Candida auris is an emerging multidrug-resistant fungus that causes a wide range of symptoms. We report finding 17 cases of C. auris infection that were originally misclassified but correctly ...identified 27.5 days later on average. Patients with a delayed diagnosis of C. auris had a 30-day mortality rate of 35.2%.
World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized ...with coronavirus disease 2019 (Covid-19).
We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry.
At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan-Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval CI, 0.81 to 1.11; P = 0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P = 0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P = 0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P = 0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration.
These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. (Funded by the World Health Organization; ISRCTN Registry number, ISRCTN83971151; ClinicalTrials.gov number, NCT04315948.).
Case Series Study of Melioidosis, Colombia Rodríguez, José Y; Morales-López, Soraya E; Rodríguez, Gerson J ...
Emerging infectious diseases,
08/2019, Letnik:
25, Številka:
8
Journal Article
Recenzirano
Odprti dostop
We report 7 cases of melioidosis in Colombia and comparision of 4 commercial systems for identifying Burkholderia pseudomallei. Phoenix systems were not a definitive method for identifying B. ...pseudomallei. For accurate identification, we recommend including this bacterium in the library databases of matrix-assisted laser desorption/ionization mass spectrometry systems in Latin America.
According to the WHO, as of September 30, 2022, 614 385 693 cases of COVID-19 and 6 522 600 confirmed deaths from the disease have been reported, with associated excess mortality exceeding 15 ...million. The insufficient number of rehabilitation units and the absence of medical education programs on long COVID, especially for primary care physicians, may result in higher costs for health systems. ...long COVID is a public health problem that affects a nonnegligible percentage of the population suffering from COVID-19, which should be considered within current health policies.
...there is an estimation that waiting one day for vaccination increased 1.9 % the number of cumulative cases in LIC compared to high-income countries (HIC) 3. ...by June 2022, under 40 % of ...healthcare workers in LIC have a complete vaccination scheme 4. ...a globally focused strategy of extended vaccination dosing intervals could reduce gaps in vaccination access 26. Furthermore, despite known lower vaccine effectiveness for infection in such variants, prevention for both hospitalisation and mortality remains high 14. ...a study evaluating the extended dosing interval strategy showed increased activity in neutralising antibody production against Omicron lineages BA.1, BA.2, BA.4 and BA.5 when compared to a shorter 3–4 week dosing interval and a similar antibody production after a booster dose indistinctly of the interval vaccination strategy 15. ...it is relevant to assess that this deferral approach complies with ethical principles in the distribution of vaccines.
•This is the first reported case of mucormycosis following esthetic surgery and was associated with medical tourism.•Mucormycosis should be considered in the differential diagnosis of necrotizing ...infections of the skin and soft tissue that evolve rapidly after cosmetic surgery performed in tropical or subtropical countries.•Elective cosmetic procedures are the most common medical tourism surgeries, and the most frequent complication is infection of the surgical site.
Mucormycosis caused by Saksenaea erythrospora is rarely reported in humans. Three previous cases have been reported in the literature, two associated with trauma (a sailing accident in Argentina and a combat trauma in Iraq) and one as a cause of invasive rhinosinusitis (India), all in immunocompetent patients . The first case of mucormycosis following esthetic surgery, associated with medical tourism, is reported herein.
A case study of an S. erythrospora infection in an immunocompetent woman after the completion of esthetic surgery (dermolipectomy and breast augmentation) is reported. The infection presented as a rapidly progressive necrotizing infection of the skin and soft tissue, which required a bilateral mastectomy and extensive surgical debridement associated with prolonged antifungal therapy. The organism was identified phenotypically and confirmed biologically after rDNA amplification and sequencing. Two months later, the patient remains hospitalized awaiting the start of reconstructive surgeries. The present case is, to the best of the authors’ knowledge, the first report from Colombia.
Mucormycosis should be considered in the differential diagnosis of necrotizing infections of the skin and soft tissue that evolve rapidly after cosmetic surgery performed in tropical or subtropical countries.
Bacteremia by non-O1/non-O139 Vibrio cholerae is a rare entity associated with high mortality rates. We report a case of non-O1/non-O139 V. cholerae bacteremia confirmed by polymerase chain reaction ...and agglutination tests. The clinicoepidemiological characteristics and therapeutic options for this infection are also described.
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