BackgroundTo control the spread of 2019 novel coronavirus disease (COVID-19), China sealed Wuhan on Jan 23, 2020 and soon expanded lockdown to other twelve cities in Hubei province. We aimed to describe the epidemiological characteristics in one of the cities and highlight the effect of current implemented lockdown and nonpharmaceutical interventions. MethodsWe retrieved data of reported cases in Huangshi

CoronavirusSARS-CoV-2Infection PreventionEpidemiologyPandemic

Hydroxychloroquine (HCQ) appears to be a promising treatment for COVID-19. However, all ongoing clinical trials with HCQ use different dosing regimens, resulting on various concentrations PK studies are therefore needed to define the optimal dosing regimen.

BackgroundAntibiotic resistance is often spread through bacterial populations via conjugative plasmids. However, plasmid transfer is not well recognized in clinical settings because of technical limitations, and health care–associated infections are usually caused by clonal transmission of a single pathogen. In 2015, multiple species of carbapenem-resistant Enterobacteriaceae (CRE), all producing a

whole genome sequencingmobile genetic elementsinfection controlcarbapenemase

BackgroundIn 2016, the first global viral hepatitis elimination targets were endorsed. An estimated one-third of the world’s population of individuals with chronic hepatitis B virus (HBV) infection live in China and liver cancer is the sixth leading cause of mortality, but coverage of first-line antiviral treatment was low. In 2015, China was one of the first countries to initiate a consultative process

Amongst 200 patients developing HAP outwith the ICU, 61% were treated empirically without broad-spectrum gram-negative coverage, with clinical cure in 69.7%. Lower disease severity markers(SIRS, hypoxia, tachypnoea, neutrophilia) and absence of diabetes mellitus and prior doxycycline treatment (but not time to HAP onset) identified patients not requiring broad-spectrum gram-negative coverage.

BackgroundRecurrent C. difficile infection (rCDI) is associated with loss of microbial diversity and microbe-derived secondary bile acids, which inhibit C. difficile germination and growth. SER-109, an investigational microbiome drug of donor-derived, purified spores, reduced recurrence in a dose-ranging, open-label Phase (Ph)1 study in subjects with multiply rCDI. MethodsIn a Ph2 double-blind trial

hepatitis BChinamodelingelimination

ABSTRACT BackgroundInfluenza viral antigens may undergo adaptive mutations during egg-based vaccine production. In the 2017-2018 influenza season, quadrivalent ccIIV (ccIIV4) vaccine was produced using an A(H3N2) seed virus propagated exclusively in cell culture, thus lacking egg adaptive changes. This study aimed to estimate the relative vaccine effectiveness (rVE) of ccIIV4 versus egg-derived quadrivalent

BackgroundIn our previous study in Luanda, Angola, initial continuous β-lactam infusion for 24 hours combined with oral acetaminophen for 48 hours showed promising results as a new treatment for childhood bacterial meningitis. We investigated whether extending this treatment regimen to 4 days would improve the outcomes further. MethodsWe conducted a randomized, double-blind, parallel-group study at

As the outbreak of COVID-19 has spread globally, determining how to prevent the spread is of paramount importance. We reported the effectiveness of different responses of four affected cities in preventing the COVID-19 spread. We expect Wenzhou anti-COVID-19 measures may provide experience for cities around the world that are experiencing this epidemic.

BackgroundMultidrug-resistant (MDR) bacteria are frequently defined using the criteria established by Magiorakos et al. (Clin Microbiol Infect 2012;18:268-81). Difficult-to-treat resistance (DTR) (Kadri et al., Clin Infect Dis 2018;67:1803-14) is a novel approach to defining resistance in Gram-negative bacilli which focuses on treatment-limiting resistance to all first-line agents (all β-lactams and

BackgroundA locally developed Case-Based Reasoning (CBR) algorithm, designed to augment antimicrobial prescribing in secondary care was evaluated. MethodsPrescribing recommendations made by a CBR algorithm were compared to decisions made by physicians in clinical practice. Comparisons were examined in two patient populations. Firstly, in patients with confirmed Escherichia coli blood stream infections

We report two independent patients from whom carbapenem and ceftazidime-avibactam-resistant Enterobacter cloacae complex strains were identified. The ceftazidime-avibactam resistance was attributed to a two amino acid deletion in the R2 loop of AmpC β-lactamase, which concurrently caused resistance to cefepime and reduced susceptibility to cefiderocol, a novel siderophore cephalosporin.

ObjectiveIn December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China. In this study, we investigate clinical and laboratory features and short-term outcomes of patients with Corona Virus Disease 2019(COVID-19). MethodsAll patients with COVID-19 admitted to Wuhan University Zhongnan Hospital in Wuhan, China, between January 3 and February 1, 2020 were included. All

We reported computed tomographic (CT) imaging findings of 3 patients with coronavirus disease 2019 (COVID-19) pneumonia with initially negative results before CT examination and finally confirmed positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse-transcription polymerase chain reaction assay.

BackgroundEvidence to inform cryptococcal antigen (CrAg)-screening guidelines among antiretroviral therapy (ART)-experienced populations are lacking. We performed a study evaluating the utility of reflex CrAg-screening in Gaborone, Botswana. MethodsCD4 count data were collected from samples tested at the HIV reference laboratory from 2014-2016. CrAg screening was performed on samples with CD4 ≤100

BackgroundMold-active primary antifungal prophylaxis (PAP) is routinely recommended in neutropenic patients with newly diagnosed AML or high-risk myelodysplastic syndrome (MDS) undergoing remission-induction chemotherapy (RIC). Isavuconazole (ISAV) is an extended spectrum mold-active triazole and has superior tolerability and less significant drug-drug interactions compared with other triazoles. MethodsIn

BackgroundTo retrospectively analyze the evolution of clinical features and thin-section CT imaging of novel coronavirus pneumonia (COVID-19) in 17 discharged patients. MethodsSerial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and CT pattern were documented in all patients during 4 weeks since admission. CT

IntroductionProgrammatic treatment outcome data for people living with HIV-2 in West Africa, where the virus is most prevalent, are scarce. MethodsHIV-2-infected adults initiating or receiving ART through the Senegalese national AIDS program were invited to participate in this prospective, longitudinal observational cohort study. We analyzed HIV-2 viral loads, CD4 counts, antiretroviral drug resistance

HIV-2 infection is endemic in some countries in West Africa. Due to the lower prevalence in industrialized countries, there is limited experience and knowledge on management of HIV-2 infected individuals in Europe. Compared to HIV-1, there are differential characteristics of HIV-2 regarding diagnostic procedures, clinical course and, most importantly, antiretroviral therapy.We integrated the published

COVID-19SARS-Cov-2AfricaPandemic

We analyzed age- and sex-specific morbidity and mortality data from SARS-COV-2 pandemic in China and Republic of Korea (ROK). Data from China exhibit a Gaussian distribution with peak morbidity in the 50-59 years cohort, while the ROK data have a bimodal distribution with highest morbidity in the 20-29 years cohort.

99DOTS is a cellphone-based strategy for monitoring tuberculosis medication adherence. In a sample of 597 Indian tuberculosis patients, we compared 99DOTS’ adherence assessments against results of urine isoniazid tests collected during unannounced home visits. 99DOTS had suboptimal accuracy for measuring adherence, partly due to poor patient engagement with 99DOTS.

BackgroundThe novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated. MethodsA total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM

BackgroundCoronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription PCR (RT-PCR) method has limitations for clinical diagnosis and treatment. MethodsA total of 323 samples from 76 COVID-19 confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based two target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and

Response-adaptive randomization (RAR) has recently gained popularity in clinical trials. The intent is noble: minimize the number of participants randomized to inferior treatments and increase the amount of information about better treatments. Unfortunately, RAR causes many problems, including: 1) bias from temporal trends, 2) inefficiency in treatment effect estimation, 3) volatility in sample size

IntroductionSeveral observational studies have shown decreases in measured influenza vaccine effectiveness (mVE) during influenza seasons. One study found decreases of 6%-11% per month during the 2011-12 to 2014-15 seasons. These findings could indicate waning immunity but could also occur if vaccine effectiveness is stable and vaccine provides partial protection in all vaccinees (“leaky”) rather than

BackgroundThe outcomes of patients with severe pulmonary blastomycosis requiring mechanical ventilation (MV) is not well understood in the modern era. Limited historical case series have reported 50-90% mortality in patients with Acute Respiratory Distress Syndrome (ARDS) caused by blastomycosis. The objective of this large retrospective cohort study was to describe the risk factors and outcomes of

BackgroundDiagnosis of schistosomiasis remains elusive soon after infection. We evaluated several diagnostic methods in a cluster of travelers simultaneously exposed to freshwater in South Africa. MethodsEosinophil count, schistosome antibody tests, stool and urine microscopy, and serum Dra1PCR assays were performed at week 4-5 (w4-5, early symptomatic phase), week 7-8 (w7-8, praziquantel treatment)

BackgroundThe Standardized Antimicrobial Administration Ratio (SAAR) is a risk-adjusted metric of antimicrobial use (AU) developed by the CDC in 2015 as a tool for hospital antimicrobial stewardship programs (ASPs) to track and compare AU to a national benchmark. In 2018, CDC updated the SAAR by expanding the locations and antimicrobial categories for which SAARs can be calculated and by modeling adult

BackgroundDemonstration of intrathecal production of Borrelia-specific antibodies (ITAb) is considered the most specific diagnostic marker of Lyme neuroborreliosis (LNB). Limitations include delayed detectabilty in early infection and continued presence long after successful treatment. Markers of active inflammation – increased CSF leukocytes, protein and CXCL13 – provide nonspecific markers of active

Community-acquired bacterial pneumonia (CABP) remains a significant cause of morbidity and mortality worldwide. Antimicrobial resistance, including in pathogens that cause CABP, continues to spread at an alarming rate. Because of these factors, the development of new antibiotic classes is urgently needed. Lefamulin, previously known as BC-3781, is a semisynthetic pleuromutilin antibiotic that was approved

BackgroundModeling of the London hepatitis C virus (HCV) epidemic in men who have sex with men (MSM) and are living with human immunodeficiency virus (HIV) suggested that early access to direct-acting antiviral (DAA) treatment may reduce incidence. With high rates of linkage to care, microelimination of HCV within MSM living with HIV may be realistic ahead of 2030 World Health Organization targets

BackgroundRapid identification of COVID-19 cases, which is crucial to outbreak containment efforts, is challenging due to the lack of pathognomonic symptoms and in settings with limited capacity for specialized nucleic acid-based reverse transcription polymerase chain reaction (PCR) testing. MethodsThis retrospective case-control study involves subjects (7 to 98 years) presenting at the designated

BackgroundThe outbreak of COVID-19 has become a big threat to China, with high contagious capacity and varied mortality. This study aimed to investigate the epidemiological and clinical characteristics of older patients with COVID-19 out of Wuhan. MethodsA retrospective study was performed, with collecting data from medical records of confirmed COVID-19 patients in Zhejiang province from Jan 17 to

BackgroundA physiological small animal model that resembles COVID-19 with low mortality is lacking. MethodsMolecular docking on the binding between angiotensin-converting enzyme 2 (ACE2) of common laboratory mammals and the receptor-binding domain of the surface spike protein of SARS-CoV-2 suggested that the golden Syrian hamster is an option. Virus challenge, contact transmission, and passive immunoprophylaxis

Mortality from coronavirus disease 2019 (COVID-19) is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share underlying pathophysiology related to the renin-angiotensin system (RAS) that may be clinically insightful. In particular, activity of the angiotensin-converting enzyme 2 (ACE2) is dysregulated in cardiovascular disease, and this enzyme is used by

BackgroundHIV-experienced clinicians are critical for positive outcomes along the HIV care continuum. However, access to HIV-experienced clinicians may be limited, particularly in nonmetropolitan areas, where HIV is increasing. We examined HIV clinician workforce capacity, focusing on HIV experience and urban-rural differences, in the US South. MethodsWe used Medicaid claims and clinician characteristics

BackgroundSupport for clinicians in HIV medicine is critical given national HIV-provider shortages. Department of Health and Human Services (DHHS) guidelines are comprehensive but complex to apply for antiretroviral therapy (ART) selection. HIV-ASSIST (www.hivassist.com) is a free tool providing ART decision-support that could augment implementation of clinical practice guidelines. MethodsWe conducted

BackgroundThe Ending the HIV Epidemic initiative, which aims to decrease the annual incidence of HIV infections in the United States (US) by 90% over the next decade, will require growth of a limited HIV provider workforce. Existing HIV training pathways within Family Medicine (FM) and Internal Medicine (IM) residency programs may address the shortage of HIV medical providers, but their curricula and

We report a COVID-19 family cluster caused by a presymptomatic case. There were 9 family members, including 8 laboratory-confirmed with COVID-19, and a 6-year-old child had no evidence of infection. Amongst the 8 patients, one adult and one 13-month-old infant were asymptomatic, one adult was diagnosed as having severe pneumonia.

BackgroundThis Phase 1b study evaluated the pharmacokinetics, safety and antiviral effects of the respiratory syncytial virus (RSV)-specific fusion inhibitor JNJ-53718678 (JNJ8678) in hospitalized RSVinfected patients (aged >1–≤24 months). MethodsPatients categorized by age (Cohort 1: ≥6–≤24 months; Cohort 2: ≥3–<6 months; Cohort 3: >1–<3 months) were randomized to oral JNJ-8678 or placebo once-daily

BackgroundIn Mali, ivermectin-based onchocerciasis elimination from the Bakoye and Falémé foci, reported in 2009–2012, was a beacon leading to policy shifting from morbidity control to elimination of transmission (EOT). These foci are also endemic for lymphatic filariasis (LF). In 2007–2016 mass ivermectin plus albendazole administration was implemented. We report Ov16 (onchocerciasis) and Wb123 (LF)

BackgroundEchinococcus multilocularis is one of the most severe and lethal parasitic diseases of humans most often reported in Europe and Asia. Only one previous case has been documented in the contiguous United States from Minnesota in 1977. European haplotypes have been identified in carnivores and domestic dogs as well as recently in patients in Western and Central Canada. MethodsWe used immunohistochemical

BackgroundDespite national immunization efforts, including universal childhood hepatitis A (HepA) vaccination recommendations in 2006, hepatitis A virus (HAV)-associated outbreaks have increased in the United States. Unvaccinated or previously uninfected persons are susceptible to HAV infection, yet the susceptibility in the U.S. population is not well known. MethodsUsing National Health and Nutrition

BACKGROUND A high prevalence of cardiac abnormalities has been reported in children with HIV taking ART in sub-Saharan Africa. We investigated the incidence and progression of cardiac abnormalities among children taking ART in Zimbabwe. METHODS A prospective cohort study was conducted at a paediatric HIV clinic from 2014 to 2017. Children with HIV aged between 6 and 16 years and taking ART ≥6 months

BACKGROUND US guidelines recommend standard genotype at HIV diagnosis ("baseline genotype") to detect transmitted drug resistance (TDR) to NNRTIs, NRTIs, and PIs. With INSTI-based regimens now recommended as first-line ART, the clinical and economic value of baseline genotypes is uncertain. METHODS We used the CEPAC model to examine the clinical impact and cost-effectiveness of Baseline Genotype compared

BACKGROUND Human T-lymphotropic virus type-1 (HTLV-1) associated myelopathy (HAM), is an inflammatory condition characterised by severe disability and high levels of infected white blood cells. The circulating cellular inflammatory changes that distinguish this condition from asymptomatic infection are not well understood. METHODS To investigate the immune characteristics of individuals with low or

BACKGROUND Genetic divergence of HIV-1/O relative to HIV-1/M impacts virological monitoring and drug susceptibility, but little is known about impact on therapeutic outcomes. We aimed to determine if responses to standardized cART were similar between groups despite strain divergence. METHODS We performed an open non-randomized study comparing the immunological, virological and clinical responses to

BackgroundHuman cytomegalovirus (HCMV) infection, especially persistent HCMV infection, is an important cause of morbidity and mortality after allogenic stem cell transplantation (allo-SCT). Antiviral agents remain the first-line therapy but are limited by side effects and acquired resistance. MethodsWe evaluated the safety and efficacy of donor-derived HCMV-specific cytotoxic T cells (CTLs) as a first-line

BackgroundTimely availability of microbiological results from positive blood cultures is essential to enable early pathogen-directed therapy. The Accelerate Pheno system (ADX) is a novel technology using fluorescence in situ hybridization for rapid species identification (ID) and morphokinetic bacterial analysis for phenotypic antimicrobial susceptibility testing (AST), with promising results. Yet

BackgroundPneumococcal conjugate vaccines (PCVs) have reduced pneumococcal diseases globally. Pneumococcal genomic surveys elucidate PCV effects on population structure but are rarely conducted in low-income settings despite the high disease burden. MethodsWe undertook whole-genome sequencing (WGS) of 660 pneumococcal isolates collected through surveys from healthy carriers 2 years from 13-valent PCV

BackgroundThe relationships between first-line drug concentrations and clinically important outcomes among patients with tuberculosis (TB) remain poorly understood. MethodsWe enrolled a prospective cohort of patients with new pulmonary TB receiving thrice-weekly treatment in India. The maximum plasma concentration of each drug was determined at months 1 and 5 using blood samples drawn 2 hours postdose

BACKGROUND Outpatient antibiotic prescribing for acute upper respiratory infections (URI) is a high priority target for antimicrobial stewardship that has not been described for cancer patients. METHODS We conducted a retrospective cohort study of adult patients at an ambulatory cancer center with ICD-10 diagnosis code consistent with URI from October 1, 2015 to September 30, 2016. We obtained antimicrobial

BACKGROUND Reactive case detection (RACD) is a widely practiced malaria elimination intervention whereby close contacts of index cases receive malaria testing to inform treatment and other interventions. However, the optimal diagnostic and operational approaches for this resource-intensive strategy are not clear. METHODS We conducted a three-year prospective national evaluation of RACD in Eswatini

BACKGROUND Hepatitis C virus (HCV) testing and treatment uptake in prisons remains low. We aimed to estimate clinical outcomes, cost-effectiveness (CE), and budgetary impact (BI) of HCV testing and treatment in United States (U.S.) prisons or linkage to care at release. METHODS We used individual-based simulation modeling with healthcare and Department of Corrections (DOC) perspectives for CE and BI

BACKGROUND Many people who inject drugs in the US have chronic Hepatitis C (HCV). Onsite treatment in opiate agonist treatment (OAT) programs addresses HCV treatment barriers, but few evidence-based models exist. METHODS We evaluated the cost-effectiveness of HCV treatment models for OAT patients using data from a randomized trial conducted in Bronx, NY. We used a decision analytic model to compare