Search

• We investigated the cross-reactive immunity against omicron BA.1/BA.5 in the individuals with heterologous NVX-CoV2373 booster. • Both third- and fourth-dose heterologous NVX-CoV2373 boosters enhanced cross-reactive immunity against omicron BA.1/BA.5 subvariants. • Remarkable ceiling effects were observed in the individuals with prior SARS-CoV-2 infection. • Prior SARS-CoV-2 infection may provide better cross-protection against diverse omicron subvariants. [ABSTRACT FROM AUTHOR]

• The cycle threshold (Ct) value of RT-PCR was not significantly reduced by remdesivir. • Infectious virus was not detected after the third dose of remdesivir despite dexamethasone treatment. • SARS-CoV-2 shedding significantly decreased after remdesivir treatment, regardless of the Ct value. • Rapid antigen test is a viable adjunctive tool that guides the decision to terminate the isolation. [ABSTRACT FROM AUTHOR]

• Serotype 3 and 19A were still most prevalent in adults in the era vaccines. • Ceftriaxone non-susceptible rate was high (32.5%) in invasive pneumococci. • Serotypes 11A/E and 19A pneumococci showed low ceftriaxone susceptibility. • Ceftriaxone non-susceptibility was related to sequence type 166 and 320. Invasive pneumococcal disease (IPD) is associated with substantial morbidity and mortality in children and elderly populations. Serotype distribution and antibiotic susceptibility of IPD isolates are changing with the implementation of pneumococcal vaccination and increasing antibiotic use worldwide. We aimed to determine serotype distribution, antibiogram, and molecular epidemiology of pneumococci in the late stage of PCV13 era. Prospective multicenter IPD surveillance study was conducted for adults aged ≥ 19 years from July 2019 to June 2021. Clinical and epidemiologic data were collected. In addition, antibiotic susceptibility test, serotype identification and multi-locus sequence typing (MLST) was taken for pneumococcal isolates. A total of 160 IPD cases were collected with mean age of 65.1 years (male, 72.5%). Serotyping was taken for 116 available pneumococcal isolates. PCV13 and PPSV23 serotypes were 32.8% (n = 38) and 56.0% (n = 65), respectively. Serotype 3 (13.8%) and 19A (9.5%) were the most common causative agents of IPD, followed by serogroup 11 (6.9%), 23A (6.9%), 10A (4.3%), and 15B (4.3%). Notably, 32.5% of invasive pneumococcal isolates were non-susceptible to ceftriaxone. Serotypes 11A, 11E and 19A pneumococci showed high ceftriaxone non-susceptible rate (80%, 100% and 81.8% respectively), and they were related to sequence type (ST) 166 and ST320. In comparison, most serotype 3 isolates were ceftriaxone susceptible and related to ST180. PCV serotypes, especially 3 and 19A, are still prevalent in adult IPDs, suggesting that individual PCV13 immunization would be necessary for the elderly people and chronically ill patients. Ceftriaxone non-susceptible rate was remarkably high in invasive pneumococcal isolates. [ABSTRACT FROM AUTHOR]

[Display omitted] • Antibiotics stewardship program (ASP) in the surgical ICU was implemented. • Comprehensive ASP decreased the use of anti-pseudomonal beta-lactams. • Susceptibilities of anti-pseudomonal beta-lactams were improved during ASP period. • Comprehensive ASP was a factor associated with decreased mortality in surgical ICU. • ASP should be implemented to improve antimicrobial use and patient outcome. We evaluated the effects of a comprehensive antimicrobial stewardship program (ASP) in a surgical intensive care unit (SICU). The ASP was implemented from March 2018 to February 2019 at an SICU in a teaching hospital. An infectious disease physician and a pharmacist visited the SICU 3 times per week for prospective audit and feedback. Outcomes were compared between the ASP period and the same months in the preceding year (pre-ASP period). The primary outcome measure was the use of anti-pseudomonal beta-lactams (APBL). Appropriate antimicrobial de-escalation and ICU mortality rates were also compared. A total of 182 and 149 patients were included in the study for the pre-ASP and ASP periods, respectively. Although disease severity was higher in the ASP group (septic shock 39.0% in pre-ASP vs 65.1% in ASP group, P < 0.001), the use of APBL as a definitive treatment was lower during ASP (68.7% vs 57.7%, OR 0.62, 95% CI 0.40–0.98). Appropriate antimicrobial de-escalation improved (63.2% vs 94.6%, P < 0.001). ICU mortality was comparable (7.7% vs 7.4%) and significantly lower during the ASP, after adjustment (adjusted OR 0.41, 95% CI 0.18–0.92, P = 0.032). A comprehensive ASP decreased the use of APBL and was associated with improved patient outcomes. [ABSTRACT FROM AUTHOR]

• More than 25% of patients with COVID-19 were asymptomatic. • Among patients with COVID-19, 26.1% presented anosmia, and 22.6% complained of ageusia with median duration of 7 days. • Mean duration of SARS-CoV-2 viral shedding was 24.5 days. • Irrespective of clinical manifestations, all patients with COVID-19 showed prolonged viral shedding. [ABSTRACT FROM AUTHOR]

• Face-to-face talking was the most important risk factor of SARS-CoV-2 transmission. • Persons aged ≥ 40 years had a higher risk of SARS-CoV-2 infection. • A crowded space and prolonged exposure may facilitate viral transmission. • 6.6% did not have any close contact with COVID-19 patients, suggesting potential airborne transmission. [ABSTRACT FROM AUTHOR]

This nationwide cohort study compared the incidence of adverse events of special interest (AESIs) between adenoviral vector-based (ChAdOx1) and mRNA-based (BNT162b2 or mRNA-1273) coronavirus disease 2019 (COVID-19) vaccines. A targeted trial emulation study was conducted using data from the National Health Insurance Service database. Vaccinees aged 18–85 years who had received at least one dose of ChAdOx1 or an mRNA-based vaccine were identified. The 42-day risks of AESIs were calculated. A total of 1 767 539 ChAdOx1 vaccinees were matched exactly with mRNA vaccinees according to their risk factors. The 42-day risks of adverse events were low (∼0 to 176 events per 100 000 persons in both vaccine groups), and the incidence rates of AESIs were comparable between the two platforms, except for a higher occurrence of acute cardiac injury (incidence rate ratio [IRR], 1.22; 95% CI, 1.10–1.35), myocarditis or pericarditis (IRR, 2.14; 95% CI, 1.14–4.04), and arrhythmia (IRR, 1.46; 95% CI, 1.24–1.71) in mRNA vaccinees. The incidence of Guillain–Barré syndrome (IRR, 0.20; 95% CI, 0.06–0.69), vasovagal syncope (IRR, 0.77; 95% CI, 0.62–0.97), radiculopathy (IRR = 0.59, 95% CI, 0.41–0.84), and aseptic arthritis (IRR, 0.81; 95% CI, 0.70–0.93) was significantly lower in mRNA-based vaccinees compared with ChAdOx1 vaccinees. A remarkable platform-dependent difference was observed in the safety profiles of COVID-19 vaccines, particularly for myocarditis or pericarditis and Guillain–Barré syndrome. However, the overall risk of AESIs was low for both vaccine platforms. [ABSTRACT FROM AUTHOR]

• Heterologous mRNA boost following GLS-5310 DNA vaccination was well tolerated. • Neutralizing antibody responses were enhanced 110 fold to GMT of 1244.8. • Binding antibody responses were enhanced 1,187-fold to GMT of 405,920. • Boosted antibody responses similar to other vaccine combinations. • Boosted T cell responses were many-fold higher than other vaccine combinations. Heterologous boost regimens are being increasingly considered against SARS-CoV-2. We report results for the 32 of 45 participants in the Phase 1 CoV2-001 clinical trial (Kim et al., Int J Iinfect Dis 2023, 128:112–120) who elected to receive an EUA-approved SARS-CoV-2 mRNA vaccine 6 to 8 months following a two-dose primary vaccination with the GLS-5310 bi-cistronic DNA vaccine given intradermally and followed by application of suction using the GeneDerm device. Receipt of EUA-approved mRNA vaccines after GLS-5310 vaccination was well-tolerated, with no reported adverse events. Immune responses were enhanced such that binding antibody titers, neutralizing antibody titers, and T-cell responses increased 1,187-fold, 110-fold, and 2.9-fold, respectively. This paper is the first description of the immune responses following heterologous vaccination with a DNA primary series and mRNA boost. [ABSTRACT FROM AUTHOR]

• Only 1.4% of coronavirus disease 2019 (COVID-19) cases occurred in acute care hospitals in South Korea. • Healthcare personnel accounted for 2.4% of the total patients with COVID-19 in South Korea. • Each hospital should prepare multiple layered defenses to prevent even small cracks in the hospital's quarantine system. • It is necessary to support and strengthen the infection control system of long-term care facilities. Since it first emerged in December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. During the pandemic of an emerging infectious disease, it is very important to prevent nosocomial outbreaks and operate hospitals safely to maintain their functions. In this article, we present the strategies for safe hospital operations based on the experiences of the Republic of Korea early in the COVID-19 pandemic. Each hospital should maintain multiple layers of defenses to prevent even small cracks in the hospital's quarantine system. [ABSTRACT FROM AUTHOR]

• This study reports the safety and immunogenicity of the GLS-5310 DNA vaccine through 48 weeks. • First clinical application of the GeneDerm suction device for DNA vaccine delivery. • GLS-5310 was well tolerated and without vaccine-associated severe adverse effects. • T cell responses of ∼1200 site forming units/106 peripheral blood mononuclear cells were maintained through 48 weeks. • T cell responses were many-fold higher than all other vaccine platforms. • Antibody responses were induced in 95.5% and maintained through 48 weeks. The CoV2-001 phase I randomized trial evaluated the safety and immunogenicity of the GLS-5310 bi-cistronic DNA vaccine through 48 weeks of follow-up. A total of 45 vaccine-naïve participants were recruited between December 31, 2020, and March 30, 2021. GLS-5310, encoding for the SARS-CoV-2 spike and open reading frame 3a (ORF3a) proteins, was administered intradermally at 0.6 mg or 1.2 mg per dose, followed by application of the GeneDerm suction device as part of a two-dose regimen spaced either 8 or 12 weeks between vaccinations. GLS-5310 was well tolerated with no serious adverse events reported. Antibody and T cell responses were dose-independent. Anti-spike antibodies were induced in 95.5% of participants with an average geometric mean titer of ∼480 four weeks after vaccination and declined minimally through 48 weeks. Neutralizing antibodies were induced in 55.5% of participants with post-vaccination geometric mean titer of 28.4. T cell responses were induced in 97.8% of participants, averaging 716 site forming units/106 cells four weeks after vaccination, increasing to 1248 at week 24, and remaining greater than 1000 through 48 weeks. GLS-5310 administered with the GeneDerm suction device was well tolerated and induced high levels of binding antibodies and T-cell responses. Antibody responses were similar to other DNA vaccines, whereas T cell responses were many-fold greater than DNA and non-DNA vaccines. [ABSTRACT FROM AUTHOR]

Background Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne disease characterized by high fever, thrombocytopenia, leukopenia, and multiple organ failure and is caused by a novel bunyavirus. Human-to-human transmission has been reported previously, but the mode of transmission has not been clarified thoroughly. Study design We identified a case of a 73-year-old woman with SFTS and performed a semi-quantitative real-time reverse transcription PCR (real-time RT-PCR) assay on her blood, tracheal aspirate, gastric aspirate and urine to detect SFTS virus (SFTSV). Results During 7-day hospitalization, all the serum samples showed positive C t values lower than 35 in both the S and M segments, suggesting the presence of the SFTSV RNA. After initiation of plasma exchange, serum SFTSV load markedly decreased, but still remained positive. The SFTS viral RNA was also detected in other body fluids, including tracheal aspirate and gastric aspirate. Conclusion These results suggest that droplet transmission can occur through close contact with infected patients. [ABSTRACT FROM AUTHOR]