baird
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, 10430 Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, OX3 7LG Oxford, UK
| | - Ungke Antonjaya
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, 10430 Jakarta, Indonesia
| | | | - Yora P Dewi
- Exeins Health Initiative, 12870 Jakarta, Indonesia
| | | | - Sotianingsih Haryanto
- Raden Mattaher Hospital, 36122 Jambi, Indonesia
- Faculty of Medicine and Health Sciences, Universitas Jambi, 36361 Jambi, Indonesia
| | - N P Diah Witari
- Faculty of Medicine and Health Sciences, Warmadewa University, 80235 Denpasar, Bali, Indonesia
| | - Stuart D Blacksell
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 10400 Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, OX3 7LG Oxford, UK
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Limanaqi F, Zecchini S, Saulle I, Strizzi S, Vanetti C, Garziano M, Cappelletti G, Parolin D, Caccia S, Trabattoni D, Fenizia C, Clerici M, Biasin M. Alpha-synuclein dynamics bridge Type-I Interferon response and SARS-CoV-2 replication in peripheral cells. Biol Res 2024; 57:2. [PMID: 38191441 PMCID: PMC10775536 DOI: 10.1186/s40659-023-00482-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Increasing evidence suggests a double-faceted role of alpha-synuclein (α-syn) following infection by a variety of viruses, including SARS-CoV-2. Although α-syn accumulation is known to contribute to cell toxicity and the development and/or exacerbation of neuropathological manifestations, it is also a key to sustaining anti-viral innate immunity. Consistently with α-syn aggregation as a hallmark of Parkinson's disease, most studies investigating the biological function of α-syn focused on neural cells, while reports on the role of α-syn in periphery are limited, especially in SARS-CoV-2 infection. RESULTS Results herein obtained by real time qPCR, immunofluorescence and western blot indicate that α-syn upregulation in peripheral cells occurs as a Type-I Interferon (IFN)-related response against SARS-CoV-2 infection. Noteworthy, this effect mostly involves α-syn multimers, and the dynamic α-syn multimer:monomer ratio. Administration of excess α-syn monomers promoted SARS-CoV-2 replication along with downregulation of IFN-Stimulated Genes (ISGs) in epithelial lung cells, which was associated with reduced α-syn multimers and α-syn multimer:monomer ratio. These effects were prevented by combined administration of IFN-β, which hindered virus replication and upregulated ISGs, meanwhile increasing both α-syn multimers and α-syn multimer:monomer ratio in the absence of cell toxicity. Finally, in endothelial cells displaying abortive SARS-CoV-2 replication, α-syn multimers, and multimer:monomer ratio were not reduced following exposure to the virus and exogenous α-syn, suggesting that only productive viral infection impairs α-syn multimerization and multimer:monomer equilibrium. CONCLUSIONS Our study provides novel insights into the biology of α-syn, showing that its dynamic conformations are implicated in the innate immune response against SARS-CoV-2 infection in peripheral cells. In particular, our results suggest that promotion of non-toxic α-syn multimers likely occurs as a Type-I IFN-related biological response which partakes in the suppression of viral replication. Further studies are needed to replicate our findings in neuronal cells as well as animal models, and to ascertain the nature of such α-syn conformations.
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Affiliation(s)
- Fiona Limanaqi
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy.
| | - Silvia Zecchini
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Irma Saulle
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, Milan, Italy
| | - Sergio Strizzi
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Claudia Vanetti
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Micaela Garziano
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, Milan, Italy
| | - Gioia Cappelletti
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Debora Parolin
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Sonia Caccia
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
| | - Claudio Fenizia
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, Milan, Italy
| | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 20148, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi, Milan, Italy.
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Yomogida K, Kjemtrup A, Martínez-López B, Ibrahim M, Contreras Z, Ngo V, Halai UA, Balter S, Feaster M, Zahn M, Shearer E, Sorvillo R, Balanji N, Torres C, Prado B, Porse C, Kramer V. Surveillance of Flea-Borne Typhus in California, 2011-2019. Am J Trop Med Hyg 2024; 110:142-149. [PMID: 38109767 PMCID: PMC10793031 DOI: 10.4269/ajtmh.23-0272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 05/06/2023] [Accepted: 09/19/2023] [Indexed: 12/20/2023] Open
Abstract
Flea-borne typhus (FBT), also referred to as murine typhus, is an acute febrile disease in humans caused by the bacteria Rickettsia typhi. Currently, cases of FBT are reported for public health surveillance purposes (i.e., to detect incidence and outbreaks) in a few U.S. states. In California, healthcare providers and testing laboratories are mandated to report to their respective local public health jurisdictions whenever R. typhi or antibodies reactive to R. typhi are detected in a patient, who then report cases to state health department. In this study, we characterize the epidemiology of flea-borne typhus cases in California from 2011 to 2019. A total of 881 cases were reported during this period, with most cases reported among residents of Los Angeles and Orange Counties (97%). Demographics, animal exposures, and clinical courses for case patients were summarized. Additionally, spatiotemporal cluster analyses pointed to five areas in southern California with persistent FBT transmission.
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Affiliation(s)
- Kyle Yomogida
- Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, California
- Vector-Borne Disease Section, California Department of Public Health, Sacramento, California
| | - Anne Kjemtrup
- Vector-Borne Disease Section, California Department of Public Health, Sacramento, California
| | - Beatriz Martínez-López
- Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, California
| | - Mireille Ibrahim
- Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California
| | - Zuelma Contreras
- Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California
| | - Van Ngo
- Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California
| | - Umme-Aiman Halai
- Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California
| | - Sharon Balter
- Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California
| | - Matt Feaster
- City of Pasadena Public Health Department, Pasadena, California
| | - Matthew Zahn
- Orange County Health Care Agency, Santa Ana, California
| | - Eric Shearer
- Orange County Health Care Agency, Santa Ana, California
| | | | - Nora Balanji
- Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, California
| | - Cindy Torres
- Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, California
| | - Belinda Prado
- Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, California
| | - Charsey Porse
- Vector-Borne Disease Section, California Department of Public Health, Sacramento, California
| | - Vicki Kramer
- Vector-Borne Disease Section, California Department of Public Health, Sacramento, California
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Hornbostel VL, Meek JI, Hansen AP, Niesobecki SA, Nawrocki CC, Hinckley AF, Connally NP. Operational Considerations for Using Deer-Targeted 4-Poster Tick Control Devices in a Tick-borne Disease Endemic Community. J Public Health Manag Pract 2024; 30:111-121. [PMID: 37566802 PMCID: PMC10840788 DOI: 10.1097/phh.0000000000001809] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
CONTEXT In the northeastern United States, recommendations to prevent diseases spread by black-legged ticks ( Ixodes scapularis ) and lone star ticks ( Amblyomma americanum ) often rely on individuals to use personal protection or yard-based strategies. The 4-Poster deer treatment stations (4-Posters) suppress tick populations by treating deer hosts with acaricide, potentially offering a community-wide approach for reducing tick-borne diseases in endemic areas. The 4-Poster deployment logistics in mainland community settings are not well documented but are needed for future public health tick control efforts. PROGRAM As part of a public health research effort to design a population-based 4-Poster effectiveness study aimed at reducing tick-borne disease incidence, TickNET researchers partnered with the Town of Ridgefield (Connecticut) to understand the feasibility and operational logistics of deploying 4-Posters on public land within a residential community to inform future public health interventions by municipalities or vector control agencies. IMPLEMENTATION We deployed three 4-Posters on a municipal property from July to December 2020 and used motion-activated cameras to record wildlife activity nearby. We documented per-device operational details, costs, materials consumed, and animal activity. EVALUATION Operation of 4-Posters was feasible, and device challenges were easily remedied. Deer visitation and heavy nontarget animal use were documented at all devices. Unexpectedly, monthly corn consumption was not correlated with monthly deer-view days. The monthly cost per device was US $1279 or US $305 per hectare with an average 21 minutes of weekly service time. DISCUSSION Use of 4-Posters by communities, public health agencies, or vector control programs may be a practicable addition to tick management programs in tick-borne disease endemic areas in the Northeast. Such programs should carefully consider local and state regulations, follow manufacturer and pesticide label guidelines, and include wildlife monitoring. High labor costs incurred in this project could be mitigated by training vector control agency or municipality staff to service 4-Posters.
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Affiliation(s)
- Victoria L Hornbostel
- Department of Biology, Western Connecticut State University, Danbury, Connecticut (Ms Hornbostel and Dr Connally); Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut (Mr Meek and Mss Hansen and Niesobecki); and Division of Vector-Borne Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado (Ms Nawrocki and Dr Hinckley)
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Sy ND, Cao M, Hall M, Kaur P, Shi Q, Xiong Y, Gan J. Distribution of pyrethroid insecticides in urban storm drain structures: Catch basins, open channels, and outfalls. Environ Pollut 2024; 340:122733. [PMID: 37875189 DOI: 10.1016/j.envpol.2023.122733] [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: 06/22/2023] [Revised: 09/18/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Surface water runoff can transport contaminants offsite to downstream aquatic ecosystems. The prevalence of impervious surfaces in urban areas enhances surface runoff and contributes to contamination of urban surface streams. Urban areas have complex drainage systems for the conveyance of drainage water, however, there is a dearth of information on the distribution of contaminants within storm drain system structures. Pyrethroid insecticides are among the most used insecticides in urban areas, and trace levels of pyrethroids are known to exert toxicity to aquatic invertebrates. To investigate pyrethroid occurrence and distribution throughout an urban drainage system, samples of water, sediment, algae, and biofilm were collected from catch basins, open channels, and outfalls in Los Angeles County, California, during the dry season. From 3 catch basins, 7 open channels, and 7 outfalls, a total of 28 water samples, 4 sediment samples, 8 algae samples, and 4 biofilm samples were collected and analyzed. Pyrethroid concentrations above the reporting limit were detected in 89% of water samples and all sediment, algae, and biofilm samples, with bifenthrin and cyfluthrin being the most frequently detected compounds. The median total pyrethroid concentrations in water, sediments, algae, and biofilms were 27 ng/L, 88 ng/g, 356 ng/g, and 3556 ng/g, respectively. Bifenthrin concentrations in catch basins were found to be significantly higher than those in open channels or outfalls. Significant correlations were found for various metrics, including between pyrethroid partitioning in water samples and total suspended solids. These findings highlight the role of underground catch basins as a sink as well as a secondary source for contaminants such as pyrethroid insecticides. Prevention of the input of these urban originated contaminants to catch basins is crucial for protecting the water quality of urban surface waters.
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Affiliation(s)
- Nathan D Sy
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA.
| | - Meixian Cao
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA; Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Matthew Hall
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA
| | - Parminder Kaur
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA
| | - Qingyang Shi
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA
| | - Yaxin Xiong
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA
| | - Jay Gan
- Department of Environmental Sciences, University of California, Riverside, CA 92521, USA
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Zou Z, Robinson JI, Steinberg LK, Henderson JP. Uropathogenic Escherichia coli wield enterobactin-derived catabolites as siderophores. J Biol Chem 2024; 300:105554. [PMID: 38072063 PMCID: PMC10788543 DOI: 10.1016/j.jbc.2023.105554] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
Uropathogenic Escherichia coli (UPEC) secrete multiple siderophore types to scavenge extracellular iron(III) ions during clinical urinary tract infections, despite the metabolic costs of biosynthesis. Here, we find the siderophore enterobactin (Ent) and its related products to be prominent components of the iron-responsive extracellular metabolome of a model UPEC strain. Using defined Ent biosynthesis and import mutants, we identify lower molecular weight dimeric exometabolites as products of incomplete siderophore catabolism, rather than prematurely released biosynthetic intermediates. In E. coli, iron acquisition from iron(III)-Ent complexes requires intracellular esterases that hydrolyze the siderophore. Although UPEC are equipped to consume the products of completely hydrolyzed Ent, we find that Ent and its derivatives may be incompletely hydrolyzed to yield products with retained siderophore activity. These results are consistent with catabolic inefficiency as means to obtain more than one iron ion per siderophore molecule. This is compatible with an evolved UPEC strategy to maximize the nutritional returns from metabolic investments in siderophore biosynthesis.
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Affiliation(s)
- Zongsen Zou
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, St Louis, Missouri, USA; Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - John I Robinson
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, St Louis, Missouri, USA; Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Lindsey K Steinberg
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, St Louis, Missouri, USA; Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jeffrey P Henderson
- Center for Women's Infectious Diseases Research, Washington University School of Medicine, St Louis, Missouri, USA; Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri, USA.
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LaReau JC, Hyde J, Brackney DE, Steven B. Introducing an environmental microbiome to axenic Aedes aegypti mosquitoes documents bacterial responses to a blood meal. Appl Environ Microbiol 2023; 89:e0095923. [PMID: 38014951 PMCID: PMC10734439 DOI: 10.1128/aem.00959-23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/10/2023] [Indexed: 11/29/2023] Open
Abstract
IMPORTANCE The blood meal of the female mosquito serves as a nutrition source to support egg development, so is an important aspect of its biology. Yet, the roles the microbiome may play in blood digestion are poorly characterized. We employed axenic mosquitoes to investigate how the microbiome differs between mosquitoes reared in the insectary versus mosquitoes that acquire their microbiome from the environment. Environmental microbiomes were more diverse and showed larger temporal shifts over the course of blood digestion. Importantly, only bacteria from the environmental microbiome performed hemolysis in culture, pointing to functional differences between bacterial populations. These data highlight that taxonomic differences between the microbiomes of insectary-reared and wild mosquitoes are potentially also related to their functional ecology. Thus, axenic mosquitoes colonized with environmental bacteria offer a way to investigate the role of bacteria from the wild in mosquito processes such as blood digestion, under controlled laboratory conditions.
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Affiliation(s)
- Jacquelyn C. LaReau
- Department of Environmental Science and Forestry, Connecticut Agricultural Experiment Station, New Haven, Connecticut, USA
| | - Josephine Hyde
- Department of Environmental Science and Forestry, Connecticut Agricultural Experiment Station, New Haven, Connecticut, USA
| | - Doug E. Brackney
- Department of Entomology, Center for Vector Biology and Zoonotic Diseases, New Haven, Connecticut, USA
| | - Blaire Steven
- Department of Environmental Science and Forestry, Connecticut Agricultural Experiment Station, New Haven, Connecticut, USA
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35
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Mohr NM, Plumb ID, Santos León E, Harland KK, Krishnadasan A, Nandi U, Hoth KF, Smithline HA, Talan DA. Factors associated with the decision to receive bivalent COVID-19 booster vaccination among health care personnel. Hum Vaccin Immunother 2023; 19:2284471. [PMID: 37994545 PMCID: PMC10760319 DOI: 10.1080/21645515.2023.2284471] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
COVID-19 vaccination is effective at reducing SARS-CoV-2 complications, but uptake has been low. Our objective in this study was to compare the importance of factors reported to influence the decision to receive a bivalent COVID-19 booster vaccine among health care personnel (HCP) tested for SARS-CoV-2 between October 2022 and April 2023 in a 20-hospital vaccine effectiveness study in the United States (n = 1656). Compared with those who had not received the booster, the factors most likely to be reported to be important were concerns about contracting COVID-19 (84.0% of those who had received the bivalent booster vs. 47.5% of those who had not, difference 36.6% points (PP), 95% confidence interval [CI] 32.1 to 41.1%), spreading infection to family members (89.2% vs. 62.8%, difference 26.3 PP, 95% CI 22.3 to 30.4%), and spreading infection to colleagues at work (85.5% vs. 59.4%, difference 26.1 PP, 95% CI 21.7 to 30.5%). HCP who had received the booster more frequently cited the primary literature (61.7% vs. 31.8%, difference 29.9 PP, 95% CI 24.6 to 35.2%) and employer recommendations (48.3% vs. 29.8%, difference 18.5 PP, 95% CI 13.2 to 23.9%) as influencing their decision. This analysis provides insight into factors for targeting future vaccine messaging.
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Affiliation(s)
- Nicholas M. Mohr
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Ian D. Plumb
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eliezer Santos León
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Karisa K. Harland
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Anusha Krishnadasan
- Olive View-UCLA Education and Research Institute, Olive View-UCLA Medical Center, Los Angeles, CA, USA
| | - Utsav Nandi
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Karin F. Hoth
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Howard A. Smithline
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Springfield, MA, USA
| | - David A. Talan
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Department of Emergency Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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36
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Cardé RT. Wind Tunnels and Airflow-Driven Assays: Methods for Establishing the Cues and Orientation Mechanisms That Modulate Female Mosquito Attraction to Human Hosts. Cold Spring Harb Protoc 2023:pdb.over107675. [PMID: 38190632 DOI: 10.1101/pdb.over107675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Understanding how female mosquitoes find a prospective host is crucial to developing means that can interfere with this process. Many methods are available to researchers studying cues and orientation mechanisms that modulate female mosquito attraction to hosts. Behaviors that can be monitored with these assays include activation, taking flight, upwind flight along an odor plume (optomotor anemotaxis), close approach to the stimulus (including hovering), and landing. Video recording can three-dimensionally document flight tracks and can correlate overall distribution patterns and moment-to-moment movements with odor contact and the presence of nearby cues such as a visual target. Here, we introduce mosquito host-seeking behaviors and methods to study them: wind tunnels (which allow orientation in free-flight), airflow-driven assays (using either tethered mosquitoes or small assay chambers that permit flight but also often dictate walking orientation), and still-air assays (wherein in odor concentration and spatial distribution are the orientation cues). We also describe factors that affect the assays and provide assay design considerations.
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Affiliation(s)
- Ring T Cardé
- Department of Entomology, University of California, Riverside, California 92521, USA
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37
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Sansom SE, Gussin GM, Schoeny M, Singh RD, Adil H, Bell P, Benson EC, Bittencourt CE, Black S, Del Mar Villanueva Guzman M, Froilan MC, Fukuda C, Barsegyan K, Gough E, Lyman M, Makhija J, Marron S, Mikhail L, Noble-Wang J, Pacilli M, Pedroza R, Saavedra R, Sexton DJ, Shimabukuro J, Thotapalli L, Zahn M, Huang SS, Hayden MK. Rapid Environmental Contamination with Candida auris and Multidrug-Resistant Bacterial Pathogens Near Colonized Patients. Clin Infect Dis 2023:ciad752. [PMID: 38059527 DOI: 10.1093/cid/ciad752] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Environmental contamination is suspected to play an important role in Candida auris transmission. Understanding speed and risks of contamination after room disinfection could inform environmental cleaning recommendations. METHODS We conducted a prospective multicenter study of environmental contamination associated with C. auris colonization at six ventilator-capable skilled nursing facilities and one acute-care hospital in Illinois and California. Known C. auris carriers were sampled at five body-sites followed by sampling of nearby room surfaces before disinfection and at 0, 4, 8, and 12-hours post-disinfection. Samples were cultured for C. auris and bacterial multidrug-resistant organisms (MDROs). Odds of surface contamination after disinfection were analyzed using multilevel generalized estimating equations. RESULTS Among 41 known C. auris carriers, colonization was detected most frequently on palms/fingertips (76%) and nares (71%). C. auris contamination was detected on 32.2% (66/205) of room surfaces pre-disinfection and 20.5% (39/190) of room surfaces by 4-hours post-disinfection. A higher number of C. auris-colonized body sites was associated with higher odds of environmental contamination at every time point following disinfection, adjusting for facility of residence. In the rooms of 38 (93%) C. auris carriers co-colonized with a bacterial MDRO, 2%-24% of surfaces were additionally contaminated with the same MDRO by 4-hours post-disinfection. CONCLUSIONS C. auris can contaminate the healthcare environment rapidly after disinfection, highlighting the challenges associated with environmental disinfection. Future research should investigate long-acting disinfectants, antimicrobial surfaces, and more effective patient skin antisepsis to reduce the environmental reservoir of C. auris and bacterial MDROs in healthcare settings.
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Affiliation(s)
- Sarah E Sansom
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Gabrielle M Gussin
- University of California, Irvine School of Medicine, Division of Infectious Diseases, Irvine CA, USA
| | - Michael Schoeny
- Rush University Medical Center, College of Nursing, Chicago IL, USA
| | - Raveena D Singh
- University of California, Irvine School of Medicine, Division of Infectious Diseases, Irvine CA, USA
| | - Hira Adil
- Chicago Department of Public Health, Chicago IL, USA
| | - Pamela Bell
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Ellen C Benson
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Cassiana E Bittencourt
- University of California, Irvine School of Medicine, Department of Pathology and Laboratory Medicine, Irvine CA, USA
| | | | | | - Mary Carl Froilan
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Christine Fukuda
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Karina Barsegyan
- University of California, Irvine School of Medicine, Division of Infectious Diseases, Irvine CA, USA
| | - Ellen Gough
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Meghan Lyman
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Jinal Makhija
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Stefania Marron
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | | | - Judith Noble-Wang
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta GA, USA
| | | | - Robert Pedroza
- University of California, Irvine School of Medicine, Division of Infectious Diseases, Irvine CA, USA
| | - Raheeb Saavedra
- University of California, Irvine School of Medicine, Division of Infectious Diseases, Irvine CA, USA
| | - D Joseph Sexton
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Julie Shimabukuro
- University of California, Irvine School of Medicine, Department of Pathology and Laboratory Medicine, Irvine CA, USA
| | - Lahari Thotapalli
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
| | - Matthew Zahn
- Orange County Health Care Agency, Santa Ana CA, USA
| | - Susan S Huang
- University of California, Irvine School of Medicine, Division of Infectious Diseases, Irvine CA, USA
| | - Mary K Hayden
- Rush University Medical Center, Division of Infectious Diseases, Chicago IL, USA
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Salomon J, Sambado SB, Crews A, Sidhu S, Seredian E, Almarinez A, Grgich R, Swei A. Macro-parasites and micro-parasites co-exist in rodent communities but are associated with different community-level parameters. Int J Parasitol Parasites Wildl 2023; 22:51-59. [PMID: 37680651 PMCID: PMC10481151 DOI: 10.1016/j.ijppaw.2023.08.006] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023]
Abstract
Wildlife species are often heavily parasitized by multiple infections simultaneously. Yet research on sylvatic transmission cycles, tend to focus on host interactions with a single parasite and neglects the influence of co-infections by other pathogens and parasites. Co-infections between macro-parasites and micro-parasites can alter mechanisms that regulate pathogenesis and are important for understanding disease emergence and dynamics. Wildlife rodent hosts in the Lyme disease system are infected with macro-parasites (i.e., ticks and helminths) and micro-parasites (i.e., Borrelia spp.), however, there has not been a study that investigates the interaction of all three parasites (i.e., I. pacificus, Borrelia spp., and helminths) and how these co-infections impact prevalence of micro-parasites. We live-trapped rodents in ten sites in northern California to collect feces, blood, ear tissue, and attached ticks. These samples were used to test for infection status of Borrelia species (i.e., micro-parasite), and describe the burden of ticks and helminths (i.e., macro-parasites). We found that some rodent hosts were co-infected with all three parasites, however, the burden or presence of concurrent macro-parasites were not associated with Borrelia infections. For macro-parasites, we found that tick burdens were positively associated with rodent Shannon diversity while negatively associated with predator diversity, whereas helminth burdens were not significantly associated with any host community metric. Ticks and tick-borne pathogens are associated with rodent host diversity, predator diversity, and abiotic factors. However, it is still unknown what factors helminths are associated with on the community level. Understanding the mechanisms that influence co-infections of multiple types of parasites within and across hosts is an increasingly critical component of characterizing zoonotic disease transmission and maintenance.
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Affiliation(s)
- Jordan Salomon
- Ecology & Evolutionary Biology Program at Texas A&M University, College Station, TX, USA
| | - Samantha B. Sambado
- Ecology, Evolution, & Marine Biology Department at University of California Santa Barbara, CA, USA
| | - Arielle Crews
- San Mateo County Mosquito and Vector Control, Burlingame, CA, USA
| | - Sukhman Sidhu
- Biology Department at San Francisco State University, San Francisco, CA, USA
| | - Eric Seredian
- Biology Department at San Francisco State University, San Francisco, CA, USA
| | - Adrienne Almarinez
- Biology Department at San Francisco State University, San Francisco, CA, USA
| | - Rachel Grgich
- Biology Department at San Francisco State University, San Francisco, CA, USA
| | - Andrea Swei
- Biology Department at San Francisco State University, San Francisco, CA, USA
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39
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Urban K, Payton C, Mamo B, Volkman H, Giorgio K, Kennedy L, Bomber YC, Rodrigues KK, Young J, Tumaylle C, Matheson J, Tasslimi A, Montour J, Jentes E. Hepatitis C Screening and Antibody Prevalence Among Newly Arrived Refugees to the United States, 2010-2017. J Immigr Minor Health 2023; 25:1323-1330. [PMID: 36995524 PMCID: PMC10062256 DOI: 10.1007/s10903-023-01471-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
Six refugee screening sites collaborated to estimate the prevalence of hepatitis C virus (HCV) antibodies among newly arrived refugees in the United States from 2010 to 2017, identify demographic characteristics associated with HCV antibody positivity, and estimate missed HCV antibody-positive adults among unscreened refugees. We utilized a cross-sectional study to examine HCV prevalence among refugees (N = 144,752). A predictive logistic regression model was constructed to determine the effectiveness of current screening practices at identifying cases. The prevalence of HCV antibodies among the 64,703 refugees screened was 1.6%. Refugees from Burundi (5.4%), Moldova (3.8%), Democratic Republic of Congo (3.2%), Burma (2.8%), and Ukraine (2.0%) had the highest positivity among refugee arrivals. An estimated 498 (0.7%) cases of HCV antibody positivity were missed among 67,787 unscreened adults. The domestic medical examination represents an opportunity to screen all adult refugees for HCV to ensure timely diagnosis and treatment.
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Affiliation(s)
- Kailey Urban
- Minnesota Department of Health, Infectious Disease Epidemiology, Prevention, and Control Division, St. Paul, MN, 55164, Türkiye.
| | - Colleen Payton
- School of Nursing and Public Health, Moravian University, Bethlehem, PA, U.S
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Blain Mamo
- Minnesota Department of Health, Infectious Disease Epidemiology, Prevention, and Control Division, St. Paul, MN, 55164, Türkiye
| | - Hannah Volkman
- Minnesota Department of Health, Infectious Disease Epidemiology, Prevention, and Control Division, St. Paul, MN, 55164, Türkiye
| | - Katherine Giorgio
- Minnesota Department of Health, Infectious Disease Epidemiology, Prevention, and Control Division, St. Paul, MN, 55164, Türkiye
| | - Lori Kennedy
- Colorado Department of Public Health and Environment, Newcomer Health Program, Health Equity Branch, Disease Control and Public Health Response Division, Denver, CO, USA
| | - Yuli Chen Bomber
- Colorado Department of Public Health and Environment, Newcomer Health Program, Health Equity Branch, Disease Control and Public Health Response Division, Denver, CO, USA
| | - Kristine Knuti Rodrigues
- Denver Health and Hospitals, Department of General Pediatrics, University of Colorado School of Medicine, Denver, CO, USA
| | - Janine Young
- Denver Health and Hospitals, Department of General Pediatrics, University of Colorado School of Medicine, Denver, CO, USA
| | - Carol Tumaylle
- Colorado Department of Human Services, Colorado Refugee Services Program, Denver, CO, USA
| | - Jasmine Matheson
- Washington State Department of Health, Office of Communicable Disease Epidemiology, Refugee and Immigrant Health Program, Shoreline, WA, USA
| | - Azadeh Tasslimi
- Washington State Department of Health, Office of Communicable Disease Epidemiology, Refugee and Immigrant Health Program, Shoreline, WA, USA
| | - Jessica Montour
- U.S. Committee for Refugees and Immigrants, Refugee Health Services, Austin, TX, USA
| | - Emily Jentes
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
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40
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Ward MJ, Sorek‐Hamer M, Henke JA, Little E, Patel A, Shaman J, Vemuri K, DeFelice NB. A Spatially Resolved and Environmentally Informed Forecast Model of West Nile Virus in Coachella Valley, California. Geohealth 2023; 7:e2023GH000855. [PMID: 38077289 PMCID: PMC10702611 DOI: 10.1029/2023gh000855] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 01/11/2024]
Abstract
West Nile virus (WNV) is the most significant arbovirus in the United States in terms of both morbidity and mortality. West Nile exists in a complex transmission cycle between avian hosts and the arthropod vector, Culex spp. mosquitoes. Human spillover events occur when humans are bitten by an infected mosquito and predicting these rates of infection and therefore the risk to humans may be associated with fluctuations in environmental conditions. In this study, we evaluate the hydrological and meteorological drivers associated with mosquito biology and viral development to determine if these associations can be used to forecast seasonal mosquito infection rates with WNV in the Coachella Valley of California. We developed and tested a spatially resolved ensemble forecast model of the WNV mosquito infection rate in the Coachella Valley using 17 years of mosquito surveillance data and North American Land Data Assimilation System-2 environmental data. Our multi-model inference system indicated that the combination of a cooler and dryer winter, followed by a wetter and warmer spring, and a cooler than normal summer was most predictive of the prevalence of West Nile positive mosquitoes in the Coachella Valley. The ability to make accurate early season predictions of West Nile risk has the potential to allow local abatement districts and public health entities to implement early season interventions such as targeted adulticiding and public health messaging before human transmission occurs. Such early and targeted interventions could better mitigate the risk of WNV to humans.
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Affiliation(s)
- Matthew J. Ward
- Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Meytar Sorek‐Hamer
- Universities Space Research Association (USRA) at NASA Ames Research CenterMoffett FieldCAUSA
| | | | - Eliza Little
- Connecticut Department of Public HealthHartfordCTUSA
| | - Aman Patel
- Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Jeffery Shaman
- Columbia Climate SchoolNew YorkNYUSA
- Mailman School of Public HealthNew YorkNYUSA
| | - Krishna Vemuri
- Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Nicholas B. DeFelice
- Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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Butler JL, Hranac R, Johnston H, Casey M, Basiliere E, Abraham AG, Czaja C. Association of Clostridioides difficile infection rates with social determinants of health in Denver area census tracts, 2016-2019. Prev Med Rep 2023; 36:102427. [PMID: 37766722 PMCID: PMC10520868 DOI: 10.1016/j.pmedr.2023.102427] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/04/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
We evaluated the association between census tract measures of socioeconomic status and Clostridioides difficile infection (CDI) rates in the Denver metro area from 2016 to 2019. Social vulnerability index, poverty, and race were associated with CDI. Findings may relate to differences in chronic disease prevalence, antibiotic exposure, and access to quality care.
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Affiliation(s)
- Jessica L. Butler
- University of Colorado Denver, Colorado School of Public Health, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Reed Hranac
- Colorado Department of Public Health and Environment, 4300 Cherry Creek S Dr., Denver, CO 80246, USA
| | - Helen Johnston
- Colorado Department of Public Health and Environment, 4300 Cherry Creek S Dr., Denver, CO 80246, USA
| | - Mary Casey
- Colorado Department of Public Health and Environment, 4300 Cherry Creek S Dr., Denver, CO 80246, USA
| | - Elizabeth Basiliere
- Colorado Department of Public Health and Environment, 4300 Cherry Creek S Dr., Denver, CO 80246, USA
| | - Alison G. Abraham
- University of Colorado Denver, Colorado School of Public Health, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Christopher Czaja
- Colorado Department of Public Health and Environment, 4300 Cherry Creek S Dr., Denver, CO 80246, USA
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Farthing TS, Jolley A, Nickel KB, Hill C, Stwalley D, Reske KA, Kwon JH, Olsen MA, Burnham JP, Dubberke ER, Lanzas C. Early coronavirus disease 2019 (COVID-19) pandemic effects on individual-level risk for healthcare-associated infections in hospitalized patients. Infect Control Hosp Epidemiol 2023; 44:1966-1971. [PMID: 37381734 PMCID: PMC10755158 DOI: 10.1017/ice.2023.83] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/08/2022] [Accepted: 04/10/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE We compared the individual-level risk of hospital-onset infections with multidrug-resistant organisms (MDROs) in hospitalized patients prior to and during the coronavirus disease 2019 (COVID-19) pandemic. We also quantified the effects of COVID-19 diagnoses and intrahospital COVID-19 burden on subsequent MDRO infection risk. DESIGN Multicenter, retrospective, cohort study. SETTING Patient admission and clinical data were collected from 4 hospitals in the St. Louis area. PATIENTS Data were collected for patients admitted between January 2017 and August 2020, discharged no later than September 2020, and hospitalized ≥48 hours. METHODS Mixed-effects logistic regression models were fit to the data to estimate patients' individual-level risk of infection with MDRO pathogens of interest during hospitalization. Adjusted odds ratios were derived from regression models to quantify the effects of the COVID-19 period, COVID-19 diagnosis, and hospital-level COVID-19 burden on individual-level hospital-onset MDRO infection probabilities. RESULTS We calculated adjusted odds ratios for COVID-19-era hospital-onset Acinetobacter spp., P. aeruginosa and Enterobacteriaceae spp infections. Probabilities increased 2.64 (95% confidence interval [CI], 1.22-5.73) times, 1.44 (95% CI, 1.03-2.02) times, and 1.25 (95% CI, 1.00-1.58) times relative to the prepandemic period, respectively. COVID-19 patients were 4.18 (95% CI, 1.98-8.81) times more likely to acquire hospital-onset MDRO S. aureus infections. CONCLUSIONS Our results support the growing body of evidence indicating that the COVID-19 pandemic has increased hospital-onset MDRO infections.
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Affiliation(s)
| | - Ashlan Jolley
- North Carolina State University, Raleigh, North Carolina
| | - Katelin B. Nickel
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Cherie Hill
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Dustin Stwalley
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Kimberly A. Reske
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Jennie H. Kwon
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Margaret A. Olsen
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Jason P. Burnham
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
| | - Erik R. Dubberke
- Division of Infectious Diseases, Washington University, St. Louis, Missouri
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43
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Contag CA, Mische L, Fong I, Karan A, Vaidya A, McCormick DW, Bower W, Hacker JK, Johnson K, SanJuan P, Crebbin L, Temmins C, Sahni H, Bogler Y, Cooper JD, Narasimhan S. Treatment of Mpox with Suspected Tecovirimat Resistance in Immunocompromised Patient, United States, 2022. Emerg Infect Dis 2023; 29:2520-2523. [PMID: 37856215 PMCID: PMC10683816 DOI: 10.3201/eid2912.230849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Reports of tecovirimat-resistant mpox have emerged after widespread use of antiviral therapy during the 2022 mpox outbreak. Optimal management of patients with persistent infection with or without suspected resistance is yet to be established. We report a successfully treated case of severe mpox in California, USA, that had suspected tecovirimat resistance.
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44
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Fall A, Han L, Yunker M, Gong YN, Li TJ, Norton JM, Abdullah O, Rothman RE, Fenstermacher KZJ, Morris CP, Pekosz A, Klein E, Mostafa HH. Evolution of Influenza A(H3N2) Viruses in 2 Consecutive Seasons of Genomic Surveillance, 2021-2023. Open Forum Infect Dis 2023; 10:ofad577. [PMID: 38088981 PMCID: PMC10715682 DOI: 10.1093/ofid/ofad577] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/15/2023] [Indexed: 12/30/2023] Open
Abstract
Background The circulation and the genomic evolution of influenza A(H3N2) viruses during the 2021/2022 and 2022/2023 seasons were studied and associated with infection outcomes. Methods Remnant influenza A-positive samples following standard-of-care testing from patients across the Johns Hopkins Health System (JHHS) were used for the study. Samples were randomly selected for whole viral genome sequencing. The sequence-based pEpitope model was used to estimate the predicted vaccine efficacy (pVE) for circulating H3N2 viruses. Clinical data were collected and associated with viral genomic data. Results A total of 121 683 respiratory specimens were tested for influenza at JHHS between 1 September 2021 and 31 December 2022. Among them, 6071 (4.99%) tested positive for influenza A. Of these, 805 samples were randomly selected for sequencing, with hemagglutinin (HA) segments characterized for 610 samples. Among the characterized samples, 581 were H3N2 (95.2%). Phylogenetic analysis of HA segments revealed the exclusive circulation of H3N2 viruses with HA segments of the 3C.2a1b.2a.2 clade. Analysis of a total of 445 complete H3N2 genomes revealed reassortments; 200 of 227 of the 2022/2023 season genomes (88.1%) were found to have reassorted with clade 3C.2a1b.1a. The pVE was estimated to be -42.53% for the 2021/2022 season and 30.27% for the 2022/2023 season. No differences in clinical presentations or admissions were observed between the 2 seasons. Conclusions The increased numbers of cases and genomic diversity of influenza A(H3N2) during the 2022/2023 season were not associated with a change in disease severity compared to the previous influenza season.
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Affiliation(s)
- Amary Fall
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lijie Han
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Madeline Yunker
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- International Master Degree Program for Molecular Medicine in Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Tai-Jung Li
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- International Master Degree Program for Molecular Medicine in Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Julie M Norton
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Omar Abdullah
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - C Paul Morris
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, Maryland, USA
| | - Andrew Pekosz
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- W.Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eili Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Center for Disease Dynamics, Economics, and Policy, Washington, District of Columbia, USA
| | - Heba H Mostafa
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Phillip KI, Webster AS, Ray SM, Britton A, Swerdlow D, Fridkin SK. Estimating the Burden of Clinically Significant Staphylococcus aureus Infections and Predictors for Hospitalization for Skin and Soft Tissue Infections, Fulton County, Georgia, 2017. Open Forum Infect Dis 2023; 10:ofad601. [PMID: 38107016 PMCID: PMC10725309 DOI: 10.1093/ofid/ofad601] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 12/19/2023] Open
Abstract
Background Incidence estimates of Staphylococcus aureus infections rarely include the full spectrum of clinically relevant disease from both community and healthcare settings. Methods We conducted a prospective study capturing all S aureus infections in Fulton County, Georgia, during 2017. Medical records of patients with any incident infection (clinical cultures growing S aureus from any site, without prior positive culture in previous 14 days) were reviewed. Estimates of disease incidence were calculated using age-, race-, and sex-specific population denominators accounting for weighted sampling methods. Multivariable logistic regression models were used to identify risk factors for hospitalization among patients with skin and soft tissue infections (SSTIs). Results The overall incidence of clinically relevant S aureus infection was 405.7 cases per 100 000 people (standard error [SE], 5.62 [range, 400.1-411.3]). Overall incidence for those of Black race was 500.84 cases per 100 000 people (SE, 14.55), whereas White patients had overall incidence of 363.67 cases per 100 000 people (SE, 13.8). SSTIs were the most common infection (2351; 225.8 cases per 100 000 people [SE, 7.1]), and 30% required hospitalization. Among SSTIs, after adjusting for invasive disease, cellulitis, diabetes, and demographics, independent predictors of hospitalization included methicillin-resistant S aureus (adjusted odds ratio [aOR], 1.6 [95% confidence interval {CI}, 1.0-2.7]) and homelessness (aOR, 4.9 [95% CI, 1.1-22]). Conclusions The burden of clinically relevant S aureus infections is high, particularly among the Black population, and risks for hospitalization among SSTIs include isolate factors and factors related to patients' vulnerability.
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Affiliation(s)
- Katherine I Phillip
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Andrew S Webster
- Division of Infectious Diseases, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
- Department of Research, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA
- Georgia Emerging Infections Program, Decatur, Georgia, USA
| | - Susan M Ray
- Division of Infectious Diseases, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
- Georgia Emerging Infections Program, Decatur, Georgia, USA
| | - Amber Britton
- Division of Infectious Diseases, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
- Department of Research, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA
- Georgia Emerging Infections Program, Decatur, Georgia, USA
| | - David Swerdlow
- Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Collegeville, Pennsylvania, USA
- Medical Affairs, HilleVax Inc, Boston, Massachusetts, USA
| | - Scott K Fridkin
- Division of Infectious Diseases, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
- Georgia Emerging Infections Program, Decatur, Georgia, USA
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Hareza DA, Cosgrove SE, Simner PJ, Harris AD, Bergman Y, Conzemius R, Jacobs E, Beisken S, Tamma PD. Is Carbapenem Therapy Necessary for the Treatment of Non-CTX-M ESBL-Producing Enterobacterales Bloodstream Infections? Clin Infect Dis 2023:ciad703. [PMID: 37972276 DOI: 10.1093/cid/ciad703] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/30/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Investigations into antibiotics for extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) bloodstream infections (BSIs) have focused on blaCTX-M genes. Outcomes of patients with non-CTX-M-producing ESBL-E BSIs and optimal treatment are unknown. METHODS A multicenter observational study investigating 500 consecutive patients with ceftriaxone-resistant Enterobacterales BSIs during 2018-2022 was conducted. Broth microdilution and whole genome sequencing confirmed antibiotic susceptibilities and ESBL gene presence, respectively. Inverse probability weighting (IPW) using propensity scores was employed to ensure patients infected with non-CTX-M and CTX-M ESBL-E BSIs were similar prior to evaluation of outcomes. RESULTS 396 patients (79.2%) were confirmed to have an ESBL-E BSI. ESBL gene family prevalence was as follows: blaCTX-M (n=370), blaSHV (n=16), blaOXY (n=12), and blaVEB (n=5). ESBL gene identification was not limited to Escherichia coli and Klebsiella species. In the IPW cohort, there was no difference in 30-day mortality or ESBL-E infection recurrence between the non-CTX-M and CTX-M groups (OR=.99, 95% CI 0.87-1.11; p=0.83) and (OR=1.10, 95% CI 0.85--1.42; p=0.47), respectively. In an exploratory analysis limited to the non-CTX-M group, 86% of the 21 patients receiving meropenem were alive on day 30; none of the 5 patients receiving piperacillin-tazobactam were alive on day 30. CONCLUSIONS Our findings suggest that non-CTX-M and CTX-M ESBL-producing Enterobacterales BSIs are equally concerning and associated with similar clinical outcomes. Meropenem may be associated with improved survival in patients with non-CTX-M ESBL-E BSIs, underscoring the potential benefit of comprehensive molecular diagnostics to enable early antibiotic optimization for patients with ESBL-E BSI, beyond just blaCTX-M genes.
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Affiliation(s)
- Dariusz A Hareza
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sara E Cosgrove
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patricia J Simner
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anthony D Harris
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Yehudit Bergman
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Emily Jacobs
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Pranita D Tamma
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Garrigues JM, Hemarajata P, Espinosa A, Hacker JK, Wynn NT, Smith TG, Gigante CM, Davidson W, Vega J, Edmondson H, Karan A, Marutani AN, Kim M, Terashita D, Balter SE, Hutson CL, Green NM. Community spread of a human monkeypox virus variant with a tecovirimat resistance-associated mutation. Antimicrob Agents Chemother 2023; 67:e0097223. [PMID: 37823631 PMCID: PMC10649028 DOI: 10.1128/aac.00972-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
ABSTRACT
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Affiliation(s)
| | - Peera Hemarajata
- Los Angeles County Department of Public Health, Downey, California, USA
| | - Alex Espinosa
- California Department of Public Health, Richmond, California, USA
| | - Jill K. Hacker
- California Department of Public Health, Richmond, California, USA
| | - Nhien T. Wynn
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Todd G. Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Whitni Davidson
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonte Vega
- Ventura County Public Health, Oxnard, California, USA
| | | | - Abraar Karan
- Los Angeles County Department of Public Health, Downey, California, USA
- Stanford University, Stanford, California, USA
| | - Amy N. Marutani
- Los Angeles County Department of Public Health, Downey, California, USA
| | - Moon Kim
- Los Angeles County Department of Public Health, Downey, California, USA
| | - Dawn Terashita
- Los Angeles County Department of Public Health, Downey, California, USA
| | - Sharon E. Balter
- Los Angeles County Department of Public Health, Downey, California, USA
| | | | - Nicole M. Green
- Los Angeles County Department of Public Health, Downey, California, USA
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Shepard JJ, Armstrong PM. Jamestown Canyon virus comes into view: understanding the threat from an underrecognized arbovirus. J Med Entomol 2023; 60:1242-1251. [PMID: 37862091 DOI: 10.1093/jme/tjad069] [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: 03/16/2023] [Revised: 05/08/2023] [Accepted: 06/08/2023] [Indexed: 10/21/2023]
Abstract
This review examines the epidemiology, ecology, and evolution of Jamestown Canyon virus (JCV) and highlights new findings from the literature to better understand the virus, the vectors driving its transmission, and its emergence as an agent of arboviral disease. We also reanalyze data from the Connecticut Arbovirus Surveillance Program which represents the largest dataset on JCV infection in mosquitoes. JCV is a member of the California serogroup of the genus Orthobunyavirus, family Peribunyaviridae, and is found throughout much of temperate North America. This segmented, negative-sense RNA virus evolves predominately by genetic drift punctuated by infrequent episodes of genetic reassortment among novel strains. It frequently infects humans within affected communities and occasionally causes febrile illness and neuroinvasive disease in people. Reported human cases are relatively rare but are on the rise during the last 20 yr, particularly within the northcentral and northeastern United States. JCV appears to overwinter and reemerge each season by transovarial or vertical transmission involving univoltine Aedes (Diptera: Culicidae) species, specifically members of the Aedes communis (de Geer) and Ae. stimulans (Walker) Groups. The virus is further amplified in a mosquito-deer transmission cycle involving a diversity of mammalophilic mosquito species. Despite progress in our understanding of this virus, many aspects of the vector biology, virology, and human disease remain poorly understood. Remaining questions and future directions of research are discussed.
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Affiliation(s)
- John J Shepard
- Center for Vector Biology and Zoonotic Diseases, Department of Entomology, The Connecticut Agricultural Experiment Station, New Haven, CT 06511, USA
| | - Philip M Armstrong
- Center for Vector Biology and Zoonotic Diseases, Department of Entomology, The Connecticut Agricultural Experiment Station, New Haven, CT 06511, USA
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Harris AD, Pineles L, Johnson JK, O’Hara LM, Smith LL, French I, Rubin J, Perlmutter R, Heller A, Klein L, Thoguru J, Blythe D, Vaeth E. Prevalence of Acinetobacter baumannii and Candida auris in Patients Receiving Mechanical Ventilation. JAMA 2023; 330:1769-1772. [PMID: 37824710 PMCID: PMC10570911 DOI: 10.1001/jama.2023.21083] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
Importance To date, only 1 statewide prevalence survey has been performed for Acinetobacter baumannii (2009) in the US, and no statewide prevalence survey has been performed for Candida auris, making the current burden of these emerging pathogens unknown. Objective To determine the prevalence of A baumannii and C auris among patients receiving mechanical ventilation in Maryland. Design, Setting, and Participants The Maryland Multi-Drug Resistant Organism Prevention Collaborative performed a statewide cross-sectional point prevalence of patients receiving mechanical ventilation admitted to acute care hospitals (n = 33) and long-term care facilities (n = 18) between March 7, 2023, and June 8, 2023. Surveillance cultures (sputum, perianal, arm/leg, and axilla/groin) were obtained from all patients receiving mechanical ventilation. Sputum, perianal, and arm/leg cultures were tested for A baumannii and antibiotic susceptibility testing was performed. Axilla/groin cultures were tested by polymerase chain reaction for C auris. Main Outcomes and Measures Prevalence of A baumannii, carbapenem-resistant A baumannii (CRAB), and C auris. Prevalence was stratified by type of facility. Results All 51 eligible health care facilities (100%) participated in the survey. A total of 482 patients receiving mechanical ventilation were screened for A baumannii and 470 were screened for C auris. Among the 482 patients who had samples collected, 30.7% (148/482) grew A baumannii, 88 of the 148 (59.5%) of these A baumannii were CRAB, and C auris was identified in 31 of 470 (6.6%). Patients in long-term care facilities were more likely to be colonized with A baumannii (relative risk [RR], 7.66 [95% CI, 5.11-11.50], P < .001), CRAB (RR, 5.48 [95% CI, 3.38-8.91], P < .001), and C auris (RR, 1.97 [95% CI, 0.99-3.92], P = .05) compared with patients in acute care hospitals. Nine patients (29.0%) with cultures positive for C auris were previously unreported to the Maryland Department of Health. Conclusions A baumannii, carbapenem-resistant A baumannii, and C auris were common among patients receiving mechanical ventilation in both acute care hospitals and long-term care facilities. Both pathogens were significantly more common in long-term care facilities than in acute care hospitals. Patients receiving mechanical ventilation in long-term care facilities are a high-risk population for emerging pathogens, and surveillance and prevention efforts should be targeted to these facilities.
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Affiliation(s)
| | - Lisa Pineles
- University of Maryland School of Medicine, Baltimore
| | | | | | | | - Indira French
- University of Maryland School of Medicine, Baltimore
| | | | | | | | - Liore Klein
- Maryland Department of Health Laboratories Administration, Baltimore
| | - John Thoguru
- Maryland Department of Health Laboratories Administration, Baltimore
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Norris EJ, Bloomquist JR. Fir (Abies balsamea) (Pinales: Pinaceae) needle essential oil enhances the knockdown activity of select insecticides. J Med Entomol 2023; 60:1350-1356. [PMID: 37963276 DOI: 10.1093/jme/tjad101] [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: 02/26/2023] [Revised: 06/23/2023] [Accepted: 08/04/2023] [Indexed: 11/16/2023]
Abstract
Because of the increased interest in plant essential oils (PEO) for both home pest control and personal bite protection, the ability of fir needle (Abies balsamea) oil to synergize the 1-h knockdown and 24-h toxicity of 9 different synthetic insecticides was evaluated. Fir needle oil strongly synergized knockdown of the neonicotinoids, clothianidin, and thiamethoxam (between 16- and 24-fold), as well as natural pyrethrins (12-fold), but had less effect with organophosphates and fipronil. For 24-h mortality, only pirimiphos-methyl was strongly synergized by fir needle oil pretreatment (18-fold). Chemical analysis and testing identified delta-3-carene is the most bioactive constituent, producing synergism similar to that of the whole oil. In fact, this constituent synergized the 24-h mortality of clothianidin to a higher degree than fir needle oil itself (4.9-fold vs. 2.4-fold). Synergism is unlikely to be mediated by effects on the nervous system, as fir needle oil caused no change in mosquito central nervous system firing at 100 ppm and did not synergize an inactive concentration of natural pyrethrins (10 nM). To better understand fir needle oil effects, we evaluated the ability of pretreatment with this oil to impact Aedes aegypti monooxygenase degradation of a model substrate, 7-ethoxycoumarin. Interestingly, both fir needle oil and delta-3-carene caused a significant increase in metabolic degradation of 7-ethoxycoumarin, perhaps indicating they upregulate oxidative metabolic processes. Such an action would explain why fir needle oil enhances knockdown, but not 24-h mortality for most of the insecticides studied here, whereas increased bioactivation would explain the synergism of pirimiphos-methyl toxicity.
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Affiliation(s)
- Edmund J Norris
- USDA/ARS Center for Medical, Agricultural, and Veterinary Entomology, Gainesville, FL 32608, USA
| | - Jeffrey R Bloomquist
- Entomology and Nematology Department, Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32608, USA
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