scholarly journals Frequency of routine testing for COVID-19 in high-risk environments to reduce workplace outbreaks

2020 ◽  
Author(s):  
Elizabeth T Chin ◽  
Benjamin Q Huynh ◽  
Matthew Murrill ◽  
Sanjay Basu ◽  
Nathan C Lo
Keyword(s):  
Active Infection ◽  
Chain Reaction ◽  
Routine Testing ◽  
Polymerase Chain Reaction Testing ◽  
Risk Environments ◽  
Testing Strategies ◽  
Returning To Work ◽  
Frequent Testing ◽  
Polymerase Chain ◽  
The Impact

AbstractShelter-in-place policies have been considered effective in mitigating the transmission of the virus SARS-CoV-2. To end such policies, routine testing and self-quarantine of those testing positive for active infection have been proposed, yet it remains unclear how often routine testing would need to be performed among workers returning to workplaces, and how effective this strategy would be to meaningfully prevent continued transmission of the virus. We simulated SARS-CoV-2 polymerase chain reaction testing to estimate the frequency of testing needed to avert continued epidemic propagation as shelter-in-place orders are relaxed. We find that testing strategies less frequent than daily (e.g. weekly testing or testing once prior to returning to work) are unlikely to prevent workforce outbreaks without additional interventions. Even given unlimited testing capacity, the impact of frequent testing may not be sufficient to reliably relax shelter-in-place policies without risking continued epidemic propagation, unless other measures are instituted to complement testing and self-isolation.

scholarly journals Peripheral Blood Leukocytes and Serum Nested Polymerase Chain Reaction Are Complementary Methods for Monitoring Active Cytomegalovirus Infection in Transplant Patients

2013 ◽  
Vol 24 (3) ◽  
pp. e69-e74 ◽  
Author(s):  
PD Andrade ◽  
MT Fioravanti ◽  
EBV Anjos ◽  
C De Oliveira ◽  
DM Albuquerque ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Cytomegalovirus Infection ◽  
Clinical Symptoms ◽  
Peripheral Blood Leukocytes ◽  
Active Infection ◽  
Chain Reaction ◽  
Blood Leukocytes ◽  
Polymerase Chain

BACKGROUND: Human cytomegalovirus is an important cause of morbidity and mortality in immunocompromised patients. Qualitative polymerase chain reaction (PCR) has proven to be a sensitive and effective technique in defining active cytomegalovirus infection, in addition to having low cost and being a useful test for situations in which there is no need for quantification. Real-time PCR has the advantage of quantification; however, the high cost of this methodology makes it impractical for routine use.OBJECTIVE: To apply a nested PCR assay to serum (sPCR) and to evaluate its efficiency to diagnose active cytomegalovirus infection compared with PCR of peripheral blood leukocytes (L-PCR).METHODS: Samples of 37 patients were prospectively evaluated. An internal control was created and applied to sPCR to exclude false-negative results.RESULTS: In total, 21 patients (57%) developed active cytomegalovirus infection. After analyzing the two methods for the diagnosis of active infection, higher sensitivity and negative predictive value of the L-PCR versus sPCR (100% versus 62%), and higher specificity and positive predictive value of sPCR versus L-PCR (81% versus 50% and 72%, respectively) were observed. Discordant results were observed in 11 patients who were L-PCR-positive but sPCR-negative for active cytomegalovirus infection, five of whom developed clinical symptoms of cytomegalovirus. Clinical symptoms were observed in 14 patients, 12 of whom were diagnosed with active infection by nested L-PCR (P=0.007) and seven by nested sPCR (P=0.02). Higher specificity and a positive predictive value for sPCR were observed.CONCLUSION: Nested L-PCR and sPCR were considered to be complementary methods for the diagnosis and management of symptomatic cytomegalovirus infection.

Persistent Leptospiruria in Five Dogs Despite Antimicrobial Treatment (2000–2017)

2019 ◽  
Vol 55 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Tara Mauro ◽  
Kenneth Harkin
Keyword(s):  
At Risk ◽  
Polymerase Chain Reaction ◽  
Antimicrobial Treatment ◽  
Renal Tubules ◽  
Chain Reaction ◽  
Polymerase Chain Reaction Testing ◽  
Pet Owners ◽  
Zoonotic Risk ◽  
The Face ◽  
Polymerase Chain

ABSTRACT In dogs with leptospirosis, doxycycline therapy is recommended as the preferred therapy for its ability to eliminate the organism from all tissues, including the renal tubules. Elimination of organisms from the renal tubules terminates leptospiruria and prevents transmission of the organism. This report describes the discovery of persistent leptospiruria in the face of therapy with doxycycline in four dogs and enrofloxacin in one dog. Leptospiruria was confirmed by polymerase chain reaction testing for pathogenic leptospires in all five dogs. In two dogs, leptospiruria resolved after a change in therapy to enrofloxacin. In three dogs, doxycycline and/or enrofloxacin were ineffective at eliminating leptospiruria, which then resolved after therapy with clarithromycin. Pet owners could be at risk as persistent leptospiruria poses a potential zoonotic risk. The potential reasons for persistent leptospiruria as demonstrated by polymerase chain reaction testing are discussed.

scholarly journals Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogen Detection in Pediatric Patients

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S503-S503
Author(s):  
Courtney C Sutton ◽  
Patti J Walton ◽  
Montgomery F Williams ◽  
Tracey L Bastian ◽  
Michael Wright ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Multiplex Polymerase Chain Reaction ◽  
Pathogen Detection ◽  
Pediatric Patients ◽  
Respiratory Pathogen ◽  
Chain Reaction ◽  
Polymerase Chain Reaction Testing ◽  
Polymerase Chain

Leptospirosis: a diagnostic conundrum

2018 ◽  
Vol 48 (4) ◽  
pp. 306-309
Author(s):  
Keerthivasan Gurumurthy ◽  
Harish Belgode Narasimha ◽  
Mukta Wyawahare ◽  
Niranjan Biswal
Keyword(s):  
The Body ◽  
Health Concern ◽  
Andaman Islands ◽  
Public Health Concern ◽  
Chain Reaction ◽  
Pathogenic Leptospira ◽  
Indian States ◽  
Polymerase Chain Reaction Testing ◽  
Laboratory Confirmation ◽  
Polymerase Chain

Leptospirosis is a serious public health concern worldwide. It is highly endemic in the Andaman Islands and its prevalence is increasing in other Indian states. Clinical features are non-specific and diagnosis relies on laboratory confirmation. The gold standard is microscopic agglutination testing, but this is not widely available. Real-time polymerase chain reaction testing of LipL32 antigen provides the earliest detection of pathogenic Leptospira in the body. We found it to be 100% specific, but it should be used in the first 10 days of illness for reliable results.

scholarly journals Clinical outcomes of concomitant use of enteral and intravenous sedatives and analgesics in mechanically ventilated patients with COVID-19

2021 ◽  
Author(s):  
Nayoung Kang ◽  
Mohammed A Alrashed ◽  
Eric M Place ◽  
Phuongthao T Nguyen ◽  
Stephen J Perona ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Institutional Review Board ◽  
Chain Reaction ◽  
Mechanically Ventilated ◽  
Ventilation Time ◽  
Institutional Review ◽  
Significant Difference ◽  
Polymerase Chain ◽  
The Impact

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To evaluate potential differences in days on mechanical ventilation for patients with coronavirus disease 2019 (COVID-19) based on route of administration of analgesic and sedative medications: intravenous (IV) alone vs IV + enteral (EN). Summary This institutional review board–approved study evaluated ventilation time and fentanyl or midazolam requirements with or without concurrent EN hydromorphone and lorazepam. Patients were included in the study if they were 18 to 89 years old and were admitted to the intensive care unit with a positive severe acute respiratory syndrome coronavirus 2 reverse transcription and polymerase chain reaction or antigen test and respiratory failure requiring invasive mechanical ventilation for more than 72 hours. In total, 100 patients were evaluated, 60 in the IV-only group and 40 in the IV + EN group. There was not a significant difference in ventilation time between the groups (mean [SD], 19.6 [12.8] days for IV + EN vs 15.6 [11.2] days for IV only; P = 0.104). However, fentanyl (2,064 [847] μg vs 2,443 [779] μg; P < 0.001) and midazolam (137 [72] mg vs 158 [70] mg; P = 0.004) requirements on day 3 were significantly higher in the IV-only group, and the increase in fentanyl requirements from day 1 to day 3 was greater in the IV-only group than in the IV + EN group (378 [625] μg vs 34 [971] μg; P = 0.033). Conclusion Addition of EN analgesic and sedative medications to those administered by the IV route did not change the duration of mechanical ventilation in patients with COVID-19, but the combination may reduce IV opioid requirements, decreasing the impact of IV medication shortages.

The Distribution of Enteric Infections Utilizing Stool Microbial Polymerase Chain Reaction Testing in Clinical Practice

2018 ◽  
Vol 63 (7) ◽  
pp. 1900-1909 ◽  
Author(s):  
Jordan E. Axelrad ◽  
Andrew Joelson ◽  
Yael Nobel ◽  
Susan Whittier ◽  
Garrett Lawlor ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Clinical Practice ◽  
Chain Reaction ◽  
Polymerase Chain Reaction Testing ◽  
Enteric Infections ◽  
Polymerase Chain
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