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  • 1
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    Online Resource
    Retrospective Cohort Analysis of Outpatient Antibiotic Use for Clostridioides difficile-Indicated Agents in British Columbia, from 2000 to 2018
    Hindawi Limited ; 2023
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2023 ( 2023-2-10), p. 1-8
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2023 ( 2023-2-10), p. 1-8
    Abstract: Background. Clostridioides difficile (CDI) is the most common cause of nosocomial diarrheal infections. Historically, metronidazole was the first-line treatment, but guidelines now indicate oral vancomycin and fidaxomicin as primary antibiotics for initial episodes. A provincial stewardship program has operated in British Columbia (BC), since 2005. Since the program's inception, surveillance of antibiotic use has been ongoing. However, this is the first study to review community-acquired CDI-indicated antibiotic use. Moreover, this study offers the first interpretation of fidaxomicin use in BC since its addition to the provincial formulary. Methods. A retrospective cohort analysis included all outpatient dispensations for CDI-related antibiotics from January 1, 2000, to December 31, 2018. Antibiotic dispensations were extracted for metronidazole, vancomycin, and fidaxomicin. Consumption rates were calculated as prescriptions per 1000 population. Rates were examined overall and then stratified by medication, age, and sex. Secondary outcomes of interest included an examination of adherence to provincial special authority criteria; and proportions of outpatient antibiotic use attributable to administrative health records for CDI. Results. The average annual rate of prescribing was 18.5 per 1000 population for all CDI-indicated antibiotics. The rate of prescribing increased (15%) over the 19-year study period, from 17.2 to 19.8 dispensations per 1000 population. Metronidazole accounted for the most antibiotics dispensed in every study year; however, by 2018 it demonstrated the most modest increase in use (15%). In comparison, fidaxomicin increased by 226% by 2018. Vancomycin had the highest percentage increase (621%), with the greatest change occurring from 2014 to 2015, correlating to the dissemination of new clinical practice guidelines. Conclusion. This is the first study to evaluate outpatient prescribing for CDI-indicated antibiotics, and one of the few studies to examine fidaxomicin since its introduction to Canadian formularies. Although causation cannot be inferred from study results, oral vancomycin, and fidaxomicin use has increased in line with, or in advance-of guidelines.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2023/9465158
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2023
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  • 2
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    COVID-19 Mortality in Children: A Referral Center Experience from Iran (Mofid Children’s Hospital, Tehran, Iran)
    Hindawi Limited ; 2022
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2022 ( 2022-3-16), p. 1-7
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2022 ( 2022-3-16), p. 1-7
    Abstract: Background. The novel coronavirus disease 2019 (COVID-19) started in Wuhan, China, in December 2019. It spread widely around the world and was described as a pandemic by the World Health Organization (WHO). The knowledge regarding the mortality rate and risk factors of COVID-19 among the pediatric population is lacking. In this regard, we aimed to report the clinical and laboratory characteristics of deceased pediatric patients with SARS-CoV-2 infection. Method. This cross-sectional study was conducted in Mofid Children’s Hospital, Tehran, Iran, from February 2020 to April 2021. Recorded documents of 59 pediatric patients (under 18 years old) assumed to have COVID-19 who had died in the COVID-19 ward and COVID-19 intensive care unit (ICU) were retrospectively evaluated. All statistical analyses were performed using SPSS software (v. 26.0, Chicago, IL). A P value of less than 0.05 was considered statistically significant. Results. From 711 COVID-19 definite and suspected patients, 59 children died. Of these deceased pediatric patients, 34 were boys (57.62%) and 25 were girls (42.37%), with a total mean age of 5.6 years. The median length of stay in the hospital was 10 days (range 1–215). 91.52% had underlying comorbidities of which neurological diseases accounted for the largest share. 54 patients were admitted to the ICU and 83.05% of them had intubation during their hospitalization. In addition, the most common reasons for death in our study were related to respiratory and multiorgan failure. Conclusion. According to our knowledge, we are the first team to report such a thorough study in the field of COVID-19 pediatric mortality in Iran. Mortality was observed in all age groups of children, especially in those with previous comorbidities, specifically neurological disease. Abnormally elevated tests of ESR, CRP, LDH, AST, and ALT as well as the presence of proteinuria and hematuria were found in more than 50% of patients in our investigations, and ICU admission between both definite and suspected groups had significant differences, so monitoring and considering these factors may help to control and reduce the progression of the disease to death.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2022/2737719
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
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  • 3
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    Tocilizumab, an Exploratory Treatment for Severe COVID-19 Patients
    Hindawi Limited ; 2022
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2022 ( 2022-3-15), p. 1-8
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2022 ( 2022-3-15), p. 1-8
    Abstract: The coronavirus disease 2019 (COVID-19) may cause cytokine storm and respiratory illness such as pneumonia and progressive respiratory failure. Tocilizumab (TCZ), a monoclonal antibody that targets the interleukin-6 (IL-6) receptor, was approved as an alternative treatment for severe COVID-19 patients despite limited real-world clinical data in China. In the present study, we will discuss and evaluate the treatment response of TCZ therapy in patients with COVID-19. The clinical characteristics, treatment, laboratory parameters of IL-6, C-reactive protein (CRP), lymphocyte counts before and after TCZ therapy, and clinical outcomes in the 13 patients with COVID-19 were retrospectively evaluated according to the related medical records. The results showed that 13 patients with COVID-19 were totally included in this study. One of them was moderately ill, 8 were seriously ill, and 4 were critically ill. Eleven patients received TCZ administration once, while the other 2 patients received it twice. The median level of IL-6 before TCZ administration was 27.91 (7.42–210.90) pg/mL. Serum IL-6 level tended to further spike firstly and then gradually decreased after TCZ therapy in 10 patients. A persistent and dramatic increase of IL-6 was observed in 2 patients who were finally dead. The CRP levels of 76.92% (10/13) of the patients were above the normal range before the start of TCZ therapy and gradually declined after the TCZ treatment. No. 1 and No. 10 patients finally died accompanied by the corresponding lymphocyte counts persistently dropping. No. 13 patient became exacerbated possibly due to inducing severe bacterial infection after TCZ treatment, while the other 10 patients showed clinical improvement. In summary, the study revealed that TCZ may have a certain therapeutic effect on severe COVID-19 patients with a risk of the cytokine storm. It is necessary to further evaluate the efficacy and safety of TCZ by rigorous randomized controlled trial in the next step.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2022/6375870
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
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  • 4
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    Potential Predictors of Poor Prognosis among Severe COVID-19 Patients: A Single-Center Study
    Hindawi Limited ; 2021
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2021 ( 2021-04-12), p. 1-12
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2021 ( 2021-04-12), p. 1-12
    Abstract: Background. Timely detection of the progression of the highly contagious coronavirus disease (COVID-19) is of utmost importance for management and intervention for patients in intensive care (ICU). Aim. This study aims to better understand this new infection and report the changes in the various laboratory tests identified in critically ill patients and associated with poor prognosis among COVID-19 patients admitted to the ICU. Methods. This was a retrospective study that included 160 confirmed SARS-CoV-2-positive patients. Results. Elevated serum ferritin, D-dimer, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and nonconjugated bilirubin levels were present in 139 (96%), 131 (96%), 107 (68%), 52 (34%), and 89 (70%) patients, respectively. Renal parameters were abnormal in a significant number of cases with elevated creatinine and blood urea nitrogen in 93 (62%) and 102 (68%) cases, respectively. Hematological profiles revealed lower red blood cell count, hemoglobin, eosinophils, basophils, monocytes, and lymphocytes in 90 (57%), 103 (65%), 89 (62%), 105 (73%), 35 (24%), and 119 (83%) cases, respectively. The neutrophil count was found to increase in 71.3% of the cases. There was significantly higher mortality (83%) among patients older than 60 years p = 0.001 and in female patients (75%) p = 0.012 . Patients with lung diseases had a poor outcome compared to patients with other comorbidities p = 0.002 . There was a significant association between elevated D-dimer levels and increased mortality p = 0.003 . Elevated levels of AST, creatinine, blood urea nitrogen, and bilirubin were significantly associated with unfavorable outcomes. Conclusion. Different parameters can be used to predict disease prognosis, especially the risk of poor prognosis. Accurate diagnosis and monitoring of disease progression from the early stages will help in reducing mortality and unfavorable outcomes.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2021/6656092
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
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  • 5
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    Evaluation of Human Respiratory Syncytial Virus and Human Parainfluenza Virus Type 3 among Hospitalized Children in Northwest of Iran
    Hindawi Limited ; 2021
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2021 ( 2021-9-22), p. 1-6
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2021 ( 2021-9-22), p. 1-6
    Abstract: Background. Acute respiratory tract infections (ARTIs) are the leading cause of illnesses in children. Human respiratory syncytial virus (HRSV) and human parainfluenza viruses (HPIVs) are among the most common etiologic agents associated with viral respiratory tract infections in children worldwide. Nevertheless, limited information is available on the spread of infections of these two viruses in northwest Iran. Objective. The purpose of the current study is to evaluate the frequency of RSV and HPIV-3 and clinical features among Iranian children with confirmed respiratory infections between April 2019 and March 2020. Methods. 100 nasopharyngeal swabs were collected from hospitalized patients (under 5 years old) with ARTI from Tabriz Children’s Hospital. Detection of respiratory viruses was performed using the nested RT-PCR method. Results. Respiratory syncytial virus and HPIV-3 were recognized in 18% (18/100) and 2% (2/100) of children, respectively. Ten (55.6%) of the RSV-positive samples were male, while 8 (44.4%) were female. HPIV‐3 was found only among 2 male patients (100%). Most patients (61.1%) with RSV infection were less than 12 months old. Additionally, samples that were positive for HPIV-3 were less than 12 months old. RSV infections had occurred mainly during the winter season. Conclusions. This study confirms that RSV can be one of the important respiratory pathogens in children in northwestern Iran. However, according to this study, HPIV-3 has a lower prevalence among children in this area than RSV. Therefore, implementing a routine diagnosis for respiratory pathogens can improve the management of respiratory infections in children.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2021/2270307
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
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  • 6
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    Spatiotemporal Study of COVID-19 in Fars Province, Iran, October-November 2020: Establishment of Early Warning System
    Hindawi Limited ; 2022
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2022 ( 2022-5-30), p. 1-12
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2022 ( 2022-5-30), p. 1-12
    Abstract: Background. Using time series and spatiotemporal analyses, this study aimed to establish an Early Warning System (EWS) for COVID-19 in Fars province Iran. Methods. A EWS was conducted on (i) daily basis city-level time series data including 53 554 cases recorded during 18 February–30 September 2020, which were applied to forecast COVID-19 cases during 1 October–14 November 2020, and (ii) the spatiotemporal analysis, which was conducted on the forecasted cases to predict spatiotemporal outbreaks of COVID-19. Results. A total of 55 369 cases were forecasted during 1 October–14 November 2020, most of which (26.9%) occurred in Shiraz. In addition, 65.80% and 34.20% of the cases occurred in October and November, respectively. Four significant spatiotemporal outbreaks were predicted, with the Most Likely Cluster (MLC) occurring in ten cities during 2–22 October ( P 〈 0.001 for all). Moreover, subgroup analysis demonstrated that Zarrindasht was the canon of the epidemic on 6 October ( P = 0.04 ). As a part of EWS, the epidemic was triggered from Jahrom, involving the MLC districts in the center, west, and south parts of the province. Then, it showed a tendency to move towards Zarrindasht in the south and progress to Lar in the southernmost part. Afterwards, it simultaneously progressed to Fasa and Sepidan in the central and northwestern parts of the province, respectively. Conclusion. EWS, which was established based on the current protocol, alarmed policymakers and health managers on the progression of the epidemic and on where and when to implement medical facilities. These findings can be used to tailor province-level policies to servile the ongoing epidemic in the area; however, governmental level effort is needed to control the epidemic at a larger scale in the future.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2022/4965411
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
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  • 7
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    Predictors of COVID-19 Infection: A Prevalence Study of Hospitalized Patients
    Hindawi Limited ; 2021
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2021 ( 2021-10-13), p. 1-8
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2021 ( 2021-10-13), p. 1-8
    Abstract: Aim. To find the predictors of coronavirus disease 2019 (COVID-19) in hospitalized patients. Methods. A prevalence study compared the characteristics of COVID-19 patients with non-COVID-19 patients from January 19, 2020, to February 18, 2020, during the COVID-19 outbreak. Laboratory test results and pulmonary chest imaging of confirmed COVID-19 and non-COVID-19 patients were collected by retrieving medical records in our center. Results. 96 COVID-19 patients and 122 non-COVID-19 patients were enrolled in this study. COVID-19 patients were older (53 vs. 39; P   〈  0.001) and had higher body mass index (BMI) than non-COVID-19 group (24.21 ± 3.51 vs. 23.00 ± 3.27, P  = 0.011); however, differences in gender were not observed between the two groups. Logistic regression analysis showed that exposure history (OR: 23.34, P   〈  0.001), rhinorrhea (odds radio (OR): 0.12, P  = 0.006), alanine aminotransferase (ALT) (OR: 1.03, P  = 0.049), lactate dehydrogenase (LDH) (OR: 1.01, P  = 0.020), lymphocyte (OR: 0.27, P  = 0.007), and bilateral involvement on chest CT imaging (OR: 23.01, P   〈  0.001) were independent risk factors for COVID-19. Moreover, bilateral involvement on chest CT imaging (AUC = 0.904, P   〈  0.001) had significantly higher AUC than others in predicting COVID-19. Conclusions. Exposure history, elevated ALT and LDH, absence of rhinorrhea, lymphopenia, and bilateral involvement on chest CT imaging provide robust evidence for the diagnosis of COVID-19, especially in resource-limited conditions where nucleic acid detection is not readily available.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2021/6213450
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
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  • 8
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    Microbiological and Clinicoepidemiological Profile of a Series of Patients with Infective Endocarditis at a Center in Eastern Nepal
    Hindawi Limited ; 2021
    In:  Canadian Journal of Infectious Diseases and Medical Microbiology Vol. 2021 ( 2021-7-22), p. 1-8
    Details
    In: Canadian Journal of Infectious Diseases and Medical Microbiology, Hindawi Limited, Vol. 2021 ( 2021-7-22), p. 1-8
    Abstract: Background. The microbiological and clinicoepidemiological profile of infective endocarditis (IE) has undergone significant change over time. The pattern of IE studied at local level provides broader vision in understanding the current scenario of this disease. This study aimed to depict the overall picture of IE and its changing profile by evaluating the microbiological and clinicoepidemiological features in the context of a tertiary care center of eastern Nepal. Methods. The descriptive study was conducted from September 2017 to August 2018 among IE patients presenting to B. P. Koirala Institute of Health Sciences, Nepal. Detailed history and clinical manifestations of patients were noted. Microorganisms isolated from the blood culture were processed for identification by standard microbiological methods, and susceptibility testings were done. Each patient was assessed daily during hospital stay. Results. Ten definite and 7 possible endocarditis cases were studied. The mean age was 41.4 ± 15.85 (17–70) years with predominance of male (4.7 : 1). Rheumatic heart disease (41.1%) was the most common underlying heart disease observed followed by injection drug user endocarditis (23.5%). All the cases had native valve endocarditis. Aortic valve was the most common valve involved (35.3%) followed by mitral, tricuspid, and pulmonary valves. Blood culture positivity was 53%. Staphylococcus aureus was the major causative agent responsible for 23.5% of the cases followed by Enterococcus faecium, Enterococcus faecalis, and Pseudomonas aeruginosa. Mortality of 2 cases (11.8%) was associated with S. aureus and P. aeruginosa. Majority of patients developed acute kidney injury (35.3%) and congestive cardiac failure (23.5%). Conclusion. IE patients in our center exhibited differences from the west in terms of age at presentation and predisposing factors but held similarity in terms of commonly isolated microorganisms. The changing patterns of IE, etiological agents, and their antimicrobial susceptibility observed in this study may be helpful for clinicians in formulating a new empirical antibiotic treatment protocol.
    Type of Medium: Online Resource
    ISSN: 1918-1493 , 1712-9532
    URL: Article
    DOI: 10.1155/2021/9980465
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
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  • 9
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    Access to and quality of elective care: a prospective cohort study using hernia surgery as a tracer condition in 83 countries
    Elsevier BV ; 2024
    In:  The Lancet Global Health Vol. 12, No. 7 ( 2024-07), p. e1094-e1103
    Details
    In: The Lancet Global Health, Elsevier BV, Vol. 12, No. 7 ( 2024-07), p. e1094-e1103
    Type of Medium: Online Resource
    ISSN: 2214-109X
    URL: Article
    DOI: 10.1016/S2214-109X(24)00142-6
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2723488-5
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  • 10
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    A second update on mapping the human genetic architecture of COVID-19
    Springer Science and Business Media LLC ; 2023
    In:  Nature Vol. 621, No. 7977 ( 2023-09-07), p. E7-E26
    Details
    In: Nature, Springer Science and Business Media LLC, Vol. 621, No. 7977 ( 2023-09-07), p. E7-E26
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
    URL: Article
    DOI: 10.1038/s41586-023-06355-3
    RVK:
    TA 1000
    RVK:
    UA 1000
    RVK:
    WA 15000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 120714-3
    detail.hit.zdb_id: 1413423-8
    SSG: 11
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