The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections最新文献

{"title":"Translating metagenomics into clinical practice of complex paediatric neurological presentations","authors":"Justin Penner, J. Hassell, Julianne R. Brown, K. Mankad, N. Storey, Laura Atkinson, Nisha Ranganathan, Alexander Lennon, Jack C. D. Lee, Dimitrios Champsas, Angelika Kopec, D. Shah, C. Venturini, G. Dixon, S. De, J. Hatcher, K. Harris, K. Aquilina, Maaike Kusters, K. Moshal, D. Shingadia, A. Worth, G. Lucchini, A. Merve, T. Jacques, A. Bamford, M. Kaliakatsos, J. Breuer, S. Morfopoulou","doi":"10.1101/2023.06.02.23290816","DOIUrl":"https://doi.org/10.1101/2023.06.02.23290816","url":null,"abstract":"Background Atypical or complex paediatric neurological presentations are common clinical conundrums and often remain undiagnosed despite extensive investigations. This is particularly pronounced in immunocompromised patients. Here we show that clinical metagenomics (CMg) is a valuable adjunct diagnostic tool to be used by neuro-infection multidisciplinary teams (MDTs). Methods We included patients referred to the Great Ormond Street Hospital neuro-infection MDT in whom diagnostic uncertainty remained, despite a standardised comprehensive set of investigations, and who were referred for untargeted CMg on brain tissue and/or cerebrospinal fluid (CSF). In a retrospective review, two clinicians independently assessed whether CMg in conjunction with the MDT resulted in a change of management. Findings 60 undiagnosed patients met the inclusion criteria. We detected the causative pathogen by CMg in 14/60 (23%), with 12/36 patients known to be immunocompromised. CMg results, even when negative, informed patient care, resulting in changes in clinical management in 42/57 (74%). Six patients had unexpected findings of pathogens not identified on prior samples. In four patients, the pathogen was found solely in the brain biopsy and was absent from all other specimens, including CSF. Interpretation CMg is particularly useful when conventional diagnostic techniques for meningoencephalitis are exhausted and proved to be an important diagnostic tool for immunocompromised patients. CMg provided increased reassurance against an infective aetiology prior to recommending immunosuppressive or immunomodulatory treatment. Specialised MDTs should advocate for early brain biopsies and routine CMg in an experienced laboratory for undiagnosed complex neurological cases affecting immunocompromised patients. Funding: the authors declare no funding","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"77 21-22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72454726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Thermal Imaging to Measure Hand Hygiene Quality","authors":"Chaofan Wang, Weiwei Jiang, Kangning Yang, Zhanna Sarsenbayeva, Benjamin Tag, Tilman Dingler, Jorge Gonçalves, V. Kostakos","doi":"10.48550/arXiv.2302.02233","DOIUrl":"https://doi.org/10.48550/arXiv.2302.02233","url":null,"abstract":"OBJECTIVES\u0000Hand hygiene has long been promoted as the most effective way to prevent the transmission of infection. However, due to the low compliance and quality of hand hygiene reported in previous studies, constant monitoring of healthcare workers' hand hygiene compliance and quality is crucial. In this study, we investigate the feasibility of using a thermal camera together with an RGB camera to detect hand coverage of alcohol-based formulation, thereby monitoring handrub quality.\u0000\u0000\u0000METHODS\u0000We recruited 32 participants for this study. Participants were required to perform four types of handrubs to produce different hand coverage of alcohol-based formulation. After each task, participants' hands were photographed under a thermal camera and an RGB camera, while an ultraviolet (UV) test was used to provide the ground truth of hand coverage of alcohol-based formulation. Then, a U-Net was used to segment areas covered with alcohol-based formulations from thermal images, and the system performance was evaluated by comparing coverage differences between thermal images and UV images regarding accuracy and Dice coefficient.\u0000\u0000\u0000RESULTS\u0000The system yields promising results in terms of accuracy (93.5%) and Dice coefficient (87.1%) when observations take place 10 seconds after performing handrub. In addition, we also examine the system performance change over a 60-second observation period, and the accuracy and Dice coefficient still remain at about 92.4% and 85.7% when observation happens at the 60-second time point.\u0000\u0000\u0000CONCLUSIONS\u0000Given these encouraging results, thermal imaging shows its potential feasibility in providing accurate, constant, and systematic hand hygiene quality monitoring.","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89879896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmission of monkeypox virus through sexual contact - A novel route of infection.","authors":"Joseph Heskin, Amy Belfield, Charlotte Milne, Nicklas Brown, Yasmin Walters, Christopher Scott, Margherita Bracchi, Luke Sp Moore, Nabeela Mughal, Tommy Rampling, Alan Winston, Mark Nelson, Sarah Duncan, Rachael Jones, D Ashley Price, Borja Mora-Peris","doi":"10.1016/j.jinf.2022.05.028","DOIUrl":"10.1016/j.jinf.2022.05.028","url":null,"abstract":"","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"14 1","pages":"334-363"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76446750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of pharmacy-led versus conventionally delivered antiviral treatment for hepatitis C in patients receiving opioid substitution therapy: an economic evaluation alongside a pragmatic cluster randomised trial.","authors":"G. Myring, Aaron G. Lim, William Hollingworth, Hugh McLeod, Lewis Beer, P. Vickerman, Matthew Hickman, A. Radley, John F. Dillon","doi":"10.2139/ssrn.4019338","DOIUrl":"https://doi.org/10.2139/ssrn.4019338","url":null,"abstract":"BACKGROUND\u0000Elimination targets for hepatitis C have been set across the world. In the UK almost 90% of infections are in people who inject drugs. Evidence shows community case-finding is effective at identifying and treating undiagnosed patients. The aim of this analysis was to assess, from a healthcare provider perspective, the cost-effectiveness of a new pharmacist-led test and treat pathway for hepatitis C in opioid agonist treatment (OAT) patients attending community pharmacies compared to conventional care.\u0000\u0000\u0000METHODS\u0000In a cluster randomised controlled trial, pharmacies were randomised to the pharmacist-led or conventional care pathway. Mean cost per OAT patient and per patient initiating treatment was identified for each pathway. A Markov model tracking disease progression was developed, with a 50-year time horizon and 3·5% time discount rate, to estimate the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained and the probability of being cost-effective at a £30,000 per QALY willingness-to-pay threshold. Probabilistic sensitivity analysis was performed for a range of drug discounts, re-infection rates, and model assumptions.\u0000\u0000\u0000FINDINGS\u0000Mean cost per OAT patient (£3,674 vs £1,965) and per patient initiating treatment (£863 vs £404) was higher in the pharmacist-led pathway, due to higher uptake of testing and pharmacist time requirements. Over a 50-year time horizon the ICER per QALY gained was £31,612 at NHS indicative price for treatment (£38,979 for 12 weeks) and 12·1/100 person-years re-infection rate, reducing to £21,027/£10,220/-£501 per QALY gained with 30%/60%/90% drug price discounts and £25,373/£21,738/£14,912 per QALY gained at re-infection rates of 8/5/2 per 100 person-years. At 30%/60%/90% drug discount rates, the pharmacist-led pathway has an 80%/98%/100% probability of being cost-effective.\u0000\u0000\u0000INTERPRETATION\u0000The pharmacist-led pathway is effective at increasing testing and treatment uptake, with cost-effectiveness being highly dependent on drug price discounts.\u0000\u0000\u0000FUNDING\u0000Trial funding provided by the Scottish Government, Gilead Sciences, and Bristol-Myers Squibb.","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83958649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome characterization of monkeypox cases detected in India: Identification of three sub clusters among A.2 lineage","authors":"A. Shete, P. Yadav, Abhinendra Kumar, S. V. Patil, D. Patil, Yash Joshi, T. Majumdar, V. Relhan, R. Sahay, Meenakshy Vasu, P. Gawande, Ajay Verma, Arbind Kumar, Shivram Dhakad, Anukumar Bala Krishnan, Shubin Chenayil, Suresh Kumar, P. Abraham","doi":"10.1101/2022.09.16.507742","DOIUrl":"https://doi.org/10.1101/2022.09.16.507742","url":null,"abstract":"Since May 2022, Monkeypox, a zoonotic Orthopox DNA virus was reported in more than 102 countries indicating expansion of its geographic range. We analyzed the complete genomes sequences of Monkeypox cases from Kerala (n=5 travelled from UAE) and Delhi (n=5 no travel history), India confirmed during July to August 2022. All the retrieved MPXV sequences from India covering 90 to 99% genome belong to A.2 lineage of clade IIb. The A.2 MPXV lineage divided in three sub clusters; first cluster Kerala n=5, Delhi n=2 aligned with the USA-2022 ON674051.1; while second of Delhi n=3 aligned with USA-2022 ON675438.1 and third consists of the UK, USA and Thailand. Recent update in MPXV lineage designated all the five sequences from Kerala as A.2.1. In addition to known 16 single nucleotide polymorphisms (SNPs) along with 13 APOBEC3 cytosine deaminase activity determined specific lineage defining mutations in A.2 lineage, 25 additional APOBEC3 mutations were found in 10 reported sequences. The study emphasizes need of enhancing genomic surveillance to understand the mutation and its linkage.","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"81 1","pages":"66 - 117"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78275521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A distinct phylogenetic cluster of Monkeypox genomes suggests an early and cryptic spread of the virus","authors":"B. Jolly, V. Scaria","doi":"10.1101/2022.07.30.502168","DOIUrl":"https://doi.org/10.1101/2022.07.30.502168","url":null,"abstract":"Since its first reports in humans in 1970, monkeypox has been predominantly restricted to countries in Africa where the disease is endemic. Early in 2022, a large number of cases of the disease were reported from Europe and other countries in patients having no history of travel to regions where monkeypox is endemic. Amid a rise in cases, the availability of genome sequences of monkeypox virus isolates in the public domain provides an opportunity to understand the transmission and evolution of the virus. Here, we describe a distinct phylogenetic cluster of monkeypox virus (lineage A.2) using genome sequences available on GISAID. Lineage A.2 currently encompasses 9 genome sequences from 6 viral isolates collected from 3 countries and is distinctly different from the predominant lineage B.1 which is linked to the large European outbreak.","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"75 3","pages":"e24 - e26"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72478684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of blaKPC-33-harboring Hypervirulent ST463 Pseudomonas aeruginosa Causing Fatal Infections in China.","authors":"Piao-piao Zhang, Jie Wang, Yue Li, Weixiao Shi, Heng Cai, Q. Yang, X. Li, Yunsong Yu, Ting-ting Qu, Yan Jiang","doi":"10.2139/ssrn.4074661","DOIUrl":"https://doi.org/10.2139/ssrn.4074661","url":null,"abstract":"","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73389297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter salvage strategies in children with central venous catheter-related or -associated bloodstream infections: a systematic review and meta-analysis.","authors":"D Buonsenso, G Salerno, G Sodero, F Mariani, L Pisapia, C Gelormini, M Di Nardo, P Valentini, G Scoppettuolo, D G Biasucci","doi":"10.1016/j.jhin.2022.03.010","DOIUrl":"10.1016/j.jhin.2022.03.010","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of central venous catheter-related, or -associated, bloodstream infections (CRBSI or CLABSI) in children is not established.</p><p><strong>Aim: </strong>To evaluate success of catheter salvage strategies in paediatric patients.</p><p><strong>Methods: </strong>Studies were retrieved from medical databases and article reference lists. Data were collected relating to clinical outcomes of two treatments: systemic antibiotics alone or in association with antimicrobial lock therapy (ALT). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from a mixed logistic effects model. Heterogeneity was summarized using I² statistics. Publication bias was investigated by Egger's regression test and funnel plots.</p><p><strong>Findings: </strong>From 345 identified publications, 19 met inclusion criteria (total of 914 attempted salvage strategies). To achieve successful catheter salvage, in CRBSI the addition of ALT was superior to systemic antibiotics alone (OR: -0.40; 95% CI: -1.41, 0.62): 77% (95% CI: 69, 85; I² = 42.5%; P = 0.12) and 68% of success (95% CI: 59, 77; I² = 0; P < 0.05), respectively. CRBSI recurrence was less common in studies that used ALT compared with systemic antibiotics alone: 5% (95% CI: 0, 13; I² = 59.7%; P = 0.03) and 18% of recurrence (95% CI: 9, 28; I² = 0; P < 0.05), respectively. Recurrences were low with both antibiotic locks and ethanol lock. No clear benefits of ALT addition compared to systemic antibiotic only were found in CLABSI (OR: -0.81; 95% CI: -0.80, 2.43).</p><p><strong>Conclusion: </strong>The addition of an antimicrobial lock solution to systemic antibiotic may be beneficial for successful catheter salvage in paediatric patients with CRBSI, depending on aetiology, whereas no statistically significant difference between systemic antibiotic with or without addition of an antimicrobial lock solution was found regarding CLABSI.</p>","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"50 1","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91049282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell RNA sequencing analysis of liver reveals the enhanced entry and release abilities of human adenovirus F41, partially explaining acute hepatitis in children","authors":"Junwen Luan, Yixuan Zhou, Xiao Wang, Annan Ming, Yuwen Liu, Yupei Yuan, Junhan Liang, Leiliang Zhang","doi":"10.1016/j.jinf.2022.06.007","DOIUrl":"https://doi.org/10.1016/j.jinf.2022.06.007","url":null,"abstract":"","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"214 1","pages":"334 - 363"},"PeriodicalIF":0.0,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75751817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical distribution of cystic fibrosis carriers as population genetic determinant of COVID-19 spread and fatality in 37 countries","authors":"C. Gabbi, A. Renieri, B. Strandvik","doi":"10.1016/j.jinf.2022.06.006","DOIUrl":"https://doi.org/10.1016/j.jinf.2022.06.006","url":null,"abstract":"","PeriodicalId":77413,"journal":{"name":"The Canadian journal of infection control : the official journal of the Community & Hospital Infection Control Association-Canada = Revue canadienne de prevention des infections","volume":"139 1","pages":"318 - 321"},"PeriodicalIF":0.0,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81762160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}