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3. Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study

Author

Filiz, Mine, Erdem, Hakan, Ankarali, Handan, Puca, Edmond, Ruch, Yvon, Santos, Lurdes, Fasciana, Teresa, Giammanco, Anna M., Ghanem-Zoubi, Nesrin, Argemi, Xavier, Hansmann, Yves, Guner, Rahmet, Tonziello, Gilda, Mazzucotelli, Jean-Philippe, Como, Najada, Kose, Sukran, Batirel, Ayse, Inan, Asuman, Tulek, Necla, Pekok, Abdullah Umut, Khan, Ejaz Ahmed, Iyisoy, Atilla, Meric-Koc, Meliha, Kaya-Kalem, Ayse, Martins, Pedro Palma, Hasanoglu, Imran, Silva-Pinto, André, Oztoprak, Nefise, Duro, Raquel, Almajid, Fahad, Dogan, Mustafa, Dauby, Nicolas, Gunst, Jesper Damsgaard, Tekin, Recep, Konopnicki, Deborah, Petrosillo, Nicola, Bozkurt, Ilkay, Al Ramahi, Jamal Wadi, Popescu, Corneliu, Balkan, Ilker Inanc, Ozer-Balin, Safak, Zupanc, Tatjana Lejko, Cascio, Antonio, Dumitru, Irina Magdalena, Erdem, Aysegul, Ersoz, Gulden, Tasbakan, Meltem, Ajamieh, Oday Abu, Sirmatel, Fatma, Florescu, Simin, Gulsun, Serda, Ozkaya, Hacer Deniz, Sari, Sema, Tosun, Selma, Avci, Meltem, Cag, Yasemin, Celebi, Guven, Sagmak-Tartar, Ayse, Karakus, Sumeyra, Sener, Alper, Dedej, Arjeta, Oncu, Serkan, Del Vecchio, Rosa Fontana, Ozturk-Engin, Derya, and Agalar, Canan

Published
2024
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4. Attributable mortality of infections caused by carbapenem-resistant Enterobacterales: results from a prospective, multinational case-control-control matched cohorts study (EURECA)

Author

Serna, Almudena de la, Monteau, Sophie, Palomo, Virginia, Soriano, Elena, Gutierrez, David, Moreno, Elisa, Sojo-Dorado, Jesus, Morales, Isabel, Maldonado, Natalia, Santis, Lucia Valiente de, Ciezar, Antonio Plata, Ruiz Mesa, Juan Diego, Diaz, Beatriz Sobrino, Gomez, Ignacio Marquez, Camacho, Ines Perez, Cano, Angela, Frutos-Adame, Azahara, Guzman-Puche, Julia, Gracia-Ahufinger, Irene, Perez-Nadales, Elena, Torre-Gimenez, Julian, Pyrpasopoulou, Athina, Iosifidis, Elias, Chorafa, Elsa, Radovanovic, Ivana, Petrovic, Sladjana, Cvetkovi, Slavica, Melentijevic, Srdjan-Sanja, Bicmen, Can, Senol, Gunes, Tubau, Fe, Camara, Jordi, Daniel Gumucio, Victor, Bassoulis, Dimitris, Deliolanis, John, Pitiriga, Vassiliki Ch., Triarides, Nikolaos, Argiti, Efstathia, Legakis, Nikolaos J., Margarita, Kyriakidou, Gijón-Cordero, Desirée, Ruiz-Garbajosa, Patricia, Rossolini, Gian Maria, Nica, Maria, Talapan, Daniela, Medić, Deana, Prijić, Sanja Maričić, Caballero, Mireia Cantero, Ramírez, Lina M Parra, Bilgin, Hüseyin, Dalekos, George N., Stefos, Aggelos, Spyridis, Nikolaos, Michos, Athanasios, De Rosa, Francesco Giuseppe, Cavallo, Rossana, Petrosillo, Nicola, Dicaro, Antonio, Landini, Maria Paola, degli Atti, Marta Luisa Ciofi, Masanovic, Mileva, Matkovic, Dusan, Tsiodras, Sotirios, Blasi, Francesco, pasquale, Marta Di, Viscoli, Claudio, Vata, Andrei, Dorneanu, Olivia, Kapisyzi, Perlat, Vince, Adriana, Tsigou, Evdoxia, Maltezos, Efstratios, Komnos, Apostolos, Gogos, Charalampos, Franzetti, Fabio, Antonelli, Massimo, Lupse, Mihaela, Corneci, Dan, Tomescu, Dana, Georgescu, Anca, Bukarica, Ljiljana, Mitrović, Goran, Krstić, Nataša Lukić, Kurti, Arsim, Reuter, Sandra, Díaz-Pollán, Beatriz, Sabater, Julia Origüen, Muñoz, Patricia, Azap, Alpay, ancak, Banu, Sahin, Arife, Akalin, Halis, Paniagua-García, María, Bravo-Ferrer, Jose M., Pérez-Galera, Salvador, Kostyanev, Tomislav, de Kraker, Marlieke E.A., Feifel, Jan, Palacios-Baena, Zaira R., Schotsman, Joost, Cantón, Rafael, Daikos, George L., Carevic, Biljana, Dragovac, Gorana, Tan, Lionel K., Raka, Lul, Hristea, Adriana, Viale, Pierluigi, Akova, Murat, Cano, Ángela, Reguera, Jose María, Bartoloni, Alessandro, Florescu, Simin-Aysel, Benea, Serban, Asensio, Ángel, Korten, Volkan, Grundmann, Hajo, Goossens, Herman, Bonten, Marc J., Gutiérrez-Gutiérrez, Belén, and Rodríguez-Baño, Jesús

Published
2024
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5. Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Author

de la Serna, Almudena, Monteau, Sophie, Palomo, Virginia, Soriano, Elena, Gutierrez, David, Moreno, Elisa, Palacios, Zaira, Morales, Isabel, Maldonado, Natalia, Ciezar, Antonio Plata, Ruiz Mesa, Juan Diego, Diaz, Beatriz Sobrino, Gomez, Ignacio Marquez, Camacho, Ines Perez, Frutos-Adame, Azahara, Guzman-Puche, Julia, Gracia-Ahufinger, Irene, Perez-Nadales, Elena, Torre-Gimenez, Julian, Pyrpasopoulou, Athina, Iosifidis, Elias, Chorafa, Elsa, Radovanovic, Ivana, Petrovic, Sladjana, Cvetkovi, Slavica, Melentijevic, Srdjan-Sanja, Bicmen, Can, Senol, Gunes, Tubau, Fe, Camara, Jordi, Gumucio, Victor Daniel, Bassoulis, Dimitris, Deliolanis, John, Pitiriga, Vassiliki Ch., Triarides, Nikolaos, Argiti, Efstathia, Legakis, Nikolaos J., Margarita, Kyriakidou, Gijón-Cordero, Desirée, Ruiz-Garbajosa, Patricia, Bartoloni, Alessandro, Rossolini, Gian Maria, Florescu, Simin-Aysel, Nica, Maria, Benea, Serban, Talapan, Daniela, Medić, Deana, Prijić, Sanja Maričić, Caballero, Mireia Cantero, Parra Ramírez, Lina M., Korten, Volkan, Bilgin, Hüseyin, Dalekos, George N., Stefos, Aggelos, Spyridis, Nikolaos, Michos, Athanasios, De Rosa, Francesco Giuseppe, Cavallo, Rossana, Petrosillo, Nicola, Dicaro, Antonio, Landini, Maria Paola, Ciofi degli Atti, Marta Luisa, Masanovic, Mileva, Matkovic, Dusan, Tsiodras, Sotirios, Blasi, Francesco, Di pasquale, Marta, Viscoli, Claudio, Vata, Andrei, Dorneanu, Olivia, Kapisyzi, Perlat, Vince, Adriana, Tsigou, Evdoxia, Maltezos, Efstratios, Komnos, Apostolos, Gogos, Charalampos, Franzetti, Fabio, Antonelli, Massimo, Lupse, Mihaela, Corneci, Dan, Tomescu, Dana, Georgescu, Anca, Bukarica, Ljiljana, Mitrović, Goran, Krstić, Nataša Lukić, Kurti, Arsim, Díaz-Pollán, Beatriz, Sabater, Julia Origüen, Muñoz, Patricia, Azap, Alpay, Sancak, Banu, Sahin, Arife, Akalin, Halis, Pérez-Galera, Salvador, Bravo-Ferrer, Jose M., Paniagua, María, Kostyanev, Tomislav, de Kraker, Marlieke E.A., Feifel, Jan, Sojo-Dorado, Jesús, Schotsman, Joost, Cantón, Rafael, Daikos, George L., Carevic, Biljana, Dragovac, Gorana, Tan, Lionel K., Raka, Lul, Hristea, Adriana, Viale, Pierluigi, Akova, Murat, Reguera, Jose María, Valiente de Santis, Lucía, Torre-Cisneros, Julián, Cano, Ángela, Roilides, Emmanuel, Radulovic, Lili, Kirakli, Cenk, Shaw, Evelyn, Falagas, Matthew E., Pintado, Vicente, Goossens, Herman, Bonten, Marc J., Gutiérrez-Gutiérrez, Belén, and Rodriguez-Baño, Jesús

Published
2023
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6. Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study

Author

Blumberg, Lucille, Chaussade, Hélène, Desclaux, Arnaud, Florence, Eric, Aysel Florescu, Simin, Glans, Hedvig, Glynn, Marielle, Goorhuis, Abraham, Klein, Marina, Malvy, Denis, McCollum, Andrea, Muñoz, José, Nguyen, Duc, Quilter, Laura, Rothe, Camilla, Soentjens, Patrick, Tumiotto, Camille, Vanhamel, Jef, Angelo, Kristina M, Smith, Teresa, Camprubí-Ferrer, Daniel, Balerdi-Sarasola, Leire, Díaz Menéndez, Marta, Servera-Negre, Guillermo, Barkati, Sapha, Duvignaud, Alexandre, Huber, Kristina L B, Chakravarti, Arpita, Bottieau, Emmanuel, Greenaway, Christina, Grobusch, Martin P, Mendes Pedro, Diogo, Asgeirsson, Hilmir, Popescu, Corneliu Petru, Martin, Charlotte, Licitra, Carmelo, de Frey, Albie, Schwartz, Eli, Beadsworth, Michael, Lloveras, Susana, Larsen, Carsten S, Guagliardo, Sarah Anne J, Whitehill, Florence, Huits, Ralph, Hamer, Davidson H, Kozarsky, Phyllis, and Libman, Michael

Published
2023
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7. Carbapenem-Resistant NDM and OXA-48- like Producing K. pneumoniae : From Menacing Superbug to a Mundane Bacteria; A Retrospective Study in a Romanian Tertiary Hospital.

Author

Lazar, Dragos Stefan, Nica, Maria, Dascalu, Amalia, Oprisan, Corina, Albu, Oana, Codreanu, Daniel Romeo, Kosa, Alma Gabriela, Popescu, Corneliu Petru, and Florescu, Simin Aysel

Subjects
KLEBSIELLA pneumoniae, CARBAPENEM-resistant bacteria, TREATMENT effectiveness, HEALTH policy, BACTERIA, GRAM-negative bacteria
Abstract

Background: Carbapenem-resistant Klebsiella pneumoniae (Cr-Kpn) is becoming a growing public health problem through the failure of adequate treatment. This study's objectives are to describe the sources of Cr-Kpn in our hospital over 22 months, associating factors with the outcome of Cr-Kpn-positive patients, especially those with NDM+OXA-48-like (New Delhi Metallo-β-Lactamase and oxacillinase-48), and the effectiveness of the treatments used. Methods: A retrospective observational cohort study including all hospitalized patients with Cr-Kpn isolates. We reported data as percentages and identified independent predictors for mortality over hospital time through multivariate analysis. Results: The main type of carbapenemases identified were NDM+OXA-48-like (49.4%). The statistical analysis identified that diabetes and co-infections with the Gram-negative, non-urinary sites of infection were factors of unfavorable evolution. The Cox regression model identified factors associated with a poor outcome: ICU admission (HR of 2.38), previous medical wards transition (HR of 4.69), and carbapenemase type NDM (HR of 5.98). We did not find the superiority of an antibiotic regimen, especially in the case of NDM+OXA-48-like. Conclusions: The increase in the incidence of Cr-Kpn infections, especially with NDM+OXA-48-like pathogens, requires a paradigm shift in both the treatment of infected patients and the control of the spread of these pathogens, which calls for a change in public health policy regarding the use of antibiotics and the pursuit of a One Health approach. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Emergence of Toscana Virus, Romania, 2017-2018

Author

Popescu, Corneliu P., Cotar, Ani I., Dinu, Sorin, Zaharia, Mihaela, Tardei, Gratiela, Ceausu, Emanoil, Badescu, Daniela, Ruta, Simona, Ceianu, Cornelia S., and Florescu, Simin A.

Subjects
Bunyaviruses -- Case studies -- Identification and classification, RNA virus infections -- Case studies, Hospital patients -- Case studies, Health
Abstract

Toscana phlebovirus (TOSV; genus Phlebovirus, family Phenuiviridae) is transmitted by sand flies. Three genetic lineages (A, B, and C) with different geographic distribution have been described to date. TOSV is [...]

Published
2021
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9. Diabetes mellitus and COVID-19 in the post-acute phase patients - possible links with physical and rehabilitation medicine and balneotherapy

Author

MUNTEANU Constantin, PĂUN, Diana-Loreta, ȘUȚĂ, Alina-Maria, FLORESCU, Simin Aysel, and ONOSE, Gelu

Subjects
diabetes mellitus/ diabetes, covid-19, sars-cov-2, rehabilitation and physical medicine, natural therapeutic factors, balneotherapy, Therapeutics. Pharmacology, RM1-950
Abstract

Background. The outbreak of COVID-19 - COronaVIrus Disease 2019 - has become a significant threat to public health worldwide, with high contagious capacity and varied mortality in different countries. Diabetes mellitus (DM/ diabetes) is among the most frequently reported comorbidities in patients with COVID-19. In the field of physical and rehabilitation medicine and balneotherapy, specific rehabilitation procedures, natural therapeutic factors, and physical activity are known to be contributive to mitigating some of the DM clinical-patho-biological consequences. Objective. This systematic review aims to rigorously select related articles and identify within their content, the main possible interferences between DM and COVID-19’s pathological mechanisms, and to discuss the value of physical and rehabilitation medicine and balneotherapy in the post-acute COVID-19 recovery of the surviving patients. Methods. This systematic review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searched for open-access articles published in English, between January and May 2020, from the following databases: Cochrane, Elsevier, PubMed and Web of Science. The contextually searched syntax used was ”DIABETES AND COVID-19”. The selected articles were analyzed in detail regarding both pathologies: COVID-19 and DM. The meta-analysis proceeded was designated to estimate the prevalence of DM among COVID-19 patients. Results. Our search has been conducted on five stages, described by a PRISMA adapted flow diagram. Within the first stage, using the syntax mentioned above resulted in 1,133 articles. After eliminating, in the second stage, all the inevitable redundancies remained 1,058 articles. In the third stage, we performed a PEDro qualitative analysis score weighted selection of all the papers and were kept 91 articles. In the fourth stage, were selected relevant issues for a meta-analysis regarding the prevalence of DM diabetes among COVID-19 cases, resulting 32 papers. The fifth stage of the PRISMA adapted flow diagram was dedicated to the analysis of the data regarding the use of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM, and COVID-19 patients in rehabilitation wards. For enhancing the bibliographical sources pool, we added from external, free found sources, another 15 articles. Discussion/ Limitation. COVID-19 is an acute illness condition and DM is a chronic one. Therefore, it is difficult for now, to have enough data enabling us to see all the repercussions of COVID-19 and to completely understand the significance of physical and rehabilitation medicine and balneotherapy, which applies in COVID-19 post-acute DM patients. Conclusions. This paper overviews the current state-of-the-art knowledge in the approach of DM /diabetes as COVID-19 comorbidity, with a focal point on the roles of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM and COVID-19 patients in rehabilitation wards, for possible actual and future connexions with the comprehensive management/ rehabilitation of such both chronic and post-acute survivors.

Published
2020
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10. Prediction of unfavorable outcomes in West Nile virus neuroinvasive infection – Result of a multinational ID-IRI study

Author

Popescu, Corneliu Petru, Florescu, Simin Aysel, Hasbun, Rodrigo, Harxhi, Arjan, Evendar, Razi, Kahraman, Hasip, Neuberger, Ami, Codreanu, Daniel, Zaharia, Mihaela Florentina, Tosun, Selma, Ceausu, Emanoil, Ruta, Simona Maria, Dragovac, Gorana, Pshenichnaya, Natalia, Gopatsa, Galina, Shmaylenko, Olga, Nagy, Éva, Malbasa, Jelena Djekic, Strbac, Mirjana, Pandak, Nenad, Pullukcu, Husnu, Lakatos, Botond, Cag, Yasemin, Cascio, Antonio, Coledan, Ilaria, Oncu, Serkan, and Erdem, Hakan

Published
2020
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11. Portraying infective endocarditis: results of multinational ID-IRI study

Author

Erdem, Hakan, Puca, Edmond, Ruch, Yvon, Santos, Lurdes, Ghanem-Zoubi, Nesrin, Argemi, Xavier, Hansmann, Yves, Guner, Rahmet, Tonziello, Gilda, Mazzucotelli, Jean-Philippe, Como, Najada, Kose, Sukran, Batirel, Ayse, Inan, Asuman, Tulek, Necla, Pekok, Abdullah Umut, Khan, Ejaz Ahmed, Iyisoy, Atilla, Meric-Koc, Meliha, Kaya-Kalem, Ayse, Martins, Pedro Palma, Hasanoglu, Imran, Silva-Pinto, André, Oztoprak, Nefise, Duro, Raquel, Almajid, Fahad, Dogan, Mustafa, Dauby, Nicolas, Gunst, Jesper Damsgaard, Tekin, Recep, Konopnicki, Deborah, Petrosillo, Nicola, Bozkurt, Ilkay, Wadi, Jamal, Popescu, Corneliu, Balkan, Ilker Inanc, Ozer-Balin, Safak, Zupanc, Tatjana Lejko, Cascio, Antonio, Dumitru, Irina Magdalena, Erdem, Aysegul, Ersoz, Gulden, Tasbakan, Meltem, Ajamieh, Oday Abu, Sirmatel, Fatma, Florescu, Simin, Gulsun, Serda, Ozkaya, Hacer Deniz, Sari, Sema, Tosun, Selma, Avci, Meltem, Cag, Yasemin, Celebi, Guven, Sagmak-Tartar, Ayse, Karakus, Sumeyra, Sener, Alper, Dedej, Arjeta, Oncu, Serkan, Del Vecchio, Rosa Fontana, Ozturk-Engin, Derya, and Agalar, Canan

Published
2019
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13. Fatal Yellow Fever in Travelers to Brazil, 2018

Author

Hamer, Davidson H., Angelo, Kristina, Caumes, Eric, van Genderen, Perry J.J., Florescu, Simin A., Popescu, Corneliu P., Perret, Cecilia, McBride, Angela, Checkley, Anna, Ryan, Jenny, Cetron, Martin, and Schlagenhauf, Patricia

Published
2018

14. Detection of anti-protease inhibitors resistance mutations in HCV strains infecting treatment-naïve chronic patients from Romania

Author

Dinu Sorin, Țârdei Grațiela, Ceaușu Emanoil, Florescu Simin Aysel, Micu Laurențiu, Ecobici Alina Monica, Mihăilă Mariana, and Oprișan Gabriela

Subjects
ns3 protease, direct-acting antivirals, resistance mutations, naïve to treatment patients, Medicine
Abstract

Background: Severe complications of chronic hepatitis C – i.e. cirrhosis and hepatocellular carcinoma – are important causes of morbidity and mortality worldwide. Despite the overwhelming rates of sustained virologic response achieved after therapy with different combinations of direct-acting antiviral drugs (DAAs), treatment failure is still recorded, and is due to the mutations harboured by hepatitis C virus (HCV) resistance associated variants (RAVs) selected during therapy. Baseline RAVs testing was found significant for guiding treatment in the cases of treatment failure and, sometimes, in naïve patients.

Published
2018
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16. Training in infectious diseases across Europe in 2021 – a survey on training delivery, content and assessment

Author

Ahl, Jonas, Ambrozaitis, Arvydas, Azap, Alpay, Beović, Bojana, Castelli, Francesco, Cisneros, José Miguel, Constantinou, Costas, Van Delden, Christian, De Barra, Eoghan, De Munter, Paul, Džupová, Olga, Fätkenheuer, Gerd, Flisiak, Robert, Florescu, Simin Aysel, Fsadni, Claudia, Holmberg, Ville, Jensen-Fangel, Søren, Koehler, Philipp, Kristjánsson, Már, Lind, Andreas, Michos, Athanasios, Miller, Alastair, Muller, Zsofia, Oliveira, Joaquim, Paul, Mical, Sal, Ertan, Santini, Marija, Sargsyants, Narina, Soják, L'ubomir, Soodla, Pilleriin, Staub, Therese, Thalhammer, Florian, Verbon, Annelies, Verdon, Renaud, Wegrzyn, Zbigniew, Brockhoff, Ronja A., Hicks, Scott R., Salmanton-García, Jon, Dušek, Davorka, Stahl, Jean-Paul, Beeching, Nick J., and Cornely, Oliver A.

Published
2021
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18. Neurologic complications of influenza B virus infection in adults, Romania

Author

Popescu, Corneliu P., Florescu, Simin A., Lupulescu, Emilia, Zaharia, Mihaela, Tardei, Gratiela, Lazar, Mihaela, Ceausu, Emanoil, and Ruta, Simona M.

Subjects
Influenza viruses, Epidemics -- Development and progression -- Japan -- Romania, Influenza -- Development and progression, Encephalitis -- Development and progression, Health
Abstract

Influenza viruses are negative single-stranded RNA viruses belonging to the family Orthomvxoviridae and cause worldwide epidemics of influenza with high rates of illness and death. Human influenza A and B [...]

Published
2017
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21. Epidemiology, hospitalization cost, and socioeconomic burden of COVID-19 in Romania

Author

Laszlo Lorenzovici, Sz��kely, Andrea, Kal��, Zolt��n, Farkas-R��duly, Szabolcs, Ad��l Gy��ngyv��r Nagy, Nyulas, Bernadett, Precup, Andreea Mihaela, Pavel, Mihai Laurentiu, Gheorghe, Maria, Calcan, Alexandru, Tar, Gy��ngyi, Adam, Ovidiu, Bradacs, Aliz, Briciu, Violeta Tincuta, Florescu, Simin Aysel, Ianosi, Edith Simona, G��rbovan, Ovidiu, Siriopol, Dimitrie Cristian, and Vok��, Zolt��n

Published
2022
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22. Microbiota-based markers predictive of development of Clostridioides difficile infection

Author

Berkell, Matilda, Mysara, Mohamed, Xavier, Britto Basil, van Werkhoven, Cornelis H., Monsieurs, Pieter, Lammens, Christine, Ducher, Annie, Vehreschild, Maria J.G.T., Goossens, Herman, de Gunzburg, Jean, Bonten, Marc J. M., Malhotra, Surbhi, Ahmed, Mohamed Mysara, Engbers, Annemarie, de Regt, Marieke, Biehl, Lena M., Cornely, Oliver A., Jazmati, Nathalie, Bouverne, Marie-Noelle, Sablier-Gallis, Frederique, Mentre, France, Merle, Uta, Stallmach, Andreas, Rupp, Jan, Bogner, Johannes, Lubbert, Christoph, Silling, Gerda, Witzke, Oliver, Gikas, Achilleas, Maraki, Sofia, Daikos, George, Tsiodras, Sotirios, Skoutelis, Athanasios, Sambatakou, Helen, Pujol, Miguel, Dominguez-Luzon, M. Angeles, Aguado, Jose M., Bouza, Emilio, Cobo, Javier, Rodriguez-Bano, Jesus, Almirante, Benito, de la Cisneros, Julian Torre, Florescu, Simin A., Nica, Maria, Vata, Andrei, Hristea, Adriana, Lupse, Mihaela, Herghea, Delia, Postil, Deborah, Barraud, Olivier, Molina, Jean-Michel, De Lastours, Victoire, Guimard, Thomas, Talarmin, Jean-Philippe, Duval, Xavier, Bernard, Louis, Launay, Odile, ANTICIPATE Study Group, Engbers, Annemarie, de Regt, Marieke, Biehl, Lena M., Cornely, Oliver A., Jazmati, Nathalie, Bouverne, Marie-Noelle, Sablier-Gallis, Frederique, Mentré, France, Merle, Uta, Stallmach, Andreas, Rupp, Jan, Bogner, Johannes, Lübbert, Christoph, Silling, Gerda, Witzke, Oliver, Gikas, Achilleas, Maraki, Sofia, Daikos, George, Tsiodras, Sotirios, Skoutelis, Athanasios, Sambatakou, Helen, Pujol, Miquel, Dominguez-Luzon, M. Angeles, Aguado, Jose M., Bouza, Emilio, Cobo, Javier, Rodríguez-Baño, Jesús, Almirante, Benito, de la Torre Cisneros, Julian, Florescu, Simin A., Nica, Maria, Vata, Andrei, Hristea, Adriana, Lupse, Mihaela, Herghea, Delia, Postil, Deborah, Barraud, Olivier, Molina, Jean-Michel, De Lastours, Victoire, Guimard, Thomas, Talarmin, Jean-Philippe, Duval, Xavier, Bernard, Louis, and Launay, Odile

Subjects
0301 basic medicine, Male, Malalties bacterianes grampositives, genetic structures, Antibiotics, Medizin, General Physics and Astronomy, Prevotella, Prospective Studies, Prospective cohort study, Bifidobacterium, Multidisciplinary, biology, Microbiota, Middle Aged, 3. Good health, Anti-Bacterial Agents, Diarrhea, Cohort, Female, medicine.symptom, Engineering sciences. Technology, medicine.medical_specialty, medicine.drug_class, Science, 030106 microbiology, Predictive markers, General Biochemistry, Genetics and Molecular Biology, Article, 03 medical and health sciences, Internal medicine, medicine, Humans, Microbiome, Aged, Gram-positive bacterial infections, Bacteria, business.industry, Clostridioides difficile, General Chemistry, biology.organism_classification, medicine.disease, Gastrointestinal Microbiome, 030104 developmental biology, Next-generation sequencing, Clostridium Infections, Human medicine, business, Dysbiosis, Biomarkers
Abstract

Antibiotic-induced modulation of the intestinal microbiota can lead to Clostridioides difficile infection (CDI), which is associated with considerable morbidity, mortality, and healthcare-costs globally. Therefore, identification of markers predictive of CDI could substantially contribute to guiding therapy and decreasing the infection burden. Here, we analyze the intestinal microbiota of hospitalized patients at increased CDI risk in a prospective, 90-day cohort-study before and after antibiotic treatment and at diarrhea onset. We show that patients developing CDI already exhibit significantly lower diversity before antibiotic treatment and a distinct microbiota enriched in Enterococcus and depleted of Ruminococcus, Blautia, Prevotella and Bifidobacterium compared to non-CDI patients. We find that antibiotic treatment-induced dysbiosis is class-specific with beta-lactams further increasing enterococcal abundance. Our findings, validated in an independent prospective patient cohort developing CDI, can be exploited to enrich for high-risk patients in prospective clinical trials, and to develop predictive microbiota-based diagnostics for management of patients at risk for CDI., Clostridioides difficile infection (CDI) is the most common cause of antibiotic-associated diarrhoea (AAD); however, markers predictive of CDI or AAD development are as yet lacking. Here, to identify markers predictive of CDI, the authors profile the intestinal microbiota of 945 hospitalised patients from 34 hospitals in 6 different European countries and show distinct microbiota enriched in Enterococcus and depleted of Ruminococcus, Blautia, Prevotella and Bifidobacterium compared to non-CDI patients.

Published
2021
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23. Randomized Clinical Trial of Regdanvimab in High-Risk Patients With Mild-to-Moderate Coronavirus Disease 2019.

Author

Kim, Jin Yong, Săndulescu, Oana, Preotescu, Liliana-Lucia, Rivera-Martínez, Norma E, Dobryanska, Marta, Birlutiu, Victoria, Miftode, Egidia G, Gaibu, Natalia, Caliman-Sturdza, Olga, Florescu, Simin-Aysel, Shi, Hye Jin, Streinu-Cercel, Anca, Streinu-Cercel, Adrian, Lee, Sang Joon, Kim, Sung Hyun, Chang, Ilsung, Bae, Yun Ju, Suh, Jee Hye, Chung, Da Rae, and Kim, Sun Jung

Subjects
SARS-CoV-2, COVID-19, CLINICAL trials, CLINICAL trial registries, SARS-CoV-2 Omicron variant, CORONAVIRUS diseases
Abstract

Background We evaluated clinical effectiveness of regdanvimab (CT-P59), a severe acute respiratory syndrome coronavirus 2 neutralizing monoclonal antibody, in reducing disease progression and clinical recovery time in patients with mild-to-moderate coronavirus disease 2019 (COVID-19), primarily Alpha variant. Methods This was phase 3 of a phase 2/3 parallel-group, double-blind, randomized clinical trial. Outpatients with mild-to-moderate COVID-19 were randomized to single-dose regdanvimab 40 mg/kg (n = 656) or placebo (n = 659), alongside standard of care. The primary endpoint was COVID-19 disease progression up to day 28 among "high-risk" patients. Key secondary endpoints were disease progression (all randomized patients) and time to recovery (high-risk and all randomized patients). Results Of 1315 randomized patients, 880 were high risk; the majority were infected with Alpha variant. The proportion with disease progression was lower (14/446, 3.1% [95% confidence interval {CI}, 1.9%–5.2%] vs 48/434, 11.1% [95% CI, 8.4%–14.4%]; P  < .001) and time to recovery was shorter (median, 9.27 days [95% CI, 8.27–11.05 days] vs not reached [95% CI, 12.35–not calculable]; P  < .001) with regdanvimab than placebo. Consistent improvements were seen in all randomized and non-high-risk patients who received regdanvimab. Viral load reductions were more rapid with regdanvimab. Infusion-related reactions occurred in 11 patients (4/652 [0.6%] regdanvimab, 7/650 [1.1%] placebo). Treatment-emergent serious adverse events were reported in 5 of (4/652 [0.6%] regdanvimab and 1/650 [0.2%] placebo). Conclusions Regdanvimab was an effective treatment for patients with mild-to-moderate COVID-19, significantly reducing disease progression and clinical recovery time without notable safety concerns prior to the emergence of the Omicron variant. Clinical Trials Registration NCT04602000; 2020-003369-20 (EudraCT). [ABSTRACT FROM AUTHOR]

Published
2022
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24. Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19:The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial

Author

Angus, Derek C, Derde, Lennie, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen, Beane, Abigail, van Bentum-Puijk, Wilma, Berry, Lindsay, Bhimani, Zahra, Bonten, Marc, Bradbury, Charlotte, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Cheng, Allen C, de Jong, Menno, Detry, Michelle, Estcourt, Lise, Fitzgerald, Mark, Goossens, Herman, Green, Cameron, Haniffa, Rashan, Higgins, Alisa M, Horvat, Christopher, Hullegie, Sebastiaan J, Kruger, Peter, Lamontagne, Francois, Lawler, Patrick R, Linstrum, Kelsey, Litton, Edward, Lorenzi, Elizabeth, Marshall, John, McAuley, Daniel, McGlothin, Anna, McGuinness, Shay, McVerry, Bryan, Montgomery, Stephanie, Mouncey, Paul, Murthy, Srinivas, Nichol, Alistair, Parke, Rachael, Parker, Jane, Rowan, Kathryn, Sanil, Ashish, Santos, Marlene, Saunders, Christina, Seymour, Christopher, Turner, Anne, van de Veerdonk, Frank, Venkatesh, Balasubramanian, Zarychanski, Ryan, Berry, Scott, Lewis, Roger J, McArthur, Colin, Webb, Steven A, Gordon, Anthony C, Writing Committee for the REMAP-CAP Investigators, Angus, Derek, Cheng, Allen, De Jong, Menno, Gordon, Anthony, Lawler, Patrick, Webb, Steve, Campbell, Lewis, Forbes, Andrew, Gattas, David, Heritier, Stephane, Higgins, Lisa, Peake, Sandra, Presneill, Jeffrey, Seppelt, Ian, Trapani, Tony, Young, Paul, Bagshaw, Sean, Daneman, Nick, Ferguson, Niall, Misak, Cheryl, Hullegie, Sebastiaan, Pletz, Mathias, Rohde, Gernot, Rowan, Kathy, Alexander, Brian, Basile, Kim, Girard, Timothy, Huang, David, Vates, Jennifer, Beasley, Richard, Fowler, Robert, McGloughlin, Steve, Morpeth, Susan, Paterson, David, Venkatesh, Bala, Uyeki, Tim, Baillie, Kenneth, Duffy, Eamon, Fowler, Rob, Hills, Thomas, Orr, Katrina, Patanwala, Asad, Tong, Steve, Netea, Mihai, Bihari, Shilesh, Carrier, Marc, Fergusson, Dean, Goligher, Ewan, Haidar, Ghady, Hunt, Beverley, Kumar, Anand, Laffan, Mike, Lawless, Patrick, Lother, Sylvain, McCallum, Peter, Middeldopr, Saskia, McQuilten, Zoe, Neal, Matthew, Pasi, John, Schutgens, Roger, Stanworth, Simon, Turgeon, Alexis, Weissman, Alexandra, Adhikari, Neill, Anstey, Matthew, Brant, Emily, de Man, Angelique, Lamonagne, Francois, Masse, Marie-Helene, Udy, Andrew, Arnold, Donald, Begin, Phillipe, Charlewood, Richard, Chasse, Michael, Coyne, Mark, Cooper, Jamie, Daly, James, Gosbell, Iain, Harvala-Simmonds, Heli, Hills, Tom, MacLennan, Sheila, Menon, David, McDyer, John, Pridee, Nicole, Roberts, David, Shankar-Hari, Manu, Thomas, Helen, Tinmouth, Alan, Triulzi, Darrell, Walsh, Tim, Wood, Erica, Calfee, Carolyn, O’Kane, Cecilia, Shyamsundar, Murali, Sinha, Pratik, Thompson, Taylor, Young, Ian, Bihari, Shailesh, Hodgson, Carol, Laffey, John, McAuley, Danny, Orford, Neil, Neto, Ary, Lewis, Roger, McGlothlin, Anna, Miller, Eliza, Singh, Vanessa, Zammit, Claire, van Bentum Puijk, Wilma, Bouwman, Wietske, Mangindaan, Yara, Parker, Lorraine, Peters, Svenja, Rietveld, Ilse, Raymakers, Kik, Ganpat, Radhika, Brillinger, Nicole, Markgraf, Rene, Ainscough, Kate, Brickell, Kathy, Anjum, Aisha, Lane, Janis-Best, Richards-Belle, Alvin, Saull, Michelle, Wiley, Daisy, Bion, Julian, Connor, Jason, Gates, Simon, Manax, Victoria, van der Poll, Tom, Reynolds, John, van Beurden, Marloes, Effelaar, Evelien, Schotsman, Joost, Boyd, Craig, Harland, Cain, Shearer, Audrey, Wren, Jess, Clermont, Giles, Garrard, William, Kalchthaler, Kyle, King, Andrew, Ricketts, Daniel, Malakoutis, Salim, Marroquin, Oscar, Music, Edvin, Quinn, Kevin, Cate, Heidi, Pearson, Karen, Collins, Joanne, Hanson, Jane, Williams, Penny, Jackson, Shane, Asghar, Adeeba, Dyas, Sarah, Sutu, Mihaela, Murphy, Sheenagh, Williamson, Dawn, Mguni, Nhlanhla, Potter, Alison, Porter, David, Goodwin, Jayne, Rook, Clare, Harrison, Susie, Williams, Hannah, Campbell, Hilary, Lomme, Kaatje, Williamson, James, Sheffield, Jonathan, van’t Hoff, Willian, McCracken, Phobe, Young, Meredith, Board, Jasmin, Mart, Emma, Knott, Cameron, Smith, Julie, Boschert, Catherine, Affleck, Julia, Ramanan, Mahesh, D’Souza, Ramsy, Pateman, Kelsey, Shakih, Arif, Cheung, Winston, Kol, Mark, Wong, Helen, Shah, Asim, Wagh, Atul, Simpson, Joanne, Duke, Graeme, Chan, Peter, Cartner, Brittney, Hunter, Stephanie, Laver, Russell, Shrestha, Tapaswi, Regli, Adrian, Pellicano, Annamaria, McCullough, James, Tallott, Mandy, Kumar, Nikhil, Panwar, Rakshit, Brinkerhoff, Gail, Koppen, Cassandra, Cazzola, Federica, Brain, Matthew, Mineall, Sarah, Fischer, Roy, Biradar, Vishwanath, Soar, Natalie, White, Hayden, Estensen, Kristen, Morrison, Lynette, Smith, Joanne, Cooper, Melanie, Health, Monash, Shehabi, Yahya, Al-Bassam, Wisam, Hulley, Amanda, Whitehead, Christina, Lowrey, Julie, Gresha, Rebecca, Walsham, James, Meyer, Jason, Harward, Meg, Venz, Ellen, Williams, Patricia, Kurenda, Catherine, Smith, Kirsy, Smith, Margaret, Garcia, Rebecca, Barge, Deborah, Byrne, Deborah, Byrne, Kathleen, Driscoll, Alana, Fortune, Louise, Janin, Pierre, Yarad, Elizabeth, Hammond, Naomi, Bass, Frances, Ashelford, Angela, Waterson, Sharon, Wedd, Steve, McNamara, Robert, Buhr, Heidi, Coles, Jennifer, Schweikert, Sacha, Wibrow, Bradley, Rauniyar, Rashmi, Myers, Erina, Fysh, Ed, Dawda, Ashlish, Mevavala, Bhaumik, Litton, Ed, Ferrier, Janet, Nair, Priya, Buscher, Hergen, Reynolds, Claire, Santamaria, John, Barbazza, Leanne, Homes, Jennifer, Smith, Roger, Murray, Lauren, Brailsford, Jane, Forbes, Loretta, Maguire, Teena, Mariappa, Vasanth, Smith, Judith, Simpson, Scott, Maiden, Matthew, Bone, Allsion, Horton, Michelle, Salerno, Tania, Sterba, Martin, Geng, Wenli, Depuydt, Pieter, De Waele, Jan, De Bus, Liesbet, Fierens, Jan, Bracke, Stephanie, Reeve, Brenda, Dechert, William, Chassé, Michaël, Carrier, François Martin, Boumahni, Dounia, Benettaib, Fatna, Ghamraoui, Ali, Bellemare, David, Cloutier, Ève, Francoeur, Charles, Lamontagne, François, D’Aragon, Frédérick, Carbonneau, Elaine, Leblond, Julie, Vazquez-Grande, Gloria, Marten, Nicole, Wilson, Maggie, Albert, Martin, Serri, Karim, Cavayas, Alexandros, Duplaix, Mathilde, Williams, Virginie, Rochwerg, Bram, Karachi, Tim, Oczkowski, Simon, Centofanti, John, Millen, Tina, Duan, Erick, Tsang, Jennifer, Patterson, Lisa, English, Shane, Watpool, Irene, Porteous, Rebecca, Miezitis, Sydney, McIntyre, Lauralyn, Brochard, Laurent, Burns, Karen, Sandhu, Gyan, Khalid, Imrana, Binnie, Alexandra, Powell, Elizabeth, McMillan, Alexandra, Luk, Tracy, Aref, Noah, Andric, Zdravko, Cviljevic, Sabina, Đimoti, Renata, Zapalac, Marija, Mirković, Gordan, Baršić, Bruno, Kutleša, Marko, Kotarski, Viktor, Vujaklija Brajković, Ana, Babel, Jakša, Sever, Helena, Dragija, Lidija, Kušan, Ira, Vaara, Suvi, Pettilä, Leena, Heinonen, Jonna, Kuitunen, Anne, Karlsson, Sari, Vahtera, Annukka, Kiiski, Heikki, Ristimäki, Sanna, Azaiz, Amine, Charron, Cyril, Godement, Mathieu, Geri, Guillaume, Vieillard-Baron, Antoine, Pourcine, Franck, Monchi, Mehran, Luis, David, Mercier, Romain, Sagnier, Anne, Verrier, Nathalie, Caplin, Cecile, Siami, Shidasp, Aparicio, Christelle, Vautier, Sarah, Jeblaoui, Asma, Fartoukh, Muriel, Courtin, Laura, Labbe, Vincent, Leparco, Cécile, Muller, Grégoire, Nay, Mai-Anh, Kamel, Toufik, Benzekri, Dalila, Jacquier, Sophie, Mercier, Emmanuelle, Chartier, Delphine, Salmon, Charlotte, Dequin, PierreFrançois, Schneider, Francis, Morel, Guillaume, L’Hotellier, Sylvie, Badie, Julio, Berdaguer, Fernando Daniel, Malfroy, Sylvain, Mezher, Chaouki, Bourgoin, Charlotte, Megarbane, Bruno, Voicu, Sebastian, Deye, Nicolas, Malissin, Isabelle, Sutterlin, Laetitia, Guitton, Christophe, Darreau, Cédric, Landais, Mickaël, Chudeau, Nicolas, Robert, Alain, Moine, Pierre, Heming, Nicholas, Maxime, Virginie, Bossard, Isabelle, Nicholier, Tiphaine Barbarin, Colin, Gwenhael, Zinzoni, Vanessa, Maquigneau, Natacham, Finn, André, Kreß, Gabriele, Hoff, Uwe, Friedrich Hinrichs, Carl, Nee, Jens, Hagel, Stefan, Ankert, Juliane, Kolanos, Steffi, Bloos, Frank, Petros, Sirak, Pasieka, Bastian, Kunz, Kevin, Appelt, Peter, Schütze, Bianka, Kluge, Stefan, Nierhaus, Axel, Jarczak, Dominik, Roedl, Kevin, Weismann, Dirk, Frey, Anna, Klinikum Neukölln, Vivantes, Reill, Lorenz, Distler, Michael, Maselli, Astrid, Bélteczki, János, Magyar, István, Fazekas, Ágnes, Kovács, Sándor, Szőke, Viktória, Szigligeti, Gábor, Leszkoven, János, Collins, Daniel, Breen, Patrick, Frohlich, Stephen, Whelan, Ruth, McNicholas, Bairbre, Scully, Michael, Casey, Siobhan, Kernan, Maeve, Doran, Peter, O’Dywer, Michael, Smyth, Michelle, Hayes, Leanne, Hoiting, Oscar, Peters, Marco, Rengers, Els, Evers, Mirjam, Prinssen, Anton, Bosch Ziekenhuis, Jeroen, Simons, Koen, Rozendaal, Wim, Polderman, F, de Jager, P, Moviat, M, Paling, A, Salet, A, Rademaker, Emma, Peters, Anna Linda, de Jonge, E, Wigbers, J, Guilder, E, Butler, M, Cowdrey, Keri-Anne, Newby, Lynette, Chen, Yan, Simmonds, Catherine, McConnochie, Rachael, Ritzema Carter, Jay, Henderson, Seton, Van Der Heyden, Kym, Mehrtens, Jan, Williams, Tony, Kazemi, Alex, Song, Rima, Lai, Vivian, Girijadevi, Dinu, Everitt, Robert, Russell, Robert, Hacking, Danielle, Buehner, Ulrike, Williams, Erin, Browne, Troy, Grimwade, Kate, Goodson, Jennifer, Keet, Owen, Callender, Owen, Martynoga, Robert, Trask, Kara, Butler, Amelia, Schischka, Livia, Young, Chelsea, Lesona, Eden, Olatunji, Shaanti, Robertson, Yvonne, José, Nuno, Amaro dos Santos Catorze, Teodoro, de Lima Pereira, Tiago Nuno Alfaro, Neves Pessoa, Lucilia Maria, Castro Ferreira, Ricardo Manuel, Pereira Sousa Bastos, Joana Margarida, Aysel Florescu, Simin, Stanciu, Delia, Zaharia, Miahela Florentina, Kosa, Alma Gabriela, Codreanu, Daniel, Marabi, Yaseen, Al Qasim, Eman, Moneer Hagazy, Mohamned, Al Swaidan, Lolowa, Arishi, Hatim, Muñoz-Bermúdez, Rosana, Marin-Corral, Judith, Salazar Degracia, Anna, Parrilla Gómez, Francisco, Mateo López, Maria Isabel, Rodriguez Fernandez, Jorge, Cárcel Fernández, Sheila, Carmona Flores, Rosario, León López, Rafael, de la Fuente Martos, Carmen, Allan, Angela, Polgarova, Petra, Farahi, Neda, McWilliam, Stephen, Hawcutt, Daniel, Rad, Laura, O’Malley, Laura, Whitbread, Jennifer, Kelsall, Olivia, Wild, Laura, Thrush, Jessica, Wood, Hannah, Austin, Karen, Donnelly, Adrian, Kelly, Martin, O’Kane, Sinéad, McClintock, Declan, Warnock, Majella, Johnston, Paul, Gallagher, Linda Jude, Mc Goldrick, Clare, Mc Master, Moyra, Strzelecka, Anna, Jha, Rajeev, Kalogirou, Michael, Ellis, Christine, Krishnamurthy, Vinodh, Deelchand, Vashish, Silversides, Jon, McGuigan, Peter, Ward, Kathryn, O’Neill, Aisling, Finn, Stephanie, Phillips, Barbara, Mullan, Dee, Oritz-Ruiz de Gordoa, Laura, Thomas, Matthew, Sweet, Katie, Grimmer, Lisa, Johnson, Rebekah, Pinnell, Jez, Robinson, Matt, Gledhill, Lisa, Wood, Tracy, Morgan, Matt, Cole, Jade, Hill, Helen, Davies, Michelle, Antcliffe, David, Templeton, Maie, Rojo, Roceld, Coghlan, Phoebe, Smee, Joanna, Mackay, Euan, Cort, Jon, Whileman, Amanda, Spencer, Thomas, Spittle, Nick, Kasipandian, Vidya, Patel, Amit, Allibone, Suzanne, Genetu, Roman Mary, Ramali, Mohamed, Ghosh, Alison, Bamford, Peter, London, Emily, Cawley, Kathryn, Faulkner, Maria, Jeffrey, Helen, Smith, Tim, Brewer, Chris, Gregory, Jane, Limb, James, Cowton, Amanda, O’Brien, Julie, Nikitas, Nikitas, Wells, Colin, Lankester, Liana, Pulletz, Mark, Birch, Jenny, Wiseman, Sophie, Horton, Sarah, Alegria, Ana, Turki, Salah, Elsefi, Tarek, Crisp, Nikki, Allen, Louise, McCullagh, Iain, Robinson, Philip, Hays, Carole, Babio-Galan, Maite, Stevenson, Hannah, Khare, Divya, Pinder, Meredith, Selvamoni, Selvin, Gopinath, Amitha, Pugh, Richard, Menzies, Daniel, Mackay, Callum, Allan, Elizabeth, Davies, Gwyneth, Puxty, Kathryn, McCue, Claire, Cathcart, Susanne, Hickey, Naomi, Ireland, Jane, Yusuff, Hakeem, Isgro, Graziella, Brightling, Chris, Bourne, Michelle, Craner, Michelle, Watters, Malcolm, Prout, Rachel, Davies, Louisa, Pegler, Suzannah, Kyeremeh, Lynsey, Arbane, Gill, Wilson, Karen, Gomm, Linda, Francia, Federica, Brett, Stephen, Sousa Arias, Sonia, Elin Hall, Rebecca, Budd, Joanna, Small, Charlotte, Birch, Janine, Collins, Emma, Henning, Jeremy, Bonner, Stephen, Hugill, Keith, Cirstea, Emanuel, Wilkinson, Dean, Karlikowski, Michal, Sutherland, Helen, Wilhelmsen, Elva, Woods, Jane, North, Julie, Sundaran, Dhinesh, Hollos, Laszlo, Coburn, Susan, Walsh, Joanne, Turns, Margaret, Hopkins, Phil, Smith, John, Noble, Harriet, Depante, Maria Theresa, Clarey, Emma, Laha, Shondipon, Verlander, Mark, Williams, Alexandra, Huckle, Abby, Hall, Andrew, Cooke, Jill, Gardiner-Hill, Caroline, Maloney, Carolyn, Qureshi, Hafiz, Flint, Neil, Nicholson, Sarah, Southin, Sara, Nicholson, Andrew, Borgatta, Barbara, Turner-Bone, Ian, Reddy, Amie, Wilding, Laura, Chamara Warnapura, Loku, Agno Sathianathan, Ronan, Golden, David, Hart, Ciaran, Jones, Jo, Bannard-Smith, Jonathan, Henry, Joanne, Birchall, Katie, Pomeroy, Fiona, Quayle, Rachael, Makowski, Arystarch, Misztal, Beata, Ahmed, Iram, KyereDiabour, Thyra, Naiker, Kevin, Stewart, Richard, Mwaura, Esther, Mew, Louise, Wren, Lynn, Willams, Felicity, Innes, Richard, Doble, Patricia, Hutter, Joanne, Shovelton, Charmaine, Plumb, Benjamin, Szakmany, Tamas, Hamlyn, Vincent, Hawkins, Nancy, Lewis, Sarah, Dell, Amanda, Gopal, Shameer, Ganguly, Saibal, Smallwood, Andrew, Harris, Nichola, Metherell, Stella, Lazaro, Juan Martin, Newman, Tabitha, Fletcher, Simon, Nortje, Jurgens, Fottrell-Gould, Deirdre, Randell, Georgina, Zaman, Mohsin, Elmahi, Einas, Jones, Andrea, Hall, Kathryn, Mills, Gary, Ryalls, Kim, Bowler, Helen, Sall, Jas, Bourne, Richard, Borrill, Zoe, Duncan, Tracey, Lamb, Thomas, Shaw, Joanne, Fox, Claire, Moreno Cuesta, Jeronimo, Xavier, Kugan, Purohit, Dharam, Elhassan, Munzir, Bakthavatsalam, Dhanalakshmi, Rowland, Matthew, Hutton, Paula, Bashyal, Archana, Davidson, Neil, Hird, Clare, Chhablani, Manish, Phalod, Gunjan, Kirkby, Amy, Archer, Simon, Netherton, Kimberley, Reschreiter, Henrik, Camsooksai, Julie, Patch, Sarah, Jenkins, Sarah, Pogson, David, Rose, Steve, Daly, Zoe, Brimfield, Lutece, Claridge, Helen, Parekh, Dhruv, Bergin, Colin, Bates, Michelle, Dasgin, Joanne, McGhee, Christopher, Sim, Malcolm, Hay, Sophie Kennedy, Henderson, Steven, Phull, Mandeep-Kaur, Zaidi, Abbas, Pogreban, Tatiana, Rosaroso, Lace Paulyn, Harvey, Daniel, Lowe, Benjamin, Meredith, Megan, Ryan, Lucy, Hormis, Anil, Walker, Rachel, Collier, Dawn, Kimpton, Sarah, Oakley, Susan, Rooney, Kevin, Rodden, Natalie, Hughes, Emma, Thomson, Nicola, McGlynn, Deborah, Walden, Andrew, Jacques, Nicola, Coles, Holly, Tilney, Emma, Vowell, Emma, Schuster-Bruce, Martin, Pitts, Sally, Miln, Rebecca, Purandare, Laura, Vamplew, Luke, Spivey, Michael, Bean, Sarah, Burt, Karen, Moore, Lorraine, Day, Christopher, Gibson, Charly, Gordon, Elizabeth, Zitter, Letizia, Keenan, Samantha, Baker, Evelyn, Cherian, Shiney, Cutler, Sean, Roynon-Reed, Anna, Harrington, Kate, Raithatha, Ajay, Bauchmuller, Kris, Ahmad, Norfaizan, Grecu, Irina, Trodd, Dawn, Martin, Jane, Wrey Brown, Caroline, Arias, Ana-Marie, Craven, Thomas, Hope, David, Singleton, Jo, Clark, Sarah, Rae, Nicola, Welters, Ingeborg, Hamilton, David Oliver, Williams, Karen, Waugh, Victoria, Shaw, David, Puthucheary, Zudin, Martin, Timothy, Santos, Filipa, Uddin, Ruzena, Somerville, Alastair, Tatham, Kate Colette, Jhanji, Shaman, Black, Ethel, Dela Rosa, Arnold, Howle, Ryan, Tully, Redmond, Drummond, Andrew, Dearden, Joy, Philbin, Jennifer, Munt, Sheila, Vuylsteke, Alain, Chan, Charles, Victor, Saji, Matsa, Ramprasad, Gellamucho, Minerva, Creagh-Brown, Ben, Tooley, Joe, Montague, Laura, De Beaux, Fiona, Bullman, Laetitia, Kersiake, Ian, Demetriou, Carrie, Mitchard, Sarah, Ramos, Lidia, White, Katie, Donnison, Phil, Johns, Maggie, Casey, Ruth, Mattocks, Lehentha, Salisbury, Sarah, Dark, Paul, Claxton, Andrew, McLachlan, Danielle, Slevin, Kathryn, Lee, Stephanie, Hulme, Jonathan, Joseph, Sibet, Kinney, Fiona, Senya, Ho Jan, Oborska, Aneta, Kayani, Abdul, Hadebe, Bernard, Orath Prabakaran, Rajalakshmi, Nichols, Lesley, Thomas, Matt, Worner, Ruth, Faulkner, Beverley, Gendall, Emma, Hayes, Kati, Hamilton-Davies, Colin, Chan, Carmen, Mfuko, Celina, Abbass, Hakam, Mandadapu, Vineela, Leaver, Susannah, Forton, Daniel, Patel, Kamal, Paramasivam, Elankumaran, Powell, Matthew, Gould, Richard, Wilby, Elizabeth, Howcroft, Clare, Banach, Dorota, Fernández de Pinedo Artaraz, Ziortza, Cabreros, Leilani, White, Ian, Croft, Maria, Holland, Nicky, Pereira, Rita, Zaki, Ahmed, Johnson, David, Jackson, Matthew, Garrard, Hywel, Juhaz, Vera, Roy, Alistair, Rostron, Anthony, Woods, Lindsey, Cornell, Sarah, Pillai, Suresh, Harford, Rachel, Rees, Tabitha, Ivatt, Helen, Sundara Raman, Ajay, Davey, Miriam, Lee, Kelvin, Barber, Russell, Chablani, Manish, Brohi, Farooq, Jagannathan, Vijay, Clark, Michele, Purvis, Sarah, Wetherill, Bill, Dushianthan, Ahilanandan, Cusack, Rebecca, de Courcy-Golder, Kim, Smith, Simon, Jackson, Susan, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiao Bei, Oza, Deepali, Rhodes, Jonathan, Anderson, Tom, Morris, Sheila, Xia Le Tai, Charlotte, Thomas, Amy, Keen, Alexandra, Digby, Stephen, Cowley, Nicholas, Southern, David, Reddy, Harsha, Campbell, Andy, Watkins, Claire, Smuts, Sara, Touma, Omar, Barnes, Nicky, Alexander, Peter, Felton, Tim, Ferguson, Susan, Sellers, Katharine, Bradley-Potts, Joanne, Yates, David, Birkinshaw, Isobel, Kell, Kay, Marshall, Nicola, Carr-Knott, Lisa, Writing Committee for the REMAP-CAP Investigators, Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, Medical Microbiology and Infection Prevention, and AII - Infectious diseases

Subjects
Male, Hydrocortisone, Anti-Inflammatory Agents, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], 01 natural sciences, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Adrenal Cortex Hormones, Clinical endpoint, Medicine, 030212 general & internal medicine, Hydrocortisone/administration & dosage, Original Investigation, 2. Zero hunger, Mortality rate, Shock, Covid19, General Medicine, Middle Aged, Intensive care unit, 3. Good health, Intensive Care Units, Treatment Outcome, Early Termination of Clinical Trials, Corticosteroid, Female, Coronavirus Infections, medicine.drug, Adult, medicine.medical_specialty, Respiration, Artificial/statistics & numerical data, medicine.drug_class, Anti-Inflammatory Agents/administration & dosage, Pneumonia, Viral, UNCOVER, Adrenal Cortex Hormones/therapeutic use, 03 medical and health sciences, Betacoronavirus, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Humans, 0101 mathematics, Adverse effect, Pandemics, business.industry, SARS-CoV-2, 010102 general mathematics, COVID-19, Odds ratio, Coronavirus Infections/drug therapy, Pneumonia, Viral/drug therapy, Respiration, Artificial, COVID-19 Drug Treatment, Shock/drug therapy, Human medicine, business
Abstract

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited.Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19.Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020.Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108).Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%).Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively.Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions.Trial Registration: ClinicalTrials.gov Identifier: NCT02735707.

Published
2020

25. Travel-related infections presenting in Europe: a 20-year analysis of EuroTravNet surveillance data

Author

Grobusch, Martin P., Weld, Leisa, Goorhuis, Abraham, Hamer, Davidson H., Schunk, Mirjam, Jordan, Sabine, Mockenhaupt, Frank P., Chappuis, François, Asgeirsson, Hilmir, Caumes, Eric, Jensenius, Mogens, van Genderen, Perry J.J., Castelli, Francesco, López-Velez, Rogelio, Field, Vanessa, Bottieau, Emmanuel, Molina, Israel, Rapp, Christophe, Ménendez, Marta Díaz, Gkrania-Klotsas, Effrossyni, Larsen, Carsten S., Malvy, Denis, Lalloo, David, Gobbi, Federico, Florescu, Simin A., Gautret, Philippe, Schlagenhauf, Patricia, Stijnis, Kees, van Vugt, Michèle, Rothe, Camilla, von Sonnenburg, Frank, Vinnemeier, Christof, Ramharter, Michael, Equihua Martinez, Gabriela, Gertler, Maximilian, Eperon, Gilles, Ursing, Johan, Glans, Hedvig, Hægeland, Arnhild, Joof, Mona, Stuij, Corine, Odolini, Silvia, Tomasoni, Lina, Chamorro, Sandra, Lankester, Ted, Salvador, Fernando, Serre-Delcor, Nuria, Ficko, Cécile, Trigo, Elena, Warne, Benjamin, Jespersen, Sanne, Weijse, Christian, Duvignaud, Alexandre, Pistone, Thierry, Beeching, Nicholas, Beadsworth, Mike, Rodari, Paola, Moro, Lucia, Popescu, Corneliu P., Zaharia, Mihaela F., Javelle, Emilie, Parola, Philippe, Weber, Rainer, and Schmid-Stoll, Sabine

Subjects
wa_108
Abstract

Background\ud Disease epidemiology of (re-)emerging infectious diseases is changing rapidly, rendering surveillance of travel-associated illness important.\ud \ud Methods\ud We evaluated travel-related illness encountered at EuroTravNet clinics, the European surveillance sub-network of GeoSentinel, between March 1, 1998 and March 31, 2018.\ud \ud Findings\ud 103,739 ill travellers were evaluated, including 11,239 (10.8%) migrants, 89,620 (86.4%) patients seen post-travel, and 2,880 (2.8%) during and after travel. Despite increasing numbers of patient encounters over 20 years, the regions of exposure by year of clinic visits have remained stable. In 5-year increments, greater proportions of patients were migrants or visiting friends and relatives (VFR); business travel-associated illness remained stable; tourism-related illness decreased. Falciparum malaria was amongst the most-frequently diagnosed illnesses with 5,254 cases (5.1% of all patients) and the most-frequent cause of death (risk ratio versus all other illnesses 2.5:1). Animal exposures requiring rabies post-exposure prophylaxis increased from 0.7% (1998-2002) to 3.6% (2013-2018). The proportion of patients with seasonal influenza increased from zero in 1998-2002 to 0.9% in 2013-2018. There were 44 cases of viral haemorrhagic fever, most during the past five years. Arboviral infection numbers increased significantly as did the range of presenting arboviral diseases, Dengue and chikungunya diagnoses increased by 2.6% and 1%, respectively.\ud \ud Interpretation\ud Travel medicine must adapt to serve the changing profile of travellers, with an increase in migrants and persons visiting relatives and friends and the strong emergence of vector-borne diseases, with potential for further local transmission in Europe.\ud \ud Funding\ud This project was supported by a cooperative agreement (U50CK00189) between the Centers for Disease Control and Prevention to the International Society of Travel Medicine (ISTM) and funding from the ISTM and the Public Health Agency of Canada.

Published
2020

27. 2015/16 seasonal vaccine effectiveness against hospitalisation with influenza A(H1N1)pdm09 and B among elderly people in Europe: results from the I-MOVE+ project

Author

Rondy, Marc, Larrauri, A., Casado, I., Alfonsi, V., Pitigoi, D., Launay, O., Syrjänen, R. K., Gefenaite, G., Machado, A., Vučina, V. V., Horváth, J. K., Paradowska-Stankiewicz, I., Marbus, S. D., Gherasim, A., Díaz-González, J. A., Rizzo, C., Ivanciuc, A. E., Galtier, F., Ikonen, N., Mickiene, A., Gomez, V., Kurečić Filipović, S., Ferenczi, A., Korcinska, M. R., Van Gageldonk-Lafeber, R., Valenciano, M., Altzibar, Jone M., Arraras, Ion Garcia, Cilla, Gustavo, Marco, Elisa, Vidal, Matxalen, Omenaca, Manuel, Castilla, J., Navascues, A., Ezpeleta, C., Barrado, L., Ortega, M. T., Bella, A., Castrucci, M. R., Puzelli, S., Chironna, M., Germinario, C., Ansaldi, F., Orsi, A., Manini, I., Montomoli, E., Lupulescu, E., Lazar, M., Cherciu, C. M., Tecu, C., Mihai, M. E., Nitescu, M., Leca, D., Ceausu, E., Lenzi, N., Lesieur, Z., Loulergue, P., Foulongne, V., Letois, F., Merle, C., Vanhems, P., Lina, B., Nohynek, H., Haveri, A., Kuliese, M., Velyvyte, D., Grimalauskaite, R., Damuleviciene, G., Lesauskaite, V., Jancoriene, L., Zablockiene, B., Ambrozaitis, A., Nunes, B., Rodrigues, A. P., Gomes, V., Corte-Real, R., Pocas, J., Peres, M. J., Kaić, B., Oroszi, B., Brydak, L. B., Cieślak, K., Kowalczyk, D., Szymański, K., Jakubik, A., Skolimowska, G., Hulboj, D., Meijer, A., Van Der Hoek, W., Schneeberger, P. M., Palmieri, Annapina, Giannitelli, Stefania, Ranghiasci, Alessia, Bacruban, Rodica, Azamfire, Delia, Dumitrescu, Aura, Ianosik, Elena, Duca, Elena, Bejan, Codrina, Teodor, Andra, Florescu, Simin-Aysel, Popescu, Corneliu, Tardei, Gratiela, Charpentier, Julien, Marin, Nathalie, Doumenc, Benoit, Le Jeunne, Claire, Krivine, Anne, Momcilovic, Sonia, Benet, Thomas, Amour, Selilah, Henaff, Laetitia, Jokinen, Jukka, Lyytikainen, Outi, Palmu, Arto, Siren, Paivi, Ruokokoski, Esa, Nunes, Baltazar, Rodrigues, Ana Paula, Guiomar, Raquel, Gomes, Victor, Quaresma, Filipa, Vale, Luis, Garcia, Teresa, Bernardo, Teresa, Dias, Liliana, Fonseca, Paula, Amorim, Helena, Rolo, Joao, Pacheco, Helena, Branquinho, Paula, Corte-Real, Rita, Pocas, Jose, Lopes, Paula, Peres, Maria Joao, Ribeiro, Rosa, Duarte, Paula, Pedroso, Ermelinda, Rodrigues, Sara, Silverio, Ana Rita, Pedreira, Diana Gomes, Fonseca, Marta Ferreira, Vince, Adriana, Topić, Antea, Papić, Neven, Mihalić, Jelena Budimir, Novosel, Iva Pem, Petrović, Goranka, Zajec, Martina, Draženović, Vladimir, Hercegh, Eva, Szalai, Balint, Antmann, Katalin, Nagy, Kamilla, Unión Europea, EpiConcept, Institute of Health Carlos III, CIBER de Epidemiología y Salud Pública (CIBERESP), Istituto Superiore de Sanita, University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Instituto Nacional de Saùde Dr Ricardo Jorge [Portugal] (INSA), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale (INSERM), F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute for Health and Welfare [Helsinki], and National Institute for Public Health and the Environment [Bilthoven] (RIVM)

Subjects
Infecções Respiratórias, 0301 basic medicine, Male, Heart disease, Epidemiology, Efetividade da Vacina Antigripal, 0302 clinical medicine, Influenza A Virus, H1N1 Subtype, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Outcome Assessment, Health Care, 80 and over, Influenza A Virus, Medicine, 030212 general & internal medicine, Aged, 80 and over, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Vaccination, virus diseases, 3. Good health, Europe, Hospitalization, Influenza Vaccines, case control, elderly, hospitalisation, influenza, severe acute respiratory infection, vaccine effectiveness, vaccine-preventable diseases, Vaccine-preventable diseases, Female, Public Health, Seasons, Research Article, Human, medicine.medical_specialty, Influenza vaccine, 030106 microbiology, Aged, Humans, Influenza B virus, Influenza, Human, Logistic Models, Outcome Assessment (Health Care), Sentinel Surveillance, Vaccine Potency, Public Health, Environmental and Occupational Health, Virology, Hospital, 03 medical and health sciences, Diabetes mellitus, Internal medicine, H1N1 Subtype, Vacina Antigripal, Intensive care medicine, business.industry, Environmental and Occupational Health, Cuidados de Saúde, Case-control study, medicine.disease, Influenza, Confidence interval, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business
Abstract

Members of the I-MOVE+ project - Portugal: Baltazar Nunes, Ana Paula Rodrigues, Raquel Guiomar (Infectious Diseases Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal), Victor Gomes, Filipa Quaresma, Luis Vale, Teresa Garcia, Teresa Bernardo, Liliana Dias, Paula Fonseca, Helena Amorim, João Rolo, Helena Pacheco, Paula Branquinho, Rita Côrte-Real (Centro Hospitalar de Lisboa Central, Lisbon, Portugal),José Poças, Paula Lopes, Maria João Peres, Rosa Ribeiro, Paula Duarte, Ermelinda Pedroso, Sara Rodrigues, Ana Rita Silvério, Diana Gomes Pedreira, Marta Ferreira Fonseca, (Centro Hospitalar de Setúbal, Setúbal, Portugal). We conducted a multicentre test-negative case-control study in 27 hospitals of 11 European countries to measure 2015/16 influenza vaccine effectiveness (IVE) against hospitalised influenza A(H1N1)pdm09 and B among people aged ≥ 65 years. Patients swabbed within 7 days after onset of symptoms compatible with severe acute respiratory infection were included. Information on demographics, vaccination and underlying conditions was collected. Using logistic regression, we measured IVE adjusted for potential confounders. We included 355 influenza A(H1N1)pdm09 cases, 110 influenza B cases, and 1,274 controls. Adjusted IVE against influenza A(H1N1)pdm09 was 42% (95% confidence interval (CI): 22 to 57). It was 59% (95% CI: 23 to 78), 48% (95% CI: 5 to 71), 43% (95% CI: 8 to 65) and 39% (95% CI: 7 to 60) in patients with diabetes mellitus, cancer, lung and heart disease, respectively. Adjusted IVE against influenza B was 52% (95% CI: 24 to 70). It was 62% (95% CI: 5 to 85), 60% (95% CI: 18 to 80) and 36% (95% CI: -23 to 67) in patients with diabetes mellitus, lung and heart disease, respectively. 2015/16 IVE estimates against hospitalised influenza in elderly people was moderate against influenza A(H1N1)pdm09 and B, including among those with diabetes mellitus, cancer, lung or heart diseases. The I-MOVE+ project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 634446. info:eu-repo/semantics/publishedVersion

Published
2017

28. Malaria after international travel: a GeoSentinel analysis, 2003-2016

Author

Angelo, Kristina M., Libman, Michael, Caumes, Eric, Hamer, Davidson H., Kain, Kevin C., Leder, Karin, Grobusch, Martin P., Hagmann, Stefan H., Kozarsky, Phyllis, Lalloo, David G., Lim, Poh-Lian, Patimeteeporn, Calvin, Gautret, Philippe, Odolini, Silvia, Chappuis, Franã§ois, Esposito, Douglas H., Javelle, Emilie, Castelli, Francesco, Matteelli, Alberto, Perignon, Alice, Rothe, Camilla, Rapp, Christoph, Ficko, Cecile, Schwartz, Eli, Von Sonnenburg, Frank, Piyaphanee, Watcharapong, Silachamroon, Udomsak, Boggild, Andrea, Van Genderen, Perry, Torresi, Joe, Jensenius, Mogens, Kanagawa, Shuzo, Kato, Yasuyuki, Yansouni, Cedric, Mccarthy, Anne, Kelly, Paul, Goorhuis, Bram, López-Vélez, Rogelio, Norman, Francesco, Mendelson, Marc, Vincent, Peter, Gkrania-Klotsas, Effrossyni, Warne, Ben, Malvy, Denis, Duvignaud, Alexandre, Bottieau, Emanuel, Clerinx, Joannes, Coyle, Christina, Àsgeirsson, Hilmer, Glans, Hedvig, Schlagenhauf, Patricia, Weber, Rainer, Mockenhaupt, Frank, Harms-Zwingenberger, Gundel, Beeching, Nicholas, Hajek, Jan, Ghesquiere, Wayne, Henry, Wu, Barnett, Elizabeth, Hockberg, Natasha, Yoshimura, Yukiriro, Tachikawa, Natsuo, Cahill, John, Mckinley, George, Stauffer, William, Walker, Pat, Kuhn, Susan, Chen, Lin, Leung, Daniel, Benson, Scott, Larsen, Carsten Schade, Wejse, Christian, Field, Vanessa, Licitra, Carmelo, Klochko, Alena, Hynes, Noreen, Perez, Cecilia Perret, Connor, Bradley, Murphy, Holly, Pandey, Prativa, Vincelette, Jean, Barkati, Sapha, Florescu, Simin Aysel, Popescu, Corneliu Petru, Blumberg, Lucille, De Frey, Albie, Anderson, Susan, Shaw, Marc, Hern, Annemarie, Molina, Israel, Yates, Johnnie, Siu, Hugo, Valdez, Luis Manuel, Haulman, Jean, Roesel, David, Phu, Phi Truong Hoang, Borwein, Sarah, Division of Global Migration and Quarantine [Atlanta, GA, USA], Centers for Disease Control and Prevention (CDC), Centre for Tropical Diseases [Montréal] (TDC), McGill University = Université McGill [Montréal, Canada], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Global Health and Center for Global Health and Development [Boston, MA, USA], Boston University [Boston] (BU), Tropical Disease Unit [Toronto, Canada], University of Toronto, Victorian Infectious Diseases Service [Victoria, Australia], The Royal Melbourne Hospital, School of Public Health and Preventive Medicine [Monash University-Melbourne], Monash University [Melbourne], Department of Infectious Diseases [Amsterdam, Netherlands] (Academic Medical Center), University of Amsterdam [Amsterdam] (UvA)-Center for Tropical and Travel Medicine [Amsterdam, Netherlands], Cohen Children’s Medical Center, Department of Medicine [Atlanta, GA, USA], Emory University [Atlanta, GA], Liverpool School of Tropical Medicine (LSTM), Institute of Infectious Diseases and Epidemiology [Singapore, Singapore], Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Nanyang Technological University [Singapour], Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Department of Infectious and Tropical Diseases [Brescia, Italy], University of Brescia and Spedali Civili General Hospital [Brescia, Italy], Geneva University Hospitals - HUG [Switzerland], Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Tan Tock Seng Hospital [Singapore, Singapore], Nanyang Technological University (NTU), INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), COMBE, Isabelle, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], AII - Infectious diseases, APH - Global Health, Infectious diseases, APH - Aging & Later Life, AII - Amsterdam institute for Infection and Immunity, Lee Kong Chian School of Medicine (LKCMedicine), Hamer, Davidson H [0000-0002-4700-1495], Kain, Kevin C [0000-0001-6068-1272], Lalloo, David G [0000-0001-7680-2200], Gautret, Philippe [0000-0002-1664-958X], and Apollo - University of Cambridge Repository

Subjects
Plasmodium, Plasmodium vivax, 0302 clinical medicine, GeoSentinel, International travel, Malaria, Plasmodium spp, Parasitology, Infectious Diseases, Interquartile range, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, Science::Medicine [DRNTU], 030212 general & internal medicine, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Travel, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, wa_108, 3. Good health, Chemoprophylaxis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Risk, medicine.medical_specialty, Visiting friends and relatives, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, 030231 tropical medicine, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Environmental health, parasitic diseases, Journal Article, Humans, lcsh:RC109-216, business.industry, Public health, Research, Plasmodium falciparum, biology.organism_classification, medicine.disease, wc_750, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, qx_135, Immunology, Tropical medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, human activities
Abstract

Background\ud \ud More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation.\ud \ud Methods\ud \ud Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria.\ud \ud Results\ud \ud There were 5689 travellers included; 325 were children

Published
2017

30. CLINICAL AND EVOLUTIVE ASPECTS OF COXIELLA BURNETII INFECTION.

Author

Hoara, Maria Cristina, Florescu, Simin-Aysel, Piscu, Sebastian Alexandru, Tardei, Gratiela, and Calistru, Petre Iacob

Subjects
*COXIELLA burnetii, *Q fever, *INFECTIVE endocarditis, *HEART valves, *INFECTION, *BLOOD vessels, *ACUTE diseases
Abstract

Introduction. Coxiella burnetii is the etiological agent of Q fever, a zoonosis that is still subject of „Query”. Formerly classified as a Rickettsia, C. burnetii is a highly infectious obligate intracellular bacteria, whose main animal reservoirs are cattle, sheep and goats. Commonly following transmission through inhalation of aerosols containing the pathogen spread during animal parturition, Q fever may present as a self-limited febrile illness, pneumonia or acute hepatitis. Nevertheless, the possibility of evolving towards a chronic form exists under certain circumstances, mainly involving previously affected heart valves or blood vessels. Diagnosis is usually serologically based and Doxycycline represents the most frequent choice of antibiotherapy. Objectives. The aim of this study is to analyse the clinical and laboratory settings that led to diagnosis of acute or chronic Q fever, the treatment regimens applied and consecutive outcome within the group of patients defined below. Materials and methods. The present paper represents an observational descriptive study performed on a group composed of 24 patients admitted in our hospital along 2018 and diagnosed with confirmed or probable acute or chronic Q fever. Both male and female subjects regardless of their age were included, under the condition of meeting the CDC case definition, by integrating the serological results into the clinical context. Results and conclusions. A suggestive epidemiological frame was rarely proven. Out of the 24 subjects with ages between 34 and 80 years old, of which only 2 were women, 22 had acute Q fever, manifested mostly as a combination of atypical pneumonia and hepatitis (9 cases, representing 41. Only 2 of the acute Q fever cases had a confirmed diagnosis. Frequent complaints were fever (all cases), chills, headaches and vomiting. Only 28% of the radiologically confirmed pneumonias were accompanied by dry cough, whilst only 21% of the hepatitis cases associated jaundice. Biologically, although leukocytosis was more weakly correlated with acute disease activity, all patients exhibited a moderate to high inflammatory response (through C reactive protein). Considering the latency of specific antibodies' dosage results, the decision of initiating treatment was based on a clinical support. Antibiotherapy consisted of Doxycyclin, alone or in combinations meant to cover a larger spectrum, given the usually nonspecific symptoms and the initially low clinical suspicion for Q fever. Clinical evolution was favorable in all cases. Regarding the two patients with chronic Q fever, manifested as blood culture-negative endocarditis, of which only one was confirmed according to the CDC definition, both had presented valvular lesions before developing IE and had no history of acute infection with C. burnetii. In the first case, under empirical infective endocarditis agents (Ceftriaxone and Vancomycin), acute heart failure and necessity of surgical replacement of the affected valve occurred, only afterwards being followed by the elevated phase I IgG level that brought diagnostic confirmation. Meanwhile, the second patient did receive a combination with Doxycycline, followed by favorable clinical evolution during admission. [ABSTRACT FROM AUTHOR]

Published
2019
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31. Increased risk of chikungunya infection in travellers to Thailand during ongoing outbreak in tourist areas: cases imported to Europe and the Middle East, early 2019.

Author

Javelle, Emilie, Florescu, Simin-Aysel, Asgeirsson, Hilmir, Jmor, Shilan, Eperon, Gilles, Leshem, Eyal, Blum, Johannes, Molina, Israel, Field, Vanessa, Pietroski, Nancy, Eldin, Carole, Johnston, Victoria, Cotar, Ioana Ani, Popescu, Corneliu, Hamer, Davidson H., and Gautret, Philippe

Published
2019
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32. Cerebrospinal fluid cytokines and chemokines exhibit distinct profiles in bacterial meningitis and viral meningitis.

Author

Caragheorgheopol, Ramona, Țucureanu, Cătălin, Lazăr, Veronica, Florescu, Simin Aysel, Lazăr, Dragoş Stefan, and Caraş, Iuliana

Subjects
CEREBROSPINAL fluid, BACTERIAL meningitis, CHEMOKINES, MACHINE learning, LEUCOCYTES, MENINGITIS
Abstract

Differential diagnosis of bacterial meningitis (BM) and viral meningitis (VM) is a critical clinical challenge, as the early and accurate identification of the causative agent determines the appropriate treatment regimen and markedly improves patient outcomes. Clinical and experimental studies have demonstrated that the pathogen and the host immune response contribute to mortality and neurological sequelae. As BM is associated with the activation of an inflammatory cascade, the patterns of pro- and anti-inflammatory cytokines/chemokines (CTs/CKs) present in the cerebrospinal fluid (CSF) in response to the immune assault may be useful as sensitive markers for differentiating BM from VM. In the present study, the ability of CTs/CKs in the CSF to differentiate between BM and VM was investigated. For this, biochemical markers and CT/CK profiles were analysed in 145 CSF samples, divided into three groups: BM (n=61), VM (n=58) and the control group (C; n=26) comprising patients with meningism. The CSF concentrations of monocyte chemoattractant protein-1, interleukin (IL)-8, IL-1β, IL-6, macrophage inflammatory protein-1α (MIP-1α), epithelial-neutrophil activating peptide, IL-10, tumour necrosis factor-α (TNF-α), proteins and white blood cells were significantly higher and the CSF glucose level was significantly lower in the BM group compared with the VM and C groups (P<0.01). Correlation analysis identified 28 significant correlations between various CTs/CKs in the BM group (P<0.01), with the strongest positive correlations being for TNF-α/IL-6 (r=0.75), TNF-α/MIP-1α (r=0.69), TNF-α/IL-1β (r=0.64) and IL-1β/MIP-1α (r=0.64). To identify the optimum CT/CK patterns for predicting and classifying BM and VM, a dataset of 119 BM and VM samples was divided into training (n=90) and testing (n=29) subsets for use as input for a Random Forest (RF) machine learning algorithm. For the 29 test samples (15 BM and 14 VM), the RF algorithm correctly classified 28 samples, with 92% sensitivity and 93% specificity. The results show that the patterns of CT/CK levels in the CSF can be used to aid discrimination of BM and VM. [ABSTRACT FROM AUTHOR]

Published
2023
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33. MOLECULAR EPIDEMIOLOGY OF NON-1B HCV STRAINS INFECTING ROMANIAN PATIENTS.

Author

Dinu, Sorin, ȚÂrdei, GrațIela, Calomfirescu, Cristina, MoțOc, Adriana, Culinescu, Augustina Maria, Florescu, Simin Aysel, Sultana, Camelia, RuțÃ, Simona, Ceauşu, Emanoil, and Oprişan, Gabriela

Subjects
HEPATITIS C virus, MOLECULAR epidemiology, PHYLOGENY, GENOTYPES, ROMANIANS
Abstract

Copyright of Romanian Archives of Microbiology & Immunology is the property of Institutul Cantacuzino and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2018

34. Re-emergence of severe West Nile virus neuroinvasive disease in humans in Romania, 2012 to 2017–implications for travel medicine.

Author

Popescu, Corneliu Petru, Florescu, Simin Aysel, Cotar, Ani Ioana, Badescu, Daniela, Ceianu, Cornelia Svetlana, Zaharia, Mihaela, Tardei, Gratiela, Codreanu, Daniel, Ceausu, Emanoil, and Ruta, Simona Maria

Abstract

Background In Romania, after a major outbreak in 1996, West Nile neuroinvasive disease (WNND) was reported only in a limited number of cases annually. During 2016–2017, a significant increase in the number of WNND cases was reported at the national level, associated with high mortality rates. Methods A retrospective analysis of all cases confirmed with WNND, hospitalized during 2012–2017 in a single tertiary facility from Bucharest was performed in order to determine the annual prevalence and mortality rate and the risk factors associated with a severe outcome. Results 47 cases were confirmed as WNND. The mortality rate was 25.5%, all death occurred during 2016–2017. Coma, confusion, obtundation, sleepiness and depressed deep tendon reflexes were symptoms predicting a severe outcome. In a univariate analysis age (p < 0.001), associated cancers (p = 0.012) and low levels of chloride in the CSF (p = 0.008) were risk factors for mortality. In a multinomial logistic analysis, age older than 75 years remained the only independent predictor of death in WNND. Conclusions The increase in both the number and the mortality rate of WNND cases suggest a changing pattern of WNV infection in Romania. Public health authorities and clinicians should be aware of the risk of severe WNV infection in travelers returning from Romania. [ABSTRACT FROM AUTHOR]

Published
2018
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35. ETIOLOGICAL PROFILE OF INFECTIOUS MENINGITIS AT “DR V. BABES” CLINICAL HOSPITAL OF INFECTIOUS AND TROPICAL DISEASES, BUCHAREST.

Author

Ceausu, Emanoil, Florescu, Simin-Aysel, Nica, Maria, Smadu, Sebastian, Codreanu, Daniel, Oprisan, Corina, Dascalu, Ana Maria, Oprea, Cristiana, Lazar, Stefan, Popescu, Corneliu, Kosa, Alma, and Calistru, Petre I.

Subjects
*MENINGITIS, *ETIOLOGY of diseases, *DISEASE prevalence, *FUNGAL meningitis, *BACTERIAL meningitis, *PATIENTS
Abstract

Infectious meningitis is a serious medical problem that can be fatal if treatment is delayed. Objectives. There are presented clinical and laboratory aspects of patients with suspected meningitis, presented and hospitalized during 2014-2017 at Hospital for Infectious and Tropical Diseases Dr V. Babes Bucharest. Clinical and paraclinical variables that show statistically significant differences depending on the etiology of meningitis have been identified. Methods. Patients who showed signs and symptoms according to the case definition would be included in the study. Clinical and laboratory values were recorded in a database which was then processed to identify statistically significant differences between the group of patients with suspicion only but subsequently not ill against the group of confirmed, and also among different subgroups within the confirmed. Results. Of the 97 cases of infectious meningitis included within 3 years, 53 cases (55%) were viral, 31 (32%) bacterial, one case of fungal meningitis and 12 cases of tuberculous meningitis. [ABSTRACT FROM AUTHOR]

Published
2017
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36. First Two Imported Cases of Zika Virus Infections in Romania.

Author

Florescu, Simin Aysel, Cotar, Ani Ioana, Popescu, Corneliu Petru, Ceianu, Cornelia Svetlana, Zaharia, Mihaela, Vancea, Geta, Codreanu, Daniel, Badescu, Daniela, and Ceausu, Emanoil

Subjects
*ZIKA virus infections, *FLAVIVIRUSES, *SEROLOGY
Abstract

We report the first two cases of imported Zika virus (ZIKV) infection in Romanian patients returning from areas with ongoing outbreaks and challenges for laboratory diagnostic; first one with a classical pattern of acute flaviviral infection and the second one with an interesting pattern of a secondary flaviviral (ZIKV) infection in a yellow fever-vaccinated child living abroad in an endemic area. [ABSTRACT FROM AUTHOR]

Published
2017
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37. SIGNIFICANT DECREASING OF THE SYSTEMIC ANTIBIOTICS' CONSUMPTION ASSOCIATED WITH ANTIMICROBIAL STEWARDSHIP INTERVENTION CONDUCTED IN INFECTIOUS DISEASES UNIVERSITY HOSPITAL FROM EASTEARN EUROPE.

Author

FLORESCU, SIMIN-AYSEL, NEDELCU, NICULAE ION, CALISTRU, PETRE IACOB, PETRUC, FELICIA, and CEAUŞU, EMANOIL

Subjects
ANTIBIOTICS, ANTI-infective agents, COMMUNICABLE diseases, UNIVERSITY hospitals, PUBLIC health
Abstract

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017

38. Climate Change Is Increasing the Risk of the Reemergence of Malaria in Romania.

Author

Ivanescu, Larisa, Bodale, Ilie, Florescu, Simin-Aysel, Roman, Constantin, Acatrinei, Dumitru, and Miron, Liviu

Subjects
MALARIA diagnosis, RISK of malaria, CLIMATE change, MALARIA, PROTOZOA, SEASONS, TEMPERATURE, DATA analysis software, STATISTICAL models, DESCRIPTIVE statistics
Abstract

The climatic modifications lead to global warming; favouring the risk of the appearance and development of diseases are considered until now tropical diseases. Another important factor is the workers’ immigration, the economic crisis favouring the passive transmission of new species of culicidae from different areas. Malaria is the disease with the widest distribution in the globe. Millions of people are infected every year in Africa, India, South-East Asia, Middle East, and Central and South America, with more than 41% of the global population under the risk of infestation with malaria. The increase of the number of local cases reported in 2007–2011 indicates that the conditions can favour the high local transmission in the affected areas. In the situation presented, the establishment of the level of risk concerning the reemergence of malaria in Romania becomes a priority. [ABSTRACT FROM AUTHOR]

Published
2016
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41. Molecular epidemiology of dengue fever cases imported into Romania between 2008 and 2013.

Author

Dinu, Sorin, Pănculescu-Gătej, Ioana R., Florescu, Simin A., Popescu, Corneliu P., Sîrbu, Anca, Oprişan, Gabriela, Bădescu, Daniela, Franco, Leticia, and Ceianu, Cornelia S.

Abstract

Background: Dengue fever is the commonest arthropod-borne infection worldwide. In recent years, rapid growth in global air travel has resulted in a considerable increase in the incidence of imported cases. In Romania it is now the second most frequent cause for hospitalization (after malaria) in patients arriving from tropical regions. Methods: Serological and molecular diagnostics were applied to samples obtained between 2008 and 2013 from travelers with suspected dengue. Molecular typing was performed by RT-PCR followed by sequencing of the E-NS1 junction. [ABSTRACT FROM AUTHOR]

Published
2015
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43. TRATAMENTUL HEPATITEI ACUTE VIRALE C HVC treatment.

Author

Popescu, Corneliu Petru, Florescu, Simin Aysel, and Ceauşu, Emanoil

Subjects
*HEPATITIS C, *HEPATITIS C treatment, *INTERFERONS, *HEPATITIS, *CIRRHOSIS of the liver, *LIVER cancer, *PATIENTS
Abstract

Acute hepatitis C is an insufficient studied disease because unspecific clinical manifestations, diagnostic difficulties and limited epidemiological data. High rate of development of chronic C hepatitis, rapid progression to cirrhosis and hepatocellular carcinoma are sufficient arguments for an early treatment of acute hepatitis C. Interferon treatment of acute hepatitis C is highly efficient, fact proved by the SVR (sustained virological response) up to 94-98% in the studies of patients treated with conventional interferon or pegylated interferons. The absence of a standard therapy lead to necessity to analyse all this studies and to elaborate several treatment recommendations. The available data at this moment points to a therapy with pegylated interferon alpha-2a or alpha-2b, with 12-24 weeks duration, initiated in the first 12 weeks after acute onset of hepatitis. [ABSTRACT FROM AUTHOR]

Published
2010

44. COVID-19 in a tertiary hospital from Romania: Epidemiology, preparedness and clinical challenges.

Author

Popescu, Corneliu Petru, Marin, Alexandru, Melinte, Violeta, Gherlan, George Sebastian, Banicioiu, Filofteia Cojanu, Dogaru, Adelina, Smadu, Sebastian, Veja, Ana Maria, Nedu, Elena, Stanciu, Delia, Voinescu, Bianca, Simion, Valentina, Toderan, Andreea, Dascalu, Amalia, Oprisan, Corina, Tardei, Gratiela, Nica, Maria, Ceausu, Emanoil, Ruta, Simona Maria, and Florescu, Simin Aysel

Published
2020
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46. INFECTIOUS ENDOCARDITIS TO AN INJECTABLE DRUG USER.

Author

Nanu, Adina A., Melinte, Violeta, Florescu, Simin A., Dogaru, Adelina, Ceausu, Emanoil, and Calistru, Petre I.

Subjects
*INFECTIVE endocarditis, *MITRAL valve, *THERAPEUTICS, *STAPHYLOCOCCUS aureus, *DRUGS, *DISEASE risk factors
Abstract

Background. Injecting drug users are a particular category of patients, where infectious pathology, including infectious endocarditis, is much more common. In Romania, in 2016 there were about 21,000 opioid users (www.ana.gov.ro). Besides opioid drugs, there are also ethnobotanics and a growing trend of injecting amphetamines. Material and methods. We present the case of a young drug user diagnosed in our hospital with infected mitral valve infectious endocarditis. Particularities consist of the type of affected valve and the involvement of a strain of methicillin-sensitive aureus staphylococcus (in a patient with multiple risk factors for infection with multi-resistant strains). Results. Clinical evolution is with many ups and downs because different complications occur, but after 54 days of hospitasization he is out, then valvular surgery takes place and he returns to our clinic for the antibiotic consolidation treatment. Conclusions. This is a case of severe infection in an IDU, with many features indicating a posible negative evolution. Proper antibiotic treatment, associated with other complementary medical interventions, conducted to the favorable uotcome of this young patient. [ABSTRACT FROM AUTHOR]

Published
2019
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47. Bacterial meningoencephalitis secondary to disseminated strongyloidiasis in a pacient with COVID-19.

Author

Banicioiu, Filofteia Cojanu, Chirila, Claudia, Toderan, Andreea, Florescu, Simin-Aysel, and Popescu, Corneliu Petru

Subjects
*STRONGYLOIDIASIS, *MENINGOENCEPHALITIS, *CEREBROSPINAL fluid examination, *PARASITIC diseases, *ADULT respiratory distress syndrome, *NEMATODE infections
Abstract

Introduction. Strongyloidiasis in a parasitic diseases determined by the intestinal nematode Strongyloides stercoralis. In most cases, this disease is asymptomatic, but the immunocompromised patients can develop severe forms like hyper infestation and disseminated strongyloidiasis. There severe forms of the disease are associated with bacteremias with gastrointestinal microorganisms which can determine infectious complication anywhere in the body. Bacterial meningitis is the most common complication of this kind. Case presentation. We present you the case of a 78 years old patient who initially presented in another hospital for suddenly installed aphasia. He was clinical and paraclinical evaluated and the suspected diagnosis was acute meningoencephalitis, so he was transferred in our hospital. This is a case about a patient with an immunocompromised status determined by recent infection with SARS-CoV-2 who was hospitalized and received prolonged corticosteroid therapy. The clinical examination performed at the admission shows a patient with mediocre general status, partially cooperative, partially time-spatial oriented and to one’s own person, discreet neck stiffness, anxious-depressive mood, with acute respiratory failure. A coproparasitological examination is performed which reveals the presence of filariform larvae of Strongyloides stercoralis in the stool. Also, a parasitic PCR test from a stool sample is positive for Strongyloides stercoralis. These clinical and paraclinical findings corroborated with those found in the cerebrospinal fluid examination establish the diagnosis: acute bacterial meningoencephalitis secondary to disseminated strongyloidiasis. During the disease’s evolution, he is confirmed with a new infection with SARS-CoV-2. He receives antiviral treatment, antiparasitic treatment, antibiotic treatment and symptomatic treatment. The evolution of the disease is favorable. Conclusions. The immunocompromised status of the patient determined the evolution of the infestation with Strongyloides stercoralis to a severe form complicated with acute bacterial meningoencephalitis. The difficulty in establishing the diagnosis of strongyloidiasis is represented by the fact that Romania is a non-endemic country for the infection with this parasite. [ABSTRACT FROM AUTHOR]

Published
2023
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48. Histopathologically Confirmed Pulmonary Mucormycosis as a Complication of COVID-19: a Case Report from Romania and Insight into Pathology.

Author

GHERLAN, George Sebastian, HOARA, Maria Cristina, SMADU, Sebastian George, POPESCU, Corneliu Petru, IONESCU, Petronela, and FLORESCU, Simin-Aysel

Subjects
*COVID-19 pandemic, *MUCORMYCOSIS, *PATHOLOGY, *IRON chelates, *MYCOSES
Abstract

COVID-19 has proven to be an independent risk factor for secondary infectious complications. Amongst them, mucormycosis has recently been noticed more frequently than in the past. Caused by molds belonging to the Mucorales order, this is a rare, but potentially fatal infection unless adequately treated. Ear, nose and throat involvement is prevalent with often expansion to the orbit, sinuses or brain. Pulmonary, cutaneous and gastrointestinal infections are also recognized. Classical risk factors for progression to angioinvasive disease include poorly controlled diabetes mellitus, defects in phagocytic function (prolonged neutropenia, glucocorticoid treatment), immunosuppressive therapy associated with transplantation, malignancy, elevated levels of free iron as well as iron chelators (deferoxamine). In addition, immune dysregulation rendered by COVID-19 itself may contribute or solely lead to invasive mold disease. The largest experience comes from India, which has dealt with a challenging epidemic of COVID-19-associated mucormycosis (CAM). To our knowledge, no previous studies have reported CAM in Romania. We therefore present a case of severe COVID-19 pneumonia initially complicated by bacterial superinfection and secondary sepsis at admission in an unvaccinated 61-year-old male who presented in our clinic with respiratory failure and digestive symptoms. Although improvement occurred rapidly following antiviral, empiric large spectrum Intraantibiotics and pathogenic medication, unfavorable clinical course ensued later on. Biological and imaging investigations were consistent with pulmonary superinfection in the form of multiple different-sized upper right field opacities, which eventually evolved to form cavities. Differential diagnosis was thoroughly performed. Since unable to sterilize the lung by means of medication alone, the patient underwent major thoracic surgery with removal of the entire right lung. Microscopic study of the damaged tissue was able to determine the presence of broad, aseptate hyphae which morphologically belong to Mucorales. A diagnosis of pulmonary mucormycosis was established and proper antifungal treatment was initiated, with full recovery of the patient. [ABSTRACT FROM AUTHOR]

Published
2022
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49. Otitis with Aspergillus niger in a patient with SARS-CoV-2 and multiple comorbidities.

Author

Stoenescu, Andreea Florentina, Vancea, Geta, Ispas, Dana, Voicu-Pârvu, Nicoleta, Tudor, Nicoleta, Precup, Gabriela, Scurtu, Gabriela, Pișcu, Sebastian Alexandru, Popica, Andreea, Bontea, Raluca, Chirilă, Claudia, Sandu, Elena, Potârniche, Diana, Tăbăcaru, Octavian, Mischie, Daniela, Toderan, Andreea, Ceauşu, Emanoil, and Florescu, Simin-Aysel

Subjects
*ASPERGILLUS niger, *SARS-CoV-2, *OTITIS media, *MYOCARDIAL ischemia, *EAR canal, *SYMPTOMS
Abstract

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture. [ABSTRACT FROM AUTHOR]

Published
2021
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50. A PARTICULAR CASE OF SARS-COV-2 INFECTION IN TWINS.

Author

Stoenescu, Andreea Florentina, Vancea, Geta, Ispas, Dana, Voicu-Parvu, Nicoleta, Tudor, Nicoleta, Scurtu, Gabriela, Popescu, Raluca, Chirila, Claudia, Sandu, Elena, Ceausu, Emanoil, and Florescu, Simin-Aysel

Subjects
*SARS-CoV-2, *NEWBORN infants, *MULTIPLE pregnancy, *COVID-19, *PARENTS, *INFECTION
Abstract

Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatology, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence. [ABSTRACT FROM AUTHOR]

Published
2021
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