1
|
Lux A, Realini M, Botteon A, Maiwald M, Müller A, Sumpf B, Miliani C, Matousek P, Strobbia P, Conti C. Advanced portable micro-SORS prototype coupled with SERDS for heritage science. Analyst 2024; 149:2317-2327. [PMID: 38466379 DOI: 10.1039/d3an02215c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
We investigate the subsurface composition of turbid materials at the micro scale by means of a portable non-invasive technique, micro-spatially offset Raman spectroscopy (micro-SORS), combined with shifted excitation Raman difference spectroscopy (SERDS). This combination enables the microscale layer analysis and allows to deal effectively with highly fluorescing samples as well as ambient light, all in a form of an in-house portable prototype device optimised for applications in heritage science. The instrument comprises ability to simultaneously collect multiple spectra by means of an optical fibre bundle, thus reducing the dead time and simplifying the ease of deployment of the technique. The performance of the synergy between micro-SORS and 785 nm SERDS dual-wavelength diode laser is demonstrated on a stratified mock-up painting samples including highly fluorescing painted layers. This instrumental approach could be ground-breaking in heritage science, due to the largely unmet need of analysing the molecular composition of subsurface of artworks non-invasively and in situ, and in the presence of fluorescent background and ambient light. Moreover, many other fields are expected to benefit from this technological advancement such as solar energy, forensic and food analytical areas.
Collapse
Affiliation(s)
- A Lux
- Institute of Heritage Science, National Research Council (CNR-ISPC), Via Cozzi 53, 20125, Milan, Italy.
- Sapienza University of Rome, Faculty of Literature, Department of Classics, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - M Realini
- Institute of Heritage Science, National Research Council (CNR-ISPC), Via Cozzi 53, 20125, Milan, Italy.
| | - A Botteon
- Institute of Heritage Science, National Research Council (CNR-ISPC), Via Cozzi 53, 20125, Milan, Italy.
| | - M Maiwald
- Ferdinand-Braun-Institut Leibniz-Institut für Höchstfrequenztechnik, Gustav-Kirchhoff-Str. 4, 12489 Berlin, Germany
| | - A Müller
- Ferdinand-Braun-Institut Leibniz-Institut für Höchstfrequenztechnik, Gustav-Kirchhoff-Str. 4, 12489 Berlin, Germany
| | - B Sumpf
- Ferdinand-Braun-Institut Leibniz-Institut für Höchstfrequenztechnik, Gustav-Kirchhoff-Str. 4, 12489 Berlin, Germany
| | - C Miliani
- Institute of Heritage Science, National Research Council (CNR-ISPC), Via Cozzi 53, 20125, Milan, Italy.
| | - P Matousek
- Central Laser Facility, Research Complex at Harwell, STFC Rutherford Appleton Laboratory, Harwell Oxford, OX11 0QX, UK
| | - P Strobbia
- Department of Chemistry, University of Cincinnati, 201 Crosley Tower, Cincinnati, USA
| | - C Conti
- Institute of Heritage Science, National Research Council (CNR-ISPC), Via Cozzi 53, 20125, Milan, Italy.
| |
Collapse
|
2
|
Kavanagh KT, Maiwald M, Pontus C, Cimiotti JP, Palmieri PA, Cormier LE. Frontline Worker Safety in the Age of COVID-19: A Global Perspective. J Patient Saf 2023; 19:293-299. [PMID: 37162150 PMCID: PMC10373843 DOI: 10.1097/pts.0000000000001132] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The third annual Health Watch USA sm webinar conference assembled 16 speakers from 4 continents who shared information regarding frontline worker safety in the age of COVID-19. The U.S. Bureau of Labor Statistics reported a nearly 4000% increase in workplace illness in 2020 compared with 2019. It is estimated that 2% of the U.S. workforce is not working because of long COVID. In addition, the impact is growing with each surge. After the acute illness, patients are often described as recovered, when in fact many have only survived and are coping with the multisystem impacts of long COVID. Long COVID, including its late cognitive, cardiovascular, embolic, and diabetic complications, disproportionately impacts frontline workers, many of whom are of lower socioeconomic status and represented by ethnic minorities. Natural infection and current vaccines do not provide durable protection for reinfection. Herd immunity is not possible at this time. Although SARS-CoV-2 is unlikely to be eliminated, decreasing spread is imperative to slow the rate of mutations, decrease the number of reinfections, and lower the chances of developing long COVID. The primary mode of spread is through aerosolization. Both routine breathing and talking aerosolizes the virus. With the extremely high infectivity of SARS-CoV-2, it is unlikely that central building ventilation alone will be enough to satisfactorily mitigate spread. Additional safe active air cleaning technology, such as upper-room germicidal UV-C lighting, needs to be deployed. Misinformation and disinformation have inhibited response effectiveness. Examples include downplaying the benefit of well-fitted masks and the risks that COVID-19 and long COVID pose to children, along with believing children cannot spread the disease. The engagement of local community leaders is essential to educate the community and drive social change to accept vaccinations and other public health interventions. Vaccinations and natural immunity alone are unlikely to adequately prevent community spread and do not provide durable protection against the risk of long COVID. Frontline workers must keep their immunity as high as possible and work in settings with clean air, along with wearing N95 masks when they are in contact with the public. Finally, there needs to be a financial safety net for frontline workers and their families in the event of incapacitation or death from COVID-19.
Collapse
Affiliation(s)
| | - Matthias Maiwald
- KK Women’s and Children’s Hospital
- Yong Loo Lin School of Medicine, National University of Singapore
- Duke-National University of Singapore Graduate School of Medicine, Health Watch USA, Singapore
| | - Christine Pontus
- Massachusetts Nurses Association, United States, Health Watch USA Canton, Massachusetts
| | | | | | | |
Collapse
|
3
|
Chew SJ, Low KB, Chong CY, Maiwald M, Thoon KC, Ong RY, Yung CF, Li J, Nadua KD, Kam KQ, Tan HK, Lian DW, Tan LY, Tan NW. Paediatric actinomycosis: A 16-year, single-institution retrospective review of cases. J Paediatr Child Health 2023. [PMID: 37017147 DOI: 10.1111/jpc.16400] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/01/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023]
Abstract
AIM Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. METHODS A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020. Clinical profile, therapeutic interventions and outcomes were examined. RESULTS A total of 10 patients were identified; 7 were female. The median age at first presentation was 9.8 years (range 4.7-15.7). The most common presenting symptom was fever (n = 6, 60%), followed by facial or neck swelling (n = 3, 30%) and ear pain (n = 3, 30%). Actinomycosis occurred predominantly in the orocervicofacial region (n = 6, 60%). Four patients (40%) had preceding dental infections in the form of dental caries or gingivitis. One patient had poorly controlled insulin-dependent diabetes mellitus. Actinomycosis was confirmed via culture in four patients, histopathology in four patients and both methods in two patients. All except one patient (n = 9, 90%) underwent surgical procedures. All patients received ampicillin or amoxicillin/clavulanate or other beta-lactams, for a median duration of 6.5 months (range 1.5-14). Complications included osteomyelitis (n = 4, 40%), mastoiditis (n = 2, 20%), brain abscess (n = 1, 10%) and recurrent neck abscess (n = 1, 10%). There was no mortality and all patients achieved complete resolution. CONCLUSIONS Paediatric actinomycosis was rare in our 16-year review, but had a high complication rate. It can occur in immunocompetent patients, and dental infection was the predominant risk factor identified. Prognosis was excellent after surgical intervention and appropriate antimicrobial therapy.
Collapse
Affiliation(s)
- Siu-Jun Chew
- Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Kelly Bb Low
- Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Chia-Yin Chong
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Matthias Maiwald
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Koh-Cheng Thoon
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Rina Yl Ong
- Department of Pharmacy, KK Women's and Children's Hospital, Singapore
| | - Chee-Fu Yung
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Jiahui Li
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Karen D Nadua
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Kai-Qian Kam
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Henry Kk Tan
- Department of Otolaryngology, KK Women's and Children's Hospital, Singapore
| | - Derrick Wq Lian
- Department of Pathology, National University Hospital, Singapore
| | - Leon Yr Tan
- Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Natalie Wh Tan
- Infectious Disease Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore
- Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| |
Collapse
|
4
|
Kam KQ, Maiwald M, Chong CY, Thoon KC, Nadua KD, Loo LH, Yelen, Tan NWH, Li J, Yung CF. SARS-CoV-2 antigen rapid tests and universal screening for COVID-19 Omicron variant among hospitalized children. Am J Infect Control 2023; 51:255-260. [PMID: 36370867 PMCID: PMC9643321 DOI: 10.1016/j.ajic.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Clinical utility of universal antigen rapid test (ART) in the pediatric setting is unknown. We aimed to assess the performance and utility of universal ART in hospitalized children (≥5-year-old) to prevent nosocomial COVID-19 transmission. METHODS Cross-sectional study involving all hospitalized pediatric patients aged ≥5-year-old from 2 periods during Omicron wave. Clinical data, ART and polymerase chain reaction test results were collected. RESULTS A total of 444 patients were included from the 2 study periods, and 416 patients (93.7%) had concordant results between ART and polymerase chain reaction. The overall sensitivity and specificity of ART were 83.3% (95% CI: 75.2-89.3) and 97.5% (95% CI: 95.0-98.8), respectively. Negative predictive values of ART between the Omicron emergence and Omicron peak periods for a probable case group were 71.4% and 66.7%, respectively, and for a suspect case group 91.4% and 75.0%, respectively. Negative predictive values for an unlikely case group was >95% in both periods. Positive predictive value of ART was >85% for probable and suspect case groups in both periods. Seventy-five percent of patients (n = 15) who were incorrectly classified as SARS-CoV-2 negative by ART had potentially viable virus. No large nosocomial transmission clusters were detected. CONCLUSIONS Universal ART screening may limit nosocomial outbreaks in hospitalized children. The performance can be optimized by considering clinical symptoms, exposure and periods within COVID waves.
Collapse
Affiliation(s)
- Kai-Qian Kam
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Matthias Maiwald
- Duke-NUS Medical School, Singapore,Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore,Department of Microbiology and Immunology, National University of Singapore, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Karen Donceras Nadua
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Liat Hui Loo
- Duke-NUS Medical School, Singapore,Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Yelen
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiahui Li
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chee Fu Yung
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| |
Collapse
|
5
|
Lee MH, Mailepessov D, Yahya K, Loo LH, Maiwald M, Aik J. Air quality, meteorological variability and pediatric respiratory syncytial virus infections in Singapore. Sci Rep 2023; 13:1001. [PMID: 36653364 PMCID: PMC9848044 DOI: 10.1038/s41598-022-26184-0] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/12/2022] [Indexed: 01/19/2023] Open
Abstract
Respiratory syncytial virus (RSV) is an important cause of respiratory illness among children. While studies have focused on the air-quality and climate dependence of RSV infections, few have been undertaken in South-East Asia where the burden of respiratory illness is among the highest across the globe. This study aimed to determine the relationships between climatic factors and air quality with RSV infections among children in Singapore. We obtained all laboratory-confirmed reports of RSV infections in children below 5 years old from the largest public hospital specializing in pediatric healthcare in Singapore. We assessed the independent cumulative effects of air quality and meteorological factors on RSV infection risk using the Distributed Lag Non-Linear Model (DLNM) framework in negative binomial models adjusted for long-term trend, seasonality and changes in the diagnostic systems. We included 15,715 laboratory-confirmed RSV reports from 2009 to 2019. Daily maximum temperature exhibited a complex, non-linear association with RSV infections. Absolute humidity (Relative Risk, 90th percentile [RR90th percentile]: 1.170, 95% CI: [1.102, 1.242]) was positively associated with RSV risk. Higher levels of particulate matter of aerodynamic diameter of less than (i) 2.5 µm (PM2.5), (ii) 10 µm (PM10), carbon monoxide (CO) and sulfur dioxide (SO2) were associated with lower RSV infection risk. RSV infections exhibited both annual and within-year seasonality. Our findings suggest that falls in ambient temperature and rises in absolute humidity exacerbated pediatric RSV infection risk while increases in air pollutant concentrations were associated with lowered infection risk. These meteorological factors, together with the predictable seasonality of RSV infections, can inform the timing of mitigation measures aimed at reducing transmission.
Collapse
Affiliation(s)
- Meng Han Lee
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore
| | - Diyar Mailepessov
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore
| | - Khairunnisa Yahya
- Environmental Monitoring and Modelling Division, National Environment Agency, 40 Scotts Road, #13-00, Singapore, 228231, Singapore
| | - Liat Hui Loo
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.,Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, NUHS Tower Block, 1E Kent Ridge Road Level 11, Singapore, 119228, Singapore
| | - Joel Aik
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore. .,Duke-NUS Medical School, Pre-hospital and Emergency Research Centre, 8 College Road, Singapore, 169857, Singapore.
| |
Collapse
|
6
|
Seah A, Loo LH, Jamali N, Maiwald M, Aik J. The influence of air quality and meteorological variations on influenza A and B virus infections in a paediatric population in Singapore. Environ Res 2023; 216:114453. [PMID: 36183790 DOI: 10.1016/j.envres.2022.114453] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/11/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Influenza is an important cause of paediatric illness across the globe. However, information about the relationships between air pollution, meteorological variability and paediatric influenza A and B infections in tropical settings is limited. METHODS We analysed all daily reports of influenza A and B infections in children <5 years old obtained from the largest specialist women and children's hospital in Singapore. In separate negative binomial regression models, we assessed the dependence of paediatric influenza A and B infections on air quality and meteorological variability, using multivariable fractional polynomial modelling and adjusting for time-varying confounders. RESULTS Approximately 80% of 7329 laboratory-confirmed reports were caused by influenza A. We observed positive associations between sulphur dioxide (SO2) exposure and the subsequent risk of infection with both influenza types. We observed evidence of a harvesting effect of SO2 on Influenza A but not Influenza B. Ambient temperature was associated with a decline in influenza A reports (Relative Risk at lag 5 [RRlag5]: 0.949, 95% CI: 0.916-0.983). Rainfall was positively associated with a subsequent increase in influenza A reports (RRlag3: 1.044, 95% CI: 1.017-1.071). Nitrogen dioxide (NO2) concentration was positively associated with influenza B reports (RRlag5: 1.015, 95% CI: 1.005-1.025). There was a non-linear association between CO and influenza B reports. Absolute humidity increased the ensuing risk of influenza B (RRlag5: 4.799, 95% CI: 2.277-10.118). Influenza A and B infections displayed dissimilar but predictable within-year seasonal patterns. CONCLUSIONS We observed different independent associations between air quality and meteorological variability with paediatric influenza A and B infections. Anticipated seasonal infection peaks and variations in air quality and meteorological parameters can inform the timing of community measures aimed at reducing influenza infection risk.
Collapse
Affiliation(s)
- Annabel Seah
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore.
| | - Liat Hui Loo
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore.
| | - Natasha Jamali
- Environmental Monitoring and Modelling Division, National Environment Agency, 40 Scotts Road, #13-00, 228231, Singapore.
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore; Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, NUHS Tower Block, 1E Kent Ridge Road Level 11, 119228, Singapore.
| | - Joel Aik
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore; Pre-Hospital & Emergency Research Centre, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| |
Collapse
|
7
|
Chong CY, Tan NWH, Yung CF, Li J, Kam KQ, Nadua K, Maiwald M, Sultana R, Thoon KC. Effectiveness of maternal pertussis vaccination in Singapore: A test-negative case-control study. Vaccine 2022; 40:6570-6574. [PMID: 36216649 DOI: 10.1016/j.vaccine.2022.09.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/15/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023]
Abstract
Pertussis vaccination (Tdap -Tetanus-diphtheria-acellular pertussis) for pregnant women has been recommended since November 2017 in Singapore. In this prospective test-negative case-control study from 2018 to 2019, we aimed to evaluate vaccine effectiveness (VE) against pertussis infection and pertussis-related intensive care unit (ICU) admission according to Tdap (Tetanus-diphtheria-acellular pertussis) during pregnancy and/or infant pertussis vaccination. A total of 58 children (26 cases, 32 controls) were recruited with 4 ICU admissions. The median age was 3 months (interquartile range [IQR] 1.50-4.56 months). Overall, 25.9 % of mothers had received antenatal Tdap vaccination and 43.1 % of infants received pertussis vaccination, majority only 1 dose. Tdap in pregnancy alone without infant vaccine or with 0-1 infant dose had a VE of 97.62 % (95 % confidence interval [CI] 53.25-99.88 %), 98.17 % (95 %CI 66.61-99.9 %) respectively, against pertussis infection and 71.9 % (95 %CI 0.0-98.64), 75.86 % (95 % CI 0.0-98.78) respectively, against ICU admissions. Conclusion: Maternal Tdap vaccination was highly protective against infant pertussis and should be routinely recommended for all pregnant women.
Collapse
Affiliation(s)
- Chia-Yin Chong
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Natalie Woon-Hui Tan
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Chee-Fu Yung
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Jiahui Li
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Kai-Qian Kam
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Karen Nadua
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Matthias Maiwald
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Department of Microbiology and Immunology, National University of Singapore, 5 Science Drive 2, Singapore 117545, Singapore.
| | - Rehena Sultana
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Koh Cheng Thoon
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| |
Collapse
|
8
|
Li J, Maiwald M, Loo LH, Soong HY, Octavia S, Thoon KC, Chong CY. Clinical characteristics of macrolide-resistant Mycoplasma pneumoniae infections among hospitalised children in Singapore. Ann Acad Med Singap 2022; 51:653-656. [PMID: 36317577 DOI: 10.47102/annals-acadmedsg.2022213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Jiahui Li
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | | | | | | | | | | | | |
Collapse
|
9
|
Meyer K, Kern S, Guhl S, Bornemann-Pfeiffer M, Wander L, Maiwald M. Compact NMR Spectroscopy in the Field: A Versatile PAT Tool for Production of Specialty Chemicals. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- K. Meyer
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Germany
| | - S. Kern
- S-PACT GmbH Burtscheider Str. 1 52064 Aachen Germany
| | - S. Guhl
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Germany
| | - M. Bornemann-Pfeiffer
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Germany
| | - L. Wander
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Germany
| | - M. Maiwald
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Germany
| |
Collapse
|
10
|
Ko KKK, Chu JJK, Lim KM, Yingtaweesittikul H, Huang W, Tan SYL, Goh KCM, Tan SH, Ng TY, Maiwald M, Chia JWZ, Cao DY, Tan YE, Sim JHC, Koh TH, Nagarajan N, Suphavilai C. Clonal serotype 1c multidrug-resistant Shigella flexneri detected in multiple institutions by sentinel-site sequencing. Front Med (Lausanne) 2022; 9:964640. [PMID: 35979220 PMCID: PMC9376355 DOI: 10.3389/fmed.2022.964640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
Shigella flexneri is a major diarrhoeal pathogen, and the emergence of multidrug-resistant S. flexneri is of public health concern. We report the detection of a clonal cluster of multidrug-resistant serotype 1c (7a) S. flexneri in Singapore in April 2022. Long-read whole-genome sequence analysis found five S. flexneri isolates to be clonal and harboring the extended-spectrum β-lactamases blaCTX−M−15 and blaTEM−1. The isolates were phenotypically resistant to ceftriaxone and had intermediate susceptibility to ciprofloxacin. The S. flexneri clonal cluster was first detected in a tertiary hospital diagnostic laboratory (sentinel-site), to which the S. flexneri isolates were sent from other hospitals for routine serogrouping. Long-read whole-genome sequence analysis was performed in the sentinel-site near real-time in view of the unusually high number of S. flexneri isolates received within a short time frame. This study demonstrates that near real-time sentinel-site sequence-based surveillance of convenience samples can detect possible clonal outbreak clusters and may provide alerts useful for public health mitigations at the earliest possible opportunity.
Collapse
Affiliation(s)
- Karrie K. K. Ko
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Department of Molecular Pathology, Singapore General Hospital, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Karrie K. K. Ko ;
| | - Joash Jun Keat Chu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Kar Mun Lim
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Wenjie Huang
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Shireen Yan Ling Tan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Kenneth Choon Meng Goh
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Si Huei Tan
- Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore
| | - Tong Yong Ng
- Department of Pathology, Sengkang General Hospital, Singapore, Singapore
| | - Matthias Maiwald
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | | | | | - Yen Ee Tan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - James Heng Chiak Sim
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Tse Hsien Koh
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Niranjan Nagarajan
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Chayaporn Suphavilai
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| |
Collapse
|
11
|
Tan JHY, Choong CT, Tee NWS, Chong CY, Thoon KC, Maiwald M, Lee EYX, Tan MSS, Tan NWH. Clinical profile of children with parechovirus meningitis in Singapore. J Neurovirol 2021; 28:46-51. [PMID: 34888744 DOI: 10.1007/s13365-021-01035-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 11/04/2021] [Accepted: 11/27/2021] [Indexed: 12/01/2022]
Abstract
Human parechovirus (HPeV) is one of the most common causes of aseptic meningitis in children worldwide. This study aims to review the epidemiology, clinical presentation, and cerebrospinal fluid (CSF) findings in HPeV meningitis and compare these with Enterovirus (EV) meningitis. This is a retrospective study of children aged ≤ 1 year admitted for HPeV meningitis between November 2015 and July 2017, with positive CSF HPeV PCR and negative blood and CSF bacterial cultures. The clinical findings were compared with a historical cohort of children with EV meningitis admitted between July 2008 and July 2011. There were 71 children with HPeV meningitis, aged between 2 and 127 days, with the majority (96%) being ≤ 90 days old. The most common symptoms reported were poor feeding (42%), tachycardia out of proportion to fever (27%), and lethargy (20%). Only 2 patients (3%) had CSF pleocytosis. Cerebral spinal fluid white blood cell counts ranged from 0 to 28 cells/mm3, with a median of 3 cells/mm3 [interquartile range (IQR) 1-6 cells/mm3]. When compared to our historical cohort of EV meningitis ≤ 90 days old, children with HPeV meningitis ≤ 90 days old were less likely to have CSF pleocytosis (OR 0.008, 95% CI 0.001-0.057). HPeV and EV meningitis are known to cause sepsis-like illness in infants < 90 days old. This study further supports this, with the requirement for fluid bolus therapy for tachycardia or poor perfusion noted to be higher in children with HPeV meningitis ≤ 90 days old (OR 6.3, 95% CI 2.7-14.2).
Collapse
Affiliation(s)
- Jessica Hui Yin Tan
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore. .,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Chew Thye Choong
- Department of Paediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Nancy Wen Sim Tee
- Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
| | - Chia Yin Chong
- Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Koh Cheng Thoon
- Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore.,Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elis Yue Xian Lee
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Melody Si Shan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Natalie Woon Hui Tan
- Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
12
|
Lee EY, Tan JHY, Choong CT, Tee NWS, Chong CY, Thoon KC, Maiwald M, Tan MSS, Tan NWH. Hearing and Neurodevelopmental Outcomes of Young Infants with Parechovirus-A and Enterovirus Meningitis: Cohort Study in Singapore Children and Literature Review. Journal of Pediatric Neurology 2021. [DOI: 10.1055/s-0040-1716366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Parechovirus-A (PeV-A) and Enterovirus (EV) commonly cause childhood aseptic meningitis. Bacterial meningitis in children has been associated with devastating long-term sequelae. However, developmental outcomes are unclear in Parechovirus meningitis. This study aims to review the clinical findings and developmental outcomes of infants with PeV-A and EV meningitis. We performed a retrospective study of infants aged 90 days or younger being admitted to our hospital with PeV-A meningitis between November 2015 and July 2017, with positive cerebrospinal fluid (CSF) PeV-A PCR and negative blood and CSF bacterial cultures. Hearing and neurodevelopmental outcomes were compared with a previous cohort of infants aged 90 days or younger with EV meningitis admitted from January 2015 to December 2015. A total of 161 infants were included in our study, of which 68 infants (42.2%) had PeV-A meningitis and 93 infants (57.8%) had EV meningitis. We assessed their developmental outcome at 6 months, 1 year, and 2 years post-meningitis. At 2 years post-meningitis, three infants with PeV-A meningitis had developmental delay (5.5%), whereas none with EV meningitis had developmental delay. One patient had speech delay and autism spectrum disorder, while two had mild speech delay. When compared with our cohort of EV meningitis ≤90 days old, children with PeV-A meningitis ≤90 days old were more likely to have developmental delay 2 years post-meningitis (odds ratio 2.4, 95% confidence interval 2.0–3.0, p = 0.043). None of the patients with PeV-A or EV meningitis had sensorineural hearing loss or neurological sequelae, such as cortical blindness, oropharyngeal dysphagia, hydrocephalus, epilepsy, or cerebral palsy. Infants with PeV-A meningitis had a significant risk of developmental delay 2 years post-meningitis compared with those with EV meningitis. It is important to follow-up the developmental milestones of infants diagnosed with PeV-A meningitis for at least 2 years; and when they develop developmental delay, to ensure that they receive appropriate intervention.
Collapse
Affiliation(s)
- Elis Yuexian Lee
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jessica Hui Yin Tan
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Chew Thye Choong
- Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nancy Wen Sim Tee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
| | - Chia Yin Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Koh Cheng Thoon
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Matthias Maiwald
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Melody Si Shan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Natalie Woon Hui Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore
| |
Collapse
|
13
|
Vig PS, Wong JJM, Chong CY, Nguyen TAP, Maiwald M, Tan NWH. Poor Hygiene as a Risk Factor in the Development of Brain Abscess in Adolescents. J Paediatr Child Health 2021; 57:2043-2045. [PMID: 34687481 DOI: 10.1111/jpc.15798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Prachi Simran Vig
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Judith Ju Ming Wong
- Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore
| | - Chia Yin Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore.,Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Matthias Maiwald
- Duke-National University of Singapore Graduate Medical School, Singapore.,Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore.,Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Natalie Woon Hui Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore.,Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| |
Collapse
|
14
|
Soh S, Loo LH, Jamali N, Maiwald M, Aik J. Climate variability and seasonal patterns of paediatric parainfluenza infections in the tropics: An ecological study in Singapore. Int J Hyg Environ Health 2021; 239:113864. [PMID: 34717184 DOI: 10.1016/j.ijheh.2021.113864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Evidence of the relationship between climate variability, air pollution and human parainfluenza virus (HPIV) infections has been inconsistent. We assessed this in a paediatric population from a highly urbanized tropical city-state. METHODS We analysed all reports of HPIV infections in children <5 years old obtained from a major specialist women and children's hospital in Singapore. Assuming a negative binomial distribution and using multivariable fractional polynomial modelling, we examined the relations between climate variability, air quality and the risk of HPIV infections, adjusting for time-varying confounders. RESULTS We identified 6393 laboratory-confirmed HPIV infections from 2009 to 2019. Every 1 °C decline in temperature was associated with a 5.8% increase (RR: 0.943, 95% Confidence Interval [95% CI]: 0.903-0.984) in HPIV infection risk 6 days later. Every 10% decrease in relative humidity was associated with a 15.8% cumulative increase in HPIV risk over the next 6 days (cumulative RR: 0.842, 95% CI: 0.771-0.919). Rainfall was positively associated with HPIV risk 2 days later (RR: 1.021, 95% CI: 1.000-1.043). A within-year seasonal rise of HPIV was driven by HPIV-3 and HPIV-1 and preceded by a seasonal decline in temperature. Gender was an effect modifier of the climate-HPIV relationship. Air quality was not associated with HPIV risk. CONCLUSIONS This study demonstrates a close association between HPIV infection risk and tropical climate variability. The climate dependence and seasonal predictability of HPIV can inform the timing of community campaigns aimed at reducing infection risk and the development of hospital resources and climate adaption plans.
Collapse
Affiliation(s)
- Stacy Soh
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore.
| | - Liat Hui Loo
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore.
| | - Natasha Jamali
- Environmental Monitoring and Modelling Division, National Environment Agency, 40 Scotts Road, #13-00, 228231, Singapore.
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore; Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, NUHS Tower Block, 1E Kent Ridge Road Level 11, 119228, Singapore.
| | - Joel Aik
- Environmental Epidemiology and Toxicology Division, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore; Pre-Hospital & Emergency Research Centre, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| |
Collapse
|
15
|
Feurle GE, Moos V, Landt O, Corcoran C, Reischl U, Maiwald M. Tropheryma whipplei in Feces of Patients with Diarrhea in 3 Locations on Different Continents. Emerg Infect Dis 2021; 27:932-935. [PMID: 33622479 PMCID: PMC7920677 DOI: 10.3201/eid2703.200182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We examined fecal specimens of patients with diarrhea from 3 continents for Tropheryma whipplei and enteropathogens. T. whipplei was most common in South Africa, followed by Singapore and Germany. Its presence was associated with the presence of other pathogens. An independent causative role in diarrhea appears unlikely.
Collapse
|
16
|
Wan WY, Thoon KC, Loo LH, Chan KS, Oon LLE, Ramasamy A, Maiwald M. Trends in Respiratory Virus Infections During the COVID-19 Pandemic in Singapore, 2020. JAMA Netw Open 2021; 4:e2115973. [PMID: 34181015 PMCID: PMC8239970 DOI: 10.1001/jamanetworkopen.2021.15973] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/04/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Wei Yee Wan
- Department of Microbiology, Singapore General Hospital, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Paediatric Medicine, KK Women’s and Children’s Hospital, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Duke–National University of Singapore Graduate Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Liat Hui Loo
- Duke–National University of Singapore Graduate Medical School, Singapore
- Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, Singapore
| | - Kian Sing Chan
- Department of Molecular Pathology, Singapore General Hospital, Singapore
| | - Lynette L. E. Oon
- Duke–National University of Singapore Graduate Medical School, Singapore
- Department of Molecular Pathology, Singapore General Hospital, Singapore
| | - Adaikalavan Ramasamy
- Genome Institute of Singapore, Agency for Science, Technology, and Research (A*STAR), Singapore
| | - Matthias Maiwald
- Duke–National University of Singapore Graduate Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, Singapore
| |
Collapse
|
17
|
Poh CWM, Seah XFV, Chong CY, Ganesan I, Maiwald M, Nadua K, Kam KQ, Tan NWH. Salmonella Renal Abscess in an Immunocompetent Child: Case Report and Literature Review. Glob Pediatr Health 2021; 8:2333794X211022263. [PMID: 34104703 PMCID: PMC8170294 DOI: 10.1177/2333794x211022263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/26/2021] [Accepted: 05/13/2021] [Indexed: 11/15/2022] Open
Abstract
We describe a case of a 10-year-old immunocompetent girl with a left renal
abscess due to Group C Salmonella (Salmonella
serovar Oranienburg). Percutaneous drainage of the abscess was done. She also
received 2 weeks of intravenous ceftriaxone, followed by 4 weeks of oral
co-trimoxazole with resolution seen on ultrasound. A review of pediatric
Salmonella renal abscesses is also presented.
Collapse
Affiliation(s)
| | | | - Chia Yin Chong
- KK Women's and Children's Hospital, Singapore.,National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Nanyang Technological University, Singapore
| | - Indra Ganesan
- KK Women's and Children's Hospital, Singapore.,National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Nanyang Technological University, Singapore
| | - Matthias Maiwald
- KK Women's and Children's Hospital, Singapore.,National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Karen Nadua
- KK Women's and Children's Hospital, Singapore.,National University of Singapore, Singapore
| | - Kai-Qian Kam
- KK Women's and Children's Hospital, Singapore.,National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Natalie Woon Hui Tan
- KK Women's and Children's Hospital, Singapore.,National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Nanyang Technological University, Singapore
| |
Collapse
|
18
|
Tan KWJ, Yung CF, Maiwald M, Saffari SE, Thoon KC, Chong CY. Respiratory viral infections in hospitalised paediatric patients in the tropics. J Paediatr Child Health 2021; 57:559-565. [PMID: 33185937 DOI: 10.1111/jpc.15267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022]
Abstract
AIM Respiratory viruses are a huge disease burden globally. An understanding of the seasonal trends and the ability to predict peak periods of respiratory virus disease incidence is useful for clinical care. METHODS This is a retrospective analysis of paediatric hospitalizations of laboratory-confirmed viral respiratory tract infections in KK Women's and Children's Hospital, Singapore, from 1 January 2011 to 31 December 2016. Standard direct immunofluorescence was used to detect respiratory syncytial virus (RSV), influenza A and B viruses, parainfluenza 1, 2 and 3 viruses, metapneumovirus and adenovirus. RESULTS A total of 97 840 specimens were analysed with a positive detection rate of 23.8%. RSV made up the largest proportion (42% of the total positive results), predominating between May to September. Influenza A had two peaks, June to July and December to January. Type 3 was the most common parainfluenza virus and showed annually recurring peaks. In contrast, parainfluenza 1 and 2, metapneumovirus and adenovirus had a biennial pattern. The test of seasonality detected identifiable seasonality for RSV and parainfluenza 3 virus. CONCLUSIONS In conclusion, respiratory viruses have different and overlapping seasonality in tropical Singapore. Respiratory virus testing for patients admitted for acute respiratory infection is useful to target antiviral therapies and appropriate infection control practices.
Collapse
Affiliation(s)
| | - Chee Fu Yung
- Department of Infectious Disease, KK Women's and Children's Hospital, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Seyed E Saffari
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Koh Cheng Thoon
- Department of Infectious Disease, KK Women's and Children's Hospital, Singapore
| | - Chia Yin Chong
- Department of Infectious Disease, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
19
|
Dörfel D, Maiwald M, Daeschlein G, Müller G, Hudek R, Assadian O, Kampf G, Kohlmann T, Harnoss JC, Kramer A. Comparison of the antimicrobial efficacy of povidone-iodine-alcohol versus chlorhexidine-alcohol for surgical skin preparation on the aerobic and anaerobic skin flora of the shoulder region. Antimicrob Resist Infect Control 2021; 10:17. [PMID: 33482910 PMCID: PMC7821636 DOI: 10.1186/s13756-020-00874-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Cutibacterium acnes is part of the anaerobic skin microbiome and resides in deeper skin layers. The organism is an agent of surgical site infections (SSI) in shoulder surgery. We hypothesized that prolonged skin preparation with an agent that penetrates deeply into the skin would be beneficial. Thus, we compared two classes of antiseptics, each combined with alcohol, each applied with two different contact times. Methods Using a cross-over arrangement, shoulders of 16 healthy volunteers were treated for 2.5 min (standard) or 30 min (prolonged) with alcohol-based chlorhexidine (CHG-ALC) or alcohol-based povidone-iodine (PVP-I-ALC). Skin sites were sampled before, immediately after, and 3 h after treatment, using a standardized cup-scrub technique. Results Aerobic skin flora was reduced more effectively by PVP-I-ALC than by CHG-ALC after 2.5 min application and immediate sampling (reduction factor [RF] 2.55 ± 0.75 vs. 1.94 ± 0.91, p = 0.04), but not after prolonged contact times and 3-h sampling. Coagulase-negative staphylococci were completely eliminated after PVP-I-ALC application, but still recovered from 4 of 32 samples after CHG-ALC application. Anaerobic flora was reduced more effectively by PVP-I-ALC than CHG-ALC after standard (RF 3.96 ± 1.46 vs. 1.74 ± 1.24, p < 0.01) and prolonged (RF 3.14 ± 1.20 vs. 1.38 ± 1.16, p < 0.01) contact times and immediate sampling, but not after 3-h sampling. No adverse events were reported. Conclusions PVP-I-ALC showed marginal benefits concerning the aerobic flora, but more substantial benefits over CHG-ALC concerning the anaerobic flora of the shoulder. Standard and prolonged contact times showed superiority for PVP-I-ALC for anaerobic flora at all immediate sampling points, but missed significance at 3-h sampling. The results underscore the need for protection against C. acnes and coagulase-negative staphylococci in orthopaedic surgery. The clinical relevance of these findings, however, should be studied with SSI as an endpoint.
Collapse
Affiliation(s)
- Dorothea Dörfel
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-National University of Singapore Postgraduate School of Medicine, Singapore, Singapore
| | - Georg Daeschlein
- Department of Dermatology, University Medicine Greifswald, Greifswald, Germany.,Working Group Clinical Antisepsis, German Society of Hospital Hygiene, Berlin, Germany
| | - Gerald Müller
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Robert Hudek
- Shoulder and Elbow Surgery, Rhön-Klinikum AG, Bad Neustadt/Saale, Germany
| | - Ojan Assadian
- Regional Hospital Wiener Neustadt, Vienna, Austria.,Institute for Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - Günter Kampf
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Thomas Kohlmann
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Julian Camill Harnoss
- Department of General, Visceral and Transplantation Surgery and Study Center, German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany.
| |
Collapse
|
20
|
Li J, Thoon KC, Chong CY, Maiwald M, Kam KQ, Nadua K, Tan NWH, Yung CF. Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children. Ann Acad Med Singap 2020. [DOI: 10.47102/annals-acadmedsg.2020257] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: In this study, a comparison of clinical, epidemiological and laboratory parameters between symptomatic and asymptomatic children with SARS-CoV-2 infection was performed. Materials and Methods: Data from all children with laboratory confirmed SARS-CoV-2 infection admitted to KK Women’s and Children’s Hospital (KKH), Singapore, from January to May 2020 were analysed. Results: Of the 39 COVID-19 children included, 38.5% were asymptomatic. Household transmission accounted for 95% of cases. The presenting symptoms of symptomatic children were low-grade fever (54.2%), rhinorrhoea (45.8%), sore throat (25%), diarrhoea (12.5%) and acute olfactory dysfunction (5.4%). Children of Chinese ethnicity (37.5% vs 6.7%), complete blood count (45.8% vs 6.7%) and liver enzyme abnormalities (25% vs 7.7%) were more common in symptomatic versus asymptomatic children. All children had a mild disease course and none required oxygen supplementation or intensive care. Conclusions: The high proportion of asymptomatic infected children coupled with household transmission as the main source of paediatric COVID-19 infection underscores the importance of early screening and isolation of children upon detection of an index case of COVID-19 in a household. Symptomatic children were more likely to have abnormal laboratory parameters but they did not have a poorer outcome compared to asymptomatic cases. Keywords: COVID-19, Paediatric, Pandemic, Singapore
Collapse
Affiliation(s)
- Jiahui Li
- KK Women’s and Children’s Hospital, Singapore
| | | | | | | | | | - Karen Nadua
- KK Women’s and Children’s Hospital, Singapore
| | | | | |
Collapse
|
21
|
Chong CY, Kam KQ, Li J, Maiwald M, Loo LH, Nadua KD, Tan NWH, Yung CF, Thoon KC. Saliva is not a useful diagnostic specimen in children with Coronavirus Disease 2019. Clin Infect Dis 2020; 73:e3144-e3145. [PMID: 32927475 PMCID: PMC7543312 DOI: 10.1093/cid/ciaa1376] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Chia Yin Chong
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Kai-Qian Kam
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore.,Duke-NUS Medical School, Singapore
| | - Jiahui Li
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore.,Duke-NUS Medical School, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore.,Department of Microbiology and Immunology, National University of Singapore, Singapore
| | - Liat Hui Loo
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Karen Donceras Nadua
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore.,Duke-NUS Medical School, Singapore
| | - Natalie Woon Hui Tan
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Chee Fu Yung
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Koh Cheng Thoon
- Infectious diseases, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| |
Collapse
|
22
|
Guhl S, Maiwald M, Acker J, Meyer K. Online‐NMR‐ und ‐Raman‐Spektroskopie – Kombination von PAT‐Methoden für mehr Prozessverständnis. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- S. Guhl
- Bundesanstalt für Materialforschung und -prüfung Fachbereich 1.4 Prozessanalytik Richard-Willstätter-Str. 11 12489 Berlin Deutschland
| | - M. Maiwald
- Bundesanstalt für Materialforschung und -prüfung Fachbereich 1.4 Prozessanalytik Richard-Willstätter-Str. 11 12489 Berlin Deutschland
| | - J. Acker
- Brandenburgisch Technische Universität Cottbus-Senftenberg Fachgebiet Physikalische Chemie Universitätsplatz 1 01968 Senftenberg Deutschland
| | - K. Meyer
- Bundesanstalt für Materialforschung und -prüfung Fachbereich 1.4 Prozessanalytik Richard-Willstätter-Str. 11 12489 Berlin Deutschland
| |
Collapse
|
23
|
Abele M, Falkenstein S, Friedrich Y, Meyer K, Kern S, Korth K, Maiwald M. Industrielle Anwendungen der Niederfeld‐NMR‐Spektroskopie für die Prozess‐ und Qualitätskontrolle von Silanen. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M. Abele
- Evonik Ressource Efficiency GmbH Untere Kanalstr. 3 79618 Rheinfelden Deutschland
| | - S. Falkenstein
- Evonik Ressource Efficiency GmbH Untere Kanalstr. 3 79618 Rheinfelden Deutschland
| | - Y. Friedrich
- Evonik Ressource Efficiency GmbH Untere Kanalstr. 3 79618 Rheinfelden Deutschland
| | - K. Meyer
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Deutschland
| | - S. Kern
- S-PACT GmbH Burtscheider Str. 1 52064 Aachen Deutschland
| | - K. Korth
- Evonik Ressource Efficiency GmbH Untere Kanalstr. 3 79618 Rheinfelden Deutschland
| | - M. Maiwald
- Bundesanstalt für Materialforschung und -prüfung (BAM) Richard-Willstätter-Str. 11 12489 Berlin Deutschland
| |
Collapse
|
24
|
Kam KQ, Yung CF, Cui L, Tzer Pin Lin R, Mak TM, Maiwald M, Li J, Chong CY, Nadua K, Tan NWH, Thoon KC. A Well Infant With Coronavirus Disease 2019 With High Viral Load. Clin Infect Dis 2020; 71:847-849. [PMID: 32112082 PMCID: PMC7358675 DOI: 10.1093/cid/ciaa201] [Citation(s) in RCA: 252] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 02/25/2020] [Indexed: 12/25/2022] Open
Abstract
A well 6-month-old infant with coronavirus disease 2019 (COVID-19) had persistently positive nasopharyngeal swabs up to day 16 of admission. This case highlights the difficulties in establishing the true incidence of COVID-19, as asymptomatic individuals can excrete the virus. These patients may play important roles in human-to-human transmission in the community.
Collapse
Affiliation(s)
- Kai-Qian Kam
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Chee Fu Yung
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Lin Cui
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore
| | - Raymond Tzer Pin Lin
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore
| | - Tze Minn Mak
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jiahui Li
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Karen Nadua
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| |
Collapse
|
25
|
Yung CF, Kam KQ, Wong MSY, Maiwald M, Tan YK, Tan BH, Thoon KC. Environment and Personal Protective Equipment Tests for SARS-CoV-2 in the Isolation Room of an Infant With Infection. Ann Intern Med 2020; 173:240-242. [PMID: 32236490 PMCID: PMC7133054 DOI: 10.7326/m20-0942] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Chee Fu Yung
- Infectious Disease Service, KK Women's and Children's Hospital, Duke-NUS Medical School, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (C.F.Y.)
| | - Kai-Qian Kam
- Infectious Disease Service, KK Women's and Children's Hospital, Singapore (K.K., K.C.T.)
| | - Michelle S Y Wong
- Verification and Attribution Laboratory, DSO National Laboratories, Singapore (M.S.W., Y.K.T.)
| | | | - Yian Kim Tan
- Verification and Attribution Laboratory, DSO National Laboratories, Singapore (M.S.W., Y.K.T.)
| | - Boon Huan Tan
- Biological Defence Programme, DSO National Laboratories, Singapore (B.H.T.)
| | - Koh Cheng Thoon
- Infectious Disease Service, KK Women's and Children's Hospital, Singapore (K.K., K.C.T.)
| |
Collapse
|
26
|
Li J, Thoon KC, Chong CY, Maiwald M, Kam KQ, Nadua K, Tan NW, Yung CF. Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children. Ann Acad Med Singap 2020; 49:530-537. [PMID: 33164022] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION In this study, a comparison of clinical, epidemiological and laboratory parameters between symptomatic and asymptomatic children with SARS-CoV-2 infection was performed. MATERIALS AND METHODS Data from all children with laboratory confirmed SARS-CoV-2 infection admitted to KK Women's and Children's Hospital (KKH), Singapore, from January to May 2020 were analysed. RESULTS Of the 39 COVID-19 children included, 38.5% were asymptomatic. Household transmission accounted for 95% of cases. The presenting symptoms of symptomatic children were low-grade fever (54.2%), rhinorrhoea (45.8%), sore throat (25%), diarrhoea (12.5%) and acute olfactory dysfunction (5.4%). Children of Chinese ethnicity (37.5% vs 6.7%), complete blood count (45.8% vs 6.7%) and liver enzyme abnormalities (25% vs 7.7%) were more common in symptomatic versus asymptomatic children. All children had a mild disease course and none required oxygen supplementation or intensive care. CONCLUSIONS The high proportion of asymptomatic infected children coupled with household transmission as the main source of paediatric COVID-19 infection underscores the importance of early screening and isolation of children upon detection of an index case of COVID-19 in a household. Symptomatic children were more likely to have abnormal laboratory parameters but they did not have a poorer outcome compared to asymptomatic cases.
Collapse
Affiliation(s)
- Jiahui Li
- Infectious Disease Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Tan YY, Quek BH, Thoon KC, Maiwald M, Yung CF, Rajadurai VS, Kong JY. Successful containment of horizontal enterovirus infection in a neonatal unit in Singapore through diagnosis by polymerase chain reaction (PCR) and direct sequence analysis. J Infect Public Health 2020; 13:1556-1561. [PMID: 32653481 DOI: 10.1016/j.jiph.2020.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/10/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Enterovirus (EV) outbreaks often coincide with seasonal peaks in the community. However, they may also sporadically occur in neonatal units. Identification of EV infection in neonates can be challenging, as they tend to present with mild or nonspecific symptoms. This study reports an EV outbreak in the Neonatal Unit at KK Women's and Children's Hospital, Singapore. METHODS This is a single-center, retrospective cohort study of neonates who had positive results for EV during the outbreak. Demographic characteristics, clinical presentations and outcomes were analyzed. Control measures used to limit the spread of infection are reported. RESULTS A total of 7 cases of EV infection were identified. Their median birth weight and gestational age were 1240 g (750 -2890 g) and 28 weeks (26-35 weeks), respectively. Symptoms occurred at a median age of 48 days (9-103 days). All cases presented initially with recurrent apnea and 4 needed assisted ventilator support with CPAP (2) and mechanical ventilation (2). Serious complications occurred in 3 infants (2 with necrotizing enterocolitis and 1 with meningitis) and none died. EV was detected from rectal swabs (n = 6), CSF (n = 2) and nasopharyngeal swabs (n = 2). Viral subtyping uniformly revealed echovirus 25. Surveillance of all exposed infants by nasopharyngeal swabs was implemented, along with strict contact precautions and cohorting measures. CONCLUSIONS Premature infants with EV are more prone to serious complications, which can lead to significant morbidity. Thus, early recognition of symptoms, rapid diagnosis and prompt implementation of infection control measures are key to prevent further spread of infection.
Collapse
Affiliation(s)
- Yee Yin Tan
- Department of Neonatology, KK Women's and Children's Hospital, Singapore.
| | - Bin Huey Quek
- Department of Neonatology, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University, Singapore
| | - Koh Cheng Thoon
- Department of Pediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chee Fu Yung
- Department of Pediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Lee Kong Chian School of Medicine, National Technological University, Singapore
| | - Victor Samuel Rajadurai
- Department of Neonatology, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University, Singapore
| | - Juin Yee Kong
- Department of Neonatology, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University, Singapore
| |
Collapse
|
28
|
Affiliation(s)
- Erlangga Yusuf
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Dr. Molenwaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| |
Collapse
|
29
|
Kam KQ, Yung CF, Maiwald M, Chong CY, Soong HY, Loo LH, Tan NWH, Li J, Nadua KD, Thoon KC. Clinical Utility of Buccal Swabs for Severe Acute Respiratory Syndrome Coronavirus 2 Detection in Coronavirus Disease 2019-Infected Children. J Pediatric Infect Dis Soc 2020; 9:370-372. [PMID: 32463086 PMCID: PMC7313923 DOI: 10.1093/jpids/piaa068] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/25/2020] [Indexed: 11/13/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected from at least 1 buccal specimen in 9 of 11 coronavirus disease 2019 (COVID-19)-infected children (81.8%). Viral loads in buccal specimens were substantially lower than those in nasopharyngeal specimens. Buccal swabs are not good as COVID-19 screening specimens in children.
Collapse
Affiliation(s)
- Kai-qian Kam
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Correspondence: Kai-qian Kam, KK Women’s and Children’s Hospital,100 Bukit Timah Road, Singapore 229899 ()
| | - Chee Fu Yung
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Department of Microbiology and Immunology, National University of Singapore, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Han Yang Soong
- Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, Singapore
| | - Liat Hui Loo
- Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiahui Li
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Karen Donceras Nadua
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore,Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
30
|
Chan JC, Chong CY, Thoon KC, Tee NWS, Maiwald M, Lam JCM, Bhattacharya R, Chandran S, Yung CF, Tan NWH. Invasive paediatric Elizabethkingia meningoseptica infections are best treated with a combination of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or fluoroquinolone. J Med Microbiol 2019; 68:1167-1172. [PMID: 31199227 PMCID: PMC7423161 DOI: 10.1099/jmm.0.001021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives Elizabethkingia meningoseptica is a multi-drug-resistant organism that is associated with high mortality and morbidity in newborn and immunocompromised patients. This study aimed to identify the best antimicrobial therapy for treating this infection. Methods A retrospective descriptive study was conducted from 2010 to 2017 in a tertiary paediatric hospital in Singapore. Paediatric patients aged 0 to 18 years old with a positive culture for E. meningoseptica from any sterile site were identified from the hospital laboratory database. The data collected included clinical characteristics, antimicrobial susceptibility and treatment, and clinical outcomes. Results Thirteen cases were identified in this study. Combination therapy with piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluoroquinolone resulted in a cure rate of 81.8 %. The mortality rate was 15.4 % and neurological morbidity in patients with bacteraemia and meningitis remained high (75 %). Conclusions Treatment with combination therapy of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluroquinolone was effective in this study, with low mortality rates being observed.
Collapse
Affiliation(s)
- J C Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - C Y Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore
| | - K C Thoon
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - N W S Tee
- Duke-National University of Singapore Medical School, Singapore.,Department of Pathology and Laboratory Medicine, National University Hospital, Singapore.,Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - M Maiwald
- Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - J C M Lam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Department of Paediatric Subspecialties, Haematology/Oncology Service, KK Women's and Children's Hospital, Singapore
| | - R Bhattacharya
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore.,Department of Paediatric Subspecialties, Haematology/Oncology Service, KK Women's and Children's Hospital, Singapore
| | - S Chandran
- Duke-National University of Singapore Medical School, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - C F Yung
- Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - N W H Tan
- Duke-National University of Singapore Medical School, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
31
|
Yung CF, Maiwald M, Loo LH, Soong HY, Tan CB, Lim PK, Li L, Tan NW, Chong CY, Tee N, Thoon KC, Chan YH. Elizabethkingia anophelis and Association with Tap Water and Handwashing, Singapore. Emerg Infect Dis 2019; 24:1730-1733. [PMID: 30124415 PMCID: PMC6106401 DOI: 10.3201/eid2409.171843] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report an Elizabethkingia anophelis case cluster associated with contaminated aerators and tap water in a children’s intensive care unit in Singapore in 2017. We demonstrate a likely transmission route for E. anophelis to patients through acquisition of the bacteria on hands of healthcare workers via handwashing.
Collapse
|
32
|
Maiwald M. The concept of clinical equipoise and its relevance to infectious disease clinical trials. Pathology 2019. [DOI: 10.1016/j.pathol.2018.12.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
33
|
Seah VXF, Chew Y, Thoon KC, Tee NWS, Cui L, Chong CY, Yung CF, Maiwald M, Tanugroho RR, Tan NWH. 2341. Trends in Adenovirus Infections in Singapore Children and Outcomes of Cidofovir Treatment in the Severely Ill. Open Forum Infect Dis 2018. [PMCID: PMC6253563 DOI: 10.1093/ofid/ofy210.1994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background An increase in human adenovirus (HAdV) infections among hospitalized children in Singapore was observed since 2013. Cidofovir is often used to treat severe HAdV infections despite limited data. This study describes the epidemiology and outcomes of children with severe HAdV disease requiring high dependency (HD) or intensive care unit (ICU) admission in our hospital (KKH). Methods This is a retrospective cohort study of HAdV-infected children admitted to HD and ICU in KKH from January 2013 to September 2017. Characteristics and outcomes of those who received IV cidofovir was also reviewed. Results HAdV admissions and genotype profiles in KKH are described in Figures 1 and 2, respectively. There were 85 children with severe HAdV infection, of which 17 (20%) received cidofovir for mainly viremia (8, 47.1%) and pneumonia (7, 41.2%). Of these 17 patients, 7 (41.2%) died. More children treated with cidofovir had genotype 7 infection (8 of 17, 47.1%) vs. 13 of 68 (19.1%) who did not (P = 0.027). Characteristics of patients who received cidofovir are described in Table 1. None experienced adverse reactions from cidofovir. ![]()
![]()
All are n (%) unless stated otherwise. Conclusion More children with HAdV genotype 7 infection required cidofovir treatment. HAdV pneumonia and ICU admission are potential risk factors for mortality despite cidofovir treatment. Disclosures All authors: No reported disclosures.
Collapse
Affiliation(s)
| | - Yirong Chew
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Nancy Wen Sim Tee
- Microbiology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Lin Cui
- National Public Health Laboratory, Singapore, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Chee Fu Yung
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Matthias Maiwald
- Microbiology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | | | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | | |
Collapse
|
34
|
Maiwald M, Widmer AF. WHO's recommendation for surgical skin antisepsis is premature. Lancet Infect Dis 2018; 17:1023-1024. [PMID: 28948925 DOI: 10.1016/s1473-3099(17)30448-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 07/05/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore; Department of Microbiology, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore.
| | - Andreas F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University of Basel Hospitals, Basel, Switzerland
| |
Collapse
|
35
|
Gottu Mukkula A, Engell S, Kern S, Guhl S, Meyer K, Maiwald M. PAT-basierte iterative Optimierung der Fahrweise eines kontinuierlichen organischen Syntheseprozesses. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. R. Gottu Mukkula
- Technische Universität Dortmund; Lehrstuhl für Systemdynamik und Prozessführung; Emil Figge-Straße 70 44221 Dortmund Deutschland
| | - S. Engell
- Technische Universität Dortmund; Lehrstuhl für Systemdynamik und Prozessführung; Emil Figge-Straße 70 44221 Dortmund Deutschland
| | - S. Kern
- Bundesanstalt für Materialprüfung; Prozessanalytik; Richard Willstätter-Straße 11 12489 Berlin Deutschland
| | - S. Guhl
- Bundesanstalt für Materialprüfung; Prozessanalytik; Richard Willstätter-Straße 11 12489 Berlin Deutschland
| | - K. Meyer
- Bundesanstalt für Materialprüfung; Prozessanalytik; Richard Willstätter-Straße 11 12489 Berlin Deutschland
| | - M. Maiwald
- Bundesanstalt für Materialprüfung; Prozessanalytik; Richard Willstätter-Straße 11 12489 Berlin Deutschland
| |
Collapse
|
36
|
Guhl S, Kern S, Meyer K, Wander L, Bornemann M, Maiwald M. Produzieren Sie schon oder kalibrieren Sie noch? - Online-NMR-Spektrometer als Smarte Feldgeräte. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- S. Guhl
- Bundesanstalt für Materialforschung und -prüfung (BAM); 1.4 Prozessanalytik; Richard-Willstätter-Straße 11 12489 Berlin Deutschland
| | - S. Kern
- Bundesanstalt für Materialforschung und -prüfung (BAM); 1.4 Prozessanalytik; Richard-Willstätter-Straße 11 12489 Berlin Deutschland
| | - K. Meyer
- Bundesanstalt für Materialforschung und -prüfung (BAM); 1.4 Prozessanalytik; Richard-Willstätter-Straße 11 12489 Berlin Deutschland
| | - L. Wander
- Bundesanstalt für Materialforschung und -prüfung (BAM); 1.4 Prozessanalytik; Richard-Willstätter-Straße 11 12489 Berlin Deutschland
| | - M. Bornemann
- Bundesanstalt für Materialforschung und -prüfung (BAM); 1.4 Prozessanalytik; Richard-Willstätter-Straße 11 12489 Berlin Deutschland
| | - M. Maiwald
- Bundesanstalt für Materialforschung und -prüfung (BAM); 1.4 Prozessanalytik; Richard-Willstätter-Straße 11 12489 Berlin Deutschland
| |
Collapse
|
37
|
Josman N, Tee NWS, Maiwald M, Loo LH, Ho CKM. Pragmatic and evidence-based approach to paediatric cerebrospinal fluid reference limits for white cell count and concentrations of total protein and glucose. J Clin Pathol 2018; 71:932-935. [DOI: 10.1136/jclinpath-2018-205090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/22/2018] [Accepted: 05/23/2018] [Indexed: 11/04/2022]
Abstract
BackgroundIt is often impractical for each laboratory to establish its own paediatric reference intervals. This is particularly true for specimen types collected using invasive procedures, for example, cerebrospinal fluid (CSF).MethodsPublished CSF reference intervals for white cell count, and concentrations of total protein and glucose were reviewed by stakeholders in a paediatric hospital. Consensus reference intervals for the three CSF parameters were then subjected to verification using guidelines from the Clinical Laboratory Standards Institute and residual CSF specimens.ResultsConsensus paediatric reference intervals adapted from published studies with minor modifications were locally verified as follows. White cell count (x106 cells/L): 0–20 (<1 month); 0–10 (1–2 months); 0–5 (>2 months). Total protein (g/L): 0.3–1.2 (<1 month); 0.2–0.6 (1–3 months); 0.1–0.4 (>3 months). Glucose (mmol/L): 2.0–5.6 (<6 months); 2.4–4.3 (6 months or older).
Collapse
|
38
|
Maiwald M. Are skin antiseptics for blood culture collection really equal? Commentary on Liu, W., et al., 2016 "Skin antiseptics in venous puncture site disinfection for preventing blood culture contamination: A Bayesian network meta-analysis of randomized controlled trials". Int J Nurs Stud 2017; 75:91-92. [PMID: 28759824 DOI: 10.1016/j.ijnurstu.2017.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 07/17/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore; Department of Microbiology, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore.
| |
Collapse
|
39
|
Loo LH, Soong HY, Maiwald M, Tee NW. Assessment of Genotypic Macrolide Resistance among Mycoplasma pneumoniae Infections in Children in Singapore. Ann Acad Med Singap 2017; 46:290-292. [PMID: 28821894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Liat Hui Loo
- Microbiology Laboratory, Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | | | | | | |
Collapse
|
40
|
Batzdorf L, Zientek N, Rump D, Fischer F, Maiwald M, Emmerling F. Make and break - Facile synthesis of cocrystals and comprehensive dissolution studies. J Mol Struct 2017. [DOI: 10.1016/j.molstruc.2016.11.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
41
|
Meyer K, Rademann K, Panne U, Maiwald M. Quantitative NMR spectroscopy for gas analysis for production of primary reference gas mixtures. J Magn Reson 2017; 275:1-10. [PMID: 27951425 DOI: 10.1016/j.jmr.2016.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/24/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
Due to its direct correlation to the number of spins within a sample quantitative NMR spectroscopy (qNMR) is a promising method with absolute comparison abilities in complex systems in technical, as well as metrological applications. Most of the samples studied with qNMR are in liquid state in diluted solutions, while gas-phase applications represent a rarely applied case. Commercially available NMR equipment was used for purity assessment of liquid and liquefied hydrocarbons serving as raw materials for production of primary reference gas standards. Additionally, gas-phase studies were performed within an online NMR flow probe, as well as in a high-pressure NMR setup to check feasibility as verification method for the composition of gas mixtures.
Collapse
Affiliation(s)
- K Meyer
- Bundesanstalt für Materialforschung und -prüfung (BAM), Richard-Willstätter-Straβe 11, D-12489 Berlin, Germany.
| | - K Rademann
- Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor-Str. 2, D-12489 Berlin, Germany
| | - U Panne
- Bundesanstalt für Materialforschung und -prüfung (BAM), Richard-Willstätter-Straβe 11, D-12489 Berlin, Germany; Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor-Str. 2, D-12489 Berlin, Germany
| | - M Maiwald
- Bundesanstalt für Materialforschung und -prüfung (BAM), Richard-Willstätter-Straβe 11, D-12489 Berlin, Germany
| |
Collapse
|
42
|
Kern S, Meyer K, Paul A, Maiwald M. Ugly Spectra and Lousy interfaces - Challenges for Compact NMR Spectroscopy in Process Control. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
43
|
Meyer K, Ruiken JP, Illner M, Paul A, Müller D, Esche E, Repke JU, Maiwald M. Prozessanalytik für die moderne Verfahrenstechnik - Online-NMR- und -Raman-Spektroskopie im mizellaren Stoffsystem. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
44
|
Wee LYJ, Tanugroho RR, Thoon KC, Chong CY, Choong CT, Krishnamoorthy S, Maiwald M, Tee NWS, Tan NWH. A 15-year retrospective analysis of prognostic factors in childhood bacterial meningitis. Acta Paediatr 2016; 105:e22-9. [PMID: 26426265 DOI: 10.1111/apa.13228] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/06/2015] [Accepted: 09/23/2015] [Indexed: 01/17/2023]
Abstract
AIM This retrospective chart review aimed to identify factors in childhood bacterial meningitis that predicted disease severity and long-term outcome. METHODS The study included 112 episodes of microbiologically confirmed bacterial meningitis in children aged three days to 15 years who were admitted to a Singapore hospital from 1998 to 2013. RESULTS The mortality rate was 6%, and 44% required intensive care unit (ICU) admission. Predictive factors associated with ICU admission included pneumococcal meningitis, with an odds ratio (OR) of 5.2 and 95% confidence interval (CI) of 1.5-18.2, leukopenia (OR 5.6, 95% CI 1.7-17.9) and a cerebrospinal fluid (CSF):serum glucose ratio <0.25 (OR 4.5, 95% CI 1.4-14.4). An initial CSF white blood cell count >1000/mm(3) (OR 0.26, 95% CI 0.086-0.76) was negatively associated with ICU admission. Five years after meningitis, 32% had residual sequelae, and the associated prognostic factors were Haemophilus influenzae type b (Hib) meningitis (OR 29.5, 95% CI 2-429), seizures during their inpatient stay (OR 10.6, 95% CI 1.9-60.2) and septic shock (OR 8.4, 95% CI 1.1-62.1). CONCLUSION As mortality was low in this bacterial meningitis study, ICU admission was used as a marker of disease severity. These findings underscore the importance of the pneumococcal and Hib meningitis vaccines.
Collapse
Affiliation(s)
- Liang Yi Justin Wee
- Department of Paediatrics; KK Women's and Children's Hospital; Singapore City Singapore
| | | | - Koh Cheng Thoon
- Infectious Disease Service; Department of Paediatrics; KK Women's and Children's Hospital; Singapore City Singapore
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore City Singapore
- Duke-National University of Singapore Graduate Medical School; Singapore City Singapore
| | - Chia Yin Chong
- Infectious Disease Service; Department of Paediatrics; KK Women's and Children's Hospital; Singapore City Singapore
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore City Singapore
- Duke-National University of Singapore Graduate Medical School; Singapore City Singapore
| | - Chew Thye Choong
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore City Singapore
- Duke-National University of Singapore Graduate Medical School; Singapore City Singapore
- Neurology Service; Department of Paediatrics; KK Women's and Children's Hospital; Singapore City Singapore
| | | | - Matthias Maiwald
- Duke-National University of Singapore Graduate Medical School; Singapore City Singapore
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore City Singapore
- Department of Microbiology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore City Singapore
| | - Nancy Wen Sim Tee
- Duke-National University of Singapore Graduate Medical School; Singapore City Singapore
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore City Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service; Department of Paediatrics; KK Women's and Children's Hospital; Singapore City Singapore
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore City Singapore
- Duke-National University of Singapore Graduate Medical School; Singapore City Singapore
| |
Collapse
|
45
|
Ruhnke N, Müller A, Eppich B, Güther R, Maiwald M, Sumpf B, Erbert G, Tränkle G. Single-pass UV generation at 222.5 nm based on high-power GaN external cavity diode laser. Opt Lett 2015; 40:2127-2129. [PMID: 25927802 DOI: 10.1364/ol.40.002127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We demonstrate a compact system for single-pass frequency doubling of high-power GaN diode laser radiation. The deep UV laser light at 222.5 nm is generated in a β-BaB2O4 (BBO) crystal. A high-power GaN external cavity diode laser (ECDL) system in Littrow configuration with narrowband emission at 445 nm is used as pump source. At a pump power of 680 mW, a maximum UV power of 16 μW in continuous-wave operation at 222.5 nm is achieved. This concept enables a compact diode laser-based system emitting in the deep ultraviolet spectral range.
Collapse
|
46
|
Rajkumar V, Chiang CSM, Low JM, Cui L, Lin RTP, Tee NWS, Maiwald M, Chong CY, Thoon KC, Tan NWH. Risk Factors for Severe Adenovirus Infection in Children during an Outbreak in Singapore. Ann Acad Med Singap 2015; 44:50-59. [PMID: 25797817 DOI: 10.47102/annals-acadmedsg.v44n2p50] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Human adenoviruses (HAdVs) can cause a variety of human illnesses, with associated temporal and geographic changes in disease incidence. We report the emergence of an outbreak of HAdV infections in Singapore, presumably caused by a change of the predominating type to HAdV-7. We examined the clinical features of children admitted with HAdV infection to 1 institution and the risk factors for severe infection. MATERIALS AND METHODS This is a retrospective case-control study of all HAdV-infected children admitted during weeks 1 to 19 in 2013, as identified from laboratory records. A descriptive retrospective analysis of epidemiology, clinical data and the outcome of these children was also performed. Patients with severe infections were defined as cases, those with non-severe infections as controls, and the 2 groups were compared to find possible independent risk factors. RESULTS Eighty-five patients with HAdV infection were studied, including 11 (12.9%) cases and 74 (87.1%) controls. Binary logistic regression showed that cases were more likely to be <2 years old (adjusted OR 10.6, 95% CI, 1.8 to 63.2) and to have significant comorbidities (adjusted OR 19.9, 95% CI, 3.4 to 116.1) compared to controls. The predominant type in 2013 was HAdV-7, which differed from 2011 and 2012, when HAdV-3 was more common. There was a trend towards pneumonia being more common in patients infected with HAdV-7 than in patients infected with other types, although this did not reach statistical significance (OR 2.8, 95% CI, 0.9 to 8.7). CONCLUSION The emergence of HAdV-7 in a population where other HAdV types had circulated previously may have caused the outbreak in Singapore, and this was associated with more serious infections in children. Young age (<2 years) and significant comorbidities were associated with more severe HAdV infection.
Collapse
Affiliation(s)
- Veena Rajkumar
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Maiwald M, Widmer AF, Rotter ML. Lack of Evidence for Attributing Chlorhexidine as the Main Active Ingredient in Skin Antiseptics Preventing Surgical Site Infections. Infect Control Hosp Epidemiol 2015; 32:404-5. [DOI: 10.1086/659253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
48
|
|
49
|
Maiwald M, Widmer AF, Rotter ML. Chlorhexidine Is Not the Main Active Ingredient in Skin Antiseptics That Reduce Blood Culture Contamination Rates. Infect Control Hosp Epidemiol 2015; 31:1095-6; author reply 1096-7. [DOI: 10.1086/656561] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
50
|
Seah XFV, Ngeow JHA, Thoon KC, Tee WSN, Maiwald M, Chong CY, Tan NWH. Infant With Invasive Nontyphoidal Salmonellosis and Mastitis. Glob Pediatr Health 2015; 2:2333794X15591568. [PMID: 27335967 PMCID: PMC4784604 DOI: 10.1177/2333794x15591568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Jia Hao Alvin Ngeow
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Koh Cheng Thoon
- Infectious Disease Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
| | - Wen Sim Nancy Tee
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; National Public Health Laboratory, Singapore
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
| | - Chia Yin Chong
- Infectious Disease Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
| | - Natalie Woon Hui Tan
- Infectious Disease Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
| |
Collapse
|