COVID-19 in Hospitalized Ethiopian Children: Characteristics and Outcome Profile

ABSTRACTBackgroundConsidering the number of people affected and the burden to the health care system due to the Coronavirus pandemic, there is still a gap in understanding the disease better leaving a space for new evidence to be filled by researchers. This scarcity of evidence is observed especially among children with the virus. Understanding the disease pattern and its effect among children is vital in providing timely and targeted intervention.AimTo assess the characteristics and outcome profile of 115 RT-PCR confirmed children with COVID-19, and to determine the presence of significant difference in disease severity and survival distribution between groups among children admitted to Millennium COVID-19 Care Center in Ethiopia.MethodsA prospective cohort study was conducted among 90 consecutively admitted eligible RT-PCR confirmed COVID-19 children from end of June to mid September, 2020. Frequency tables, KM plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. A chi-square test/ Fischer’s exact test were used to determine the presence of a significant difference between the independent variables and disease severity. A statistically significant difference was detected for variables with a P-value of ≤ 0.05. Survival experience of different groups was compared using KM survival curves. Log-rank test was used to assess the presence of significant difference among survival distributions of groups for equality where a statistically significant difference in survival distribution between groups was detected for variables with a P-value of ≤ 0.05.ResultsFrom the 90 children, 67 (74.4%) achieved clinical improvement and 23 (25.6%) were censored. There was no death. The median time to clinical improvement was 14 days. The median age of the participants was 15 years and 63.3% of the participants were females. The commonest reported route of disease transmission was through close contact with a diagnosed person (45.6%). Only three (3.3%) had a history of pre-existing comorbid illness. More than a quarter (26.7%) had one or more symptoms at admission, the commonest being cough (22.2%). Seventy three (81.1%) of the patients had mild COVID-19 at admission and the rest (18.9%) had moderate disease. On the chi-square and Fischer’s exact test, children with one or more symptom at presentation (73.3% Vs 36.7%, p-value= 0.0001), fever (40.0 % Vs 60.0%, p-value=0.045), cough (20.0 % Vs 80.0%, p-value=0.0001), sore throat (44.4 % Vs 55.6%, p-value=0.011), and headache (44.4 % Vs 55.6%, p-value=0.011) were more likely to develop moderate COVID-19. On the log rank test, a significant difference in survival between groups was observed only for sex. A significantly longer time was needed for female patients to achieve clinical improvement compared to male patients (15 days Vs 14 days, p-value= 0.042).ConclusionsThe average duration of time to clinical improvement was 14 days and 74.4% achieved clinical improvement. There was no death during the observation period. The pediatric patients seemed to have a milder disease presentation and a favorable outcome compared to other countries report and also the adult pattern observed in our country. Having particular symptom groups is associated with the development of moderate COVID-19. Being female seemed to delay the time to clinical improvement. Further multicenter study with a large sample size is recommended to reach at a better conclusion.

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Changing treatment paradigms in the era of targeted therapies.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.518 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 518-518

Author(s):

Philipp Marius Papavassilis ◽

Edwin Herrmann ◽

Laura-Maria Krabbe ◽

Lothar Hertle ◽

Martin Boegemann ◽

...

Keyword(s):

Targeted Therapy ◽

Rank Test ◽

P Value ◽

Line Treatment ◽

New Agents ◽

Exact Test ◽

Significant Survival ◽

Significant Difference ◽

The University

518 Background: Our goal was to describe the change of treatment paradigms for metastatic renal cell carcinoma (mRCC) since targeted therapy became available in 2006. Methods: In this cohort population study we retrospectively investigated all mRCC patients who were treated with targeted therapy between 06/2006 and 06/2012 in the Department of Urology of the University of Münster. To distinguish nominal variables Fisher's exact test was used, in other respects Pearson's χ² test. For metrical variables the Mann-Whitney-U-Test was used. The log-rank test was chosen to derive differences between two or more groups with regard to survival. A p value <0,05 was considered statistically significant. Results: 50/158 (31.6%) patients with a median follow-up of 362 days were initially treated with immunotherapy. The most often used second line treatment after immunotherapy was sorafenib (29 patients, 58.0%). As first line treatment sunitinib was chosen most frequently (68 patients, 63.0%). There was no statistically significant difference in survival between the patients who were treated with immunotherapy and those who were not (572 vs. 554 days, p=0,745). 134 (84.4%) patients received cytoreductive nephrectomy before systemic treatment start. Comparing the survival curves there was a significant survival benefit in favor of nephrectomized patients (632 vs. 169 days, p<0,0001). Conclusions: After introduction of the new agents treatment paradigms have changed substantially. Immunotherapy is used only rarely. Cytoreductve nephrectomy should continue to be regarded as standard treatment.

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The Method and Results of a Treatment Targeting SARS-CoV-2-Activated Inflammasomes

10.21203/rs.3.rs-509122/v4 ◽

2021 ◽

Author(s):

Jong Hoon Lee ◽

Badar Kanwar ◽

Chul Joong Lee ◽

Jenny Balentine ◽

Asif Khattak ◽

...

Keyword(s):

Controlled Trial ◽

P Value ◽

Test Statistic ◽

Chi Square ◽

Exact Test ◽

Pyrin Domain ◽

Significant Difference ◽

Chemically Reacting ◽

Second Period ◽

Receptor Family

Abstract Background Clinicians considered dapsone administration to treat SARS-CoV-2 inflammasome. Dapsone is helpful in the molecular regulation of Nod-like receptor family pyrin domain-containing 3 (NLRP3).Objective To study the targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by dapsone must be responsible for its observed preventive effects, functioning as a competitor.Methods This is a randomized controlled trial (RCT). We set out to use objective criteria of improvement, such as A. a reduction in the FIO2 requirement and B. a decrease in the progression of hypoxia. We treated the patients with standard COVID-19 acute respiratory distress syndrome (ARDS) treatment with dapsone. The RCT results were analyzed.Results ARDS progression was blocked in 17 of 19 total patients at the first period. The 44 (trial 22/ control 22) subjects were analyzed during the second period. The chi-square statistic is 5.1836. The p-value is .02280. (RR 0.21, OR 0.1) Fisher's exact test statistic value is 0.0433. (The result is significant at p < .05) (RR 0.15, OR 0) It is significant at the ARDS onset stage.Conclusion There was a significant difference in dapsone treatment results in the ARDS-onset group. We confirmed that dapsone clinically treated the onset of ARDS by targeting SARS-CoV-2-activated inflammasomes. Like chemically reacting substances, inflammasome and dapsone compete, proving that it is effective in early ARDS. ClinicalTrials.gov Identifier NCT04918914

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Updated results on long-term overall survival (OS) of the French randomized phase II trial TORAVA in metastatic renal cell carcinoma (mRCC) patients.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.4625 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 4625-4625

Author(s):

Jacques-Olivier Bay ◽

Sylvie Negrier ◽

David Pérol ◽

Gwenaelle Gravis ◽

Christine Chevreau ◽

...

Keyword(s):

Survival Data ◽

Kinase Inhibitors ◽

Rank Test ◽

P Value ◽

Progression Rate ◽

Exact Test ◽

Global Comparison ◽

Line Therapy ◽

Significant Difference

4625 Background: Temsirolimus combined with bevacizumab (T+B) failed to improve the progression rate in treatment naive mRCC pts when treated in parallel to sunitinib (S) or B + Interferon (B+I) combination (Lancet Oncol 2011; 12:673-80). Long term updated survival and data on 2d line treatments were analyzed. Methods: 171 pts were treated with T+B (n=88), S (n=42) and B+I (41) respectively. Updated survival data (December 2011) and 2d line therapy after failure of the randomly assigned treatment were updated. OS was defined from the date of randomization until the date of death due to any cause, or the date of last contact. A two-tailed log-rank test was used to compare the OS distribution between the 3 arms with a 5% alpha level. Results: The median follow-up is 35.1 months (range 24.2 to 44.7). In an intent-to-treat analysis, 35-month OS rates were 37% (95% CI 27 to 48), 55% (95% CI 40 to 69) and 62% (95% CI 47 to 76) in arms T+B, S and B+I respectively (3-arm global comparison: p-value=0.0279). OS was not significantly lower in T+B arm than S arm (HR = 0.67, 95% CI 0.40 to 1.12), but significantly lower in T+B arm than B+I arm (HR = 0.48, 95% CI 0.27 to 0.86). Tyrosine kinase inhibitors were administered in 55 (79.7%), 19 (79.2%) and 23 (63.9%) pts in arms T+B, S and B+I respectively, without significant difference between arms (Fisher’s exact test: p=0.20). To note, 21% pts in S arm and 15% pts in B+I arm received an mTOR inhibitor in 2d line therapy. Conclusions: A large majority of pts in all treatment groups received a 2d line therapy after initial treatment failure. The OS rates confirm the absence of synergy or addictive effect of the B+T combination as well as the prolonged survival of pts treated with B+I.

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Outcome of Adolescents and Young Adults with Acute Myeloid Leukemia (AML) As Compared to Pediatric AML Patients: Real World Data from SEER Registry

Blood ◽

10.1182/blood.v126.23.4484.4484 ◽

2015 ◽

Vol 126 (23) ◽

pp. 4484-4484

Author(s):

Smith Giri ◽

Nunnery Sara ◽

Syed S. Nasir ◽

Michael G Martin

Keyword(s):

Overall Survival ◽

Pediatric Patients ◽

Survival Curve ◽

Population Based ◽

Early Mortality ◽

Rank Test ◽

P Value ◽

Log Rank Test ◽

Kaplan Meier ◽

Significant Difference

Abstract Background: Limited data exists regarding the characteristics and outcomes of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) which are largely under-represented in both pediatric and adult trials. We sought to compare the characteristics and outcomes of AYAs with AML using a large population based registry in the United States. Methods: We utilized Surveillance Epidemiology and End Results (SEER)-18 registry to identify all pediatric (0-18 years) and AYA (age 19-30 years) patients diagnosed with AML using appropriate histology codes based on the International Classification of Diseases for Oncology, 3rd version. Patients with acute promyelocytic leukemia (APL) were excluded from all analysis. Survival statistics were computed for each group using actuarial (Kaplan-Meier method) and compared using Z test for comparison of population proportions. Early mortality, defined as mortality within 1 month of diagnosis, was used as a surrogate for treatment related mortality. Kaplan Meier survival curves were plotted and compared using log-rank test. Multivariate analysis was done using logistic regression and Cox proportional hazard regression model. All p values were two sided and the level of significance was chosen at 0.05. Results: A total of 6343 eligible patients were identified, which comprised 2836 (44.7%) AYAs. A total of 52% (n=3346) were males, whereas 76%(n=4825) were whites. Histologically, majority of patients (56%; n=3545) were categorized as AML, not otherwise specified, followed by acute monocytic leukemia (9.9%, n=630). Majority (55%; n-3509) of the patients were diagnosed between 2001-2012. The early mortality rate was lower in the pediatric AML patients (pAML) as compared to AYAs (6.2% vs 9.2%; p<0.01). Similarly the 1 year (70.3% versus 62.1%; p <0.01) and 5 year (48.2% vs 36.4%; p<0.01) was higher in pediatric patients as compared to AYAs. Kaplan Meier plot showed worse overall survival of AYAs compared to pAMLs (Figure 1; p value of log rank <0.01). Multivariate logistic regression showed higher early mortality among AYAs as compared to pAML patients (OR 1.48; 95% CI 1.23-1.79; p<0.01). Similarly Cox regression showed worse overall survival among AYAs as compared to pAML (HR 1.34; 95% CI 1.26-1.44; p <0.01) Conclusions: Our population based analysis shows worse overall survival among AYAs as compared to pAML patients. Future clinical trials specifically focused on this age group are warranted to establish appropriate treatment regimens in this population. Figure 1. Kaplan Meier Survival curve showing cumulative survival among pediatric patients with AML as compared to AYAs. Log rank test showed statistically significant difference between the two curves (p value <0.01) Figure 1. Kaplan Meier Survival curve showing cumulative survival among pediatric patients with AML as compared to AYAs. Log rank test showed statistically significant difference between the two curves (p value <0.01) Disclosures No relevant conflicts of interest to declare.

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The Method and Results of a Treatment Targeting SARS-CoV-2-Activated Inflammasomes

10.21203/rs.3.rs-509122/v3 ◽

2021 ◽

Author(s):

Badar Kanwar ◽

Asif Khattak ◽

Chul Joong Lee ◽

Jenny Balentine ◽

R. E. Kast ◽

...

Keyword(s):

Case Series ◽

Cross Sectional Study ◽

Control Group ◽

P Value ◽

Test Statistic ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Pyrin Domain ◽

Significant Difference

Abstract Background Clinicians in critical care medicine considered dapsone administration to treat SARS-CoV-2 inflammasome. Dapsone is useful in the molecular regulation of Nod-like receptor family pyrin domain-containing 3 (NLRP3). Objective To study the targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by dapsone must be responsible for its observed preventive effects, functioning as a competitor. Methods This is case series with or without intervention; a cross-sectional study. We set out to use objective criteria of improvement, such as A. a reduction in the FIO2 requirement and B. a decrease in the progression of hypoxia. We treated the patients with standard COVID-19 ARDS treatment with dapsone 100 mg to target NLRP3 inflammasomes. Results The 22 cases were treated with standard COVID-19 therapy with dapsone (trial group), and the 22 cases were the control group. The comparison was made assuming that only decreased FIO2 was influential in the trial and control groups, which applied to only the ARDS onset stage. The chi-square statistic is 5.1836. The p-value is .02280. Fisher’s exact test statistic value is 0.0433. (The result is significant at p < .05) Furthermore, the ARDS-onset mortality rates were 0% (with dapsone) and 40% (without dapsone). Conclusion There was a significant difference in dapsone treatment results in the ARDS-onset group. We confirmed that dapsone clinically treated the onset of ARDS by targeting SARS-CoV-2-activated inflammasomes. Like chemically reacting substances, inflammasome and dapsone are competing, proving that it is only effective in treating early ARDS.

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Prognostic Impact of TS, MTHFR and XRCC1 Genetic Variants in 113 Patients with Myelodysplastic Syndromes

Blood ◽

10.1182/blood.v126.23.1675.1675 ◽

2015 ◽

Vol 126 (23) ◽

pp. 1675-1675

Author(s):

Federica Loscocco ◽

Giuseppe Visani ◽

Elisa Giacomini ◽

Annamaria Ruzzo ◽

Sara Galimberti ◽

...

Keyword(s):

Myelodysplastic Syndromes ◽

Genetic Variants ◽

Rank Test ◽

P Value ◽

Prognostic Impact ◽

Genotype Distribution ◽

Log Rank Test ◽

Hazard Risk ◽

Significant Difference ◽

Variant Alleles

Abstract Background: Several studies have suggested that genetic variability related with single nucleotide polymorphisms (SNPs) of the BER system, DNA synthesis and folate-metabolizing pathway genes could modulate DNA repair capacity. Moreover, these genes are supposed to be related to cancer risk. However, the prognostic impact of the association of individual and/or combined genetic variants in patients with myelodysplastic syndromes (MDS) remains undetermined. Methods: We genotyped 113 MDS patients, 54 with IPSS low/int-1 receiving only best supportive care (BSC group) and 59 with IPSS int-2/high treated with azacitidine (AZA-group), for the following polymorphisms: XRCC1 194 and 399, APE1 148, XRCC3 241, TS5'-UTR (2R/3R and G/C) and 3'-UTR (6bp+/6bp-), MTHFR 677 and 1298. Genomic DNA was analyzed by High Resolution Melting assay and restriction digests of PCR products. Overall survival (OS) was calculated using the Kaplan-Meier estimate probabilities, and differences between survival curves were analyzed by the log-rank test. Multivariate analyses were performed using the Cox method. Results: For all the target genes, the distribution of genotypes was consistent with the Hardy-Weinberg equilibrium. Among the baseline characteristics analyzed (age, sex, diagnosis according to WHO, hemoglobin) there was no statistically significant difference in the genotype distribution of studied polymorphisms. In the BSC group, the variants XRCC1 399 GG [Hazard ratio (HR)=7.07; p=0.02], -6/-6 of TS3'-UTR (HR=4.65; p=0.05), 2R/3G, 3C/3G, 3G/3G of TS5'-UTR (HR=11.44; p=0.02) and TT of MTHFR 677 (HR=67.12; p<0.001), were associated with a statistically significant adverse clinical outcome compared to variant alleles (Table 1). This is consistent with the enzymatic activity reduction attributed to these genetic variants. Multivariable regression model analysis was also performed in the AZA group for the same genetic variants. We found similar results for the association between XRCC1 399 GG(HR=5.71 p=0.002), TS3'-UTR +6/+6(HR=0.097 p=0.004), MTHFR 677 TT (HR=8.58 p<0.001) and survival, but not for SNPs in TS5'-UTR (Table 2). Finally, we performed an exploratory analysis to investigate the combined effect of the unfavorable genotypes on survival. In the BSC group, the 3-year OS was 33% for those patients with ≥2 variant alleles, as compared to 62.5%, and 100%, respectively, for those with 2 or 0/1 variant alleles. The predictive role of the adverse genotypes combination on survival was confirmed also in the AZA group, suggesting that patients with a higher number of genetic variants had a shorter survival. Interestingly, when we compared survival of patients with adverse genotypes between BSC and AZA groups, we did not find any statistically significant difference between the 2 groups (Kaplan-Meyer and Log-rank test). Therefore, we speculated that azacitidine could give a survival advantage to patients with unfavorable genetic variants, independently from IPSS at diagnosis. Conclusion: Our study reveals, for the first time, an associations between genetic variants in TS, MTHFR and XRCC1 genes, BSC, azacitidine and survival in MDS patients. If confirmed, they could represent new prognostic markers able to provide guidance for clinical management of MDS patients. In particular, the presence of adverse genotypes could represent a biomarker to treat patients with low-risk IPSS with azacitidine, if confirmed on larger series. Further studies with larger population are needed to validate these associations, especially in SNPs with low variant allele frequency. Table 1. Gene Genotype Hazard risk 95,0% CI forHazard Risk Lower 95,0% CI forHazard Risk Upper p value XRCC1 399 [G/G] versus [A/G-A/A] 7,072 1,295 38,619 0,024 TS5'-UTR [3G/3G, 3G/3C, 2R/3G] versus [2R/2R, 2R/3C, 3C/3C] 11,447 1,330 98,544 0,026 TS3'-UTR [Del/Del] versus [Del/Ins, Ins/Ins] 4,653 0,946 22,874 0,058 MTHFR 677 [T/T] versus [C/T-C/C] 67,125 6,409 703,081 <0,001 Table 2. Gene Genotype Hazard risk 95,0% CI forHazard Risk Lower 95,0% CI forHazard Risk Upper p value XRCC1 399 [G/G] versus [A/G-A/A] 5,713 1,904 17,142 0,002 TS3'-UTR [Ins/Ins] versus [Ins6/del6, del6/del6] 0,097 0,019 0,479 0,004 MTHFR 677 [T/T] versus [C/T-C/C] 8,587 2,749 26,828 <0,001 Disclosures Finelli: Celgene: Other: Speaker, Research Funding; Novartis: Other: Speaker; Janssen: Other: Speaker.

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Association of HIPEC with survival in patients with ovarian metastases of gastrointestinal origin.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15124 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15124-e15124 ◽

Cited By ~ 1

Author(s):

Srividya Srinivasamaharaj ◽

Dhruv Ranchhodbhai Chaudhary ◽

Xiaoyong Wu ◽

Shesh Rai ◽

Mary Ann Sanders ◽

...

Keyword(s):

Pancreatic Cancer ◽

Chart Review ◽

Rank Test ◽

P Value ◽

Chi Square ◽

Ovarian Metastases ◽

Log Rank Test ◽

Kaplan Meier ◽

Ovarian Involvement

e15124 Background: Metastatic ovarian involvement in primary gastrointestinal (GI) carcinomas (CA) is associated with a poor prognosis. We performed a survival analysis in patients with ovarian metastases, based on site of primary GI CA (appendiceal, colorectal (CRC), gastric, and pancreatic). We also examined the association between hyperthermic intraperitoneal chemotherapy (HIPEC) and death in these patients. Methods: A search was conducted in a single institution pathology database for patients with primary GI CA and ovarian metastases diagnosed from 2010 to 2017. The search yielded 39 patients, and data pertaining to tumor characteristics and treatment were obtained by chart review. Chi-square (log rank) test was used to test for associations between both site of primary GI CA and HIPEC, and death, and Kaplan-Meier analysis was done. P-value < 0.05 was deemed statistically significant. Results: CRC accounted for the majority of patients (51.29%) with appendiceal CA accounting for 23.08% and gastric and pancreatic cancer making up the remainder. Primary site of malignancy was associated with survival (p = 0.036), favoring those with appendiceal and colorectal primaries. A total of 30 patients (76.92%) received HIPEC. Having undergone HIPEC was significantly associated with survival (p = 0.017). Conclusions: Ovarian metastases secondary to gastric and pancreatic cancer were associated with inferior survival as compared to those with appendiceal or colorectal primaries. A significant association was demonstrated between HIPEC and survival. Further investigation to define the role of HIPEC in the treatment of carcinomas of gastrointestinal primaries is warranted.

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P4698Survival outcomes in patients with Eisenmenger syndrome after heart-lung or bilateral sequential lung transplantation

European Heart Journal ◽

10.1093/eurheartj/ehz745.1079 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Kearney ◽

N Bart ◽

K Khush ◽

D Hayes ◽

A Keogh

Keyword(s):

Lung Transplantation ◽

Septal Defect ◽

Cardiac Repair ◽

Rank Test ◽

P Value ◽

Eisenmenger Syndrome ◽

Post Transplant ◽

Log Rank Test ◽

Significant Difference

Abstract Background Eisenmenger syndrome (ES) is defined as pulmonary hypertension secondary to a right to left intracardiac shunt, commonly an atrial septal defect (ASD) or ventricular septal defect (VSD). Heart-lung (HLTx) or bilateral sequential lung transplantation (BSLT) are both treatment options for some candidates. The choice between these two procedures has varied historically and according to transplant centre preference and donor availability. We completed a retrospective study to determine if BSLT with cardiac repair was associated with better outcomes compared to HLTx. Aim This study compared post-transplant survival in patients with ES undergoing HLTx or BSLT. Method Using the International Society Heart and Lung Transplantation Registry data, we identified all patients with ES between October 1, 1987 and March 31, 2018. Results A total of 177 patients underwent HLTx for ES ASD and 101 who underwent BSLT with cardiac repair. Median follow up was 890 days (range 0–9888 days) for the entire post-transplant cohort. 126 HLTx and 66 BSLT patients died in the follow up period. A total of 173 ES VSD patients underwent HLTx in the database, and 52 underwent BSLT with cardiac repair. Median follow up was 460 days (range 0–8406 days) for the entire post-transplant cohort. 116 HLTx and 36 BSLT patients died during the follow up period. Figure 1 demonstratres the comparative Kaplan-Meier survival curves following BSLT or HLTx for Eisenmenger's ASD and VSD patients. No statistically significant difference in Eisenmenger survival between combined heart-lung transplantation or bilateral sequential lung transplantation group (ASD log rank test p value = 0.99, VSD log rank test p value = 0.1 performed for the first 6 year). Figure 1 Conclusions Our analysis determined that patients with ES and either VSD or ASD had similar long-term survival comparing HLTx with BSLT and cardiac repair.

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Efficacy of enterotoxigenicEscherichia colivaccine for bovine clinical mastitis

Journal of Dairy Research ◽

10.1017/s0022029911000069 ◽

2011 ◽

Vol 78 (2) ◽

pp. 149-153 ◽

Cited By ~ 2

Author(s):

Kazuhide Morimoto ◽

Madoka Shimizu ◽

Tomoyasu Kurose ◽

Keiji Nakatani ◽

Shinji Akita ◽

...

Keyword(s):

Incidence Rate ◽

Clinical Mastitis ◽

Rank Test ◽

Event Analysis ◽

Exact Test ◽

Fisher's Exact Test ◽

Log Rank Test ◽

Significant Difference ◽

Fisher’S Exact Test ◽

And Control

An enterotoxigenicEscherichia coli(ETEC) vaccine designed to prevent diarrhoea was inoculated into dairy cows, and the occurrence of clinical mastitis was investigated for 2 years. Half of 480 cows in five farms were subcutaneously inoculated with ETEC vaccine (Imocolibov) twice with a 1-month interval in 2007 and 2008. Fisher's exact test and survival (time to event) analysis with the log-rank test were used to compare vaccinates and controls. In 2007, there was no significant difference in the incidence rate of mastitis between vaccinate (20·3%) and control (17·1%) cows. The rate of death or culling due to mastitis was lower in vaccinated cows (7·4%) than in control cows (29·2%,P=0·07, Fisher's exact test;P=0·02, log-rank test). In 2008, there was no significant difference in both the incidence rate of mastitis and the rate of death or culling due to mastitis. Milk productivity was compared between vaccinates and controls in one farm. Multi-way analysis of variance (ANOVA) was performed for the amount of 4% fat-corrected milk, and there was no significant difference between vaccinates and controls. These results suggest that ETEC vaccine inoculation reduces death or culling due to mastitis, whereas no preventive effect on the development of mastitis was observed.

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Clostridioides difficile Infection Rates after Ceftolozane–Tazobactam and Ceftazidime–Avibactam Treatment Compared to Carbapenem Treatment: A Retrospective Single-Center Study

Hygiene ◽

10.3390/hygiene1030009 ◽

2021 ◽

Vol 1 (3) ◽

pp. 99-105

Author(s):

Nagisa Godefroy ◽

Helga Junot ◽

Laurence Drieux-Rouzet ◽

Cyril Méloni ◽

Charles-Edouard Luyt ◽

...

Keyword(s):

P Value ◽

Beta Lactam ◽

Chi Square ◽

Exact Test ◽

Clostridioides Difficile ◽

Single Center Study ◽

Significant Difference ◽

Clostridioides Difficile Infection ◽

Chi Square Test ◽

Few Data

Introduction: Ceftolozane–tazobactam (CT) and ceftazidime–avibactam (CZA) are new beta-lactam/beta-lactamase inhibitors (BL/IBL) and antibiotics. There are few data regarding their impact on Clostridioides difficile infections (CDI). The objective of our study was, therefore, to determine and compare the number of CDI occurring after treatment with CT or CZA and carbapenem (CBP). Methods: All patients who received at least one dose of CT or CZA in our hospital between 1 January 2018 and 31 December 2019 were included. We compared, during the same period, the number of CDI after CT or CZA treatment and CBPs by using a chi-square test of Fischer’s exact test when required. p value < 0.05 was considered as significant. Results: Among the 53 patients receiving CZA and 42 patients receiving CT, two and one, respectively, developed a CDI within 90 days. Of the three (3%) patients who developed a CDI, one died 15 days after his second CDI (36 days after initiation of CZA). Of the 2291 patients receiving CBP, 37 (1.6%) developed a CDI within 90 days. There was no significant difference between the number of CDI occurring after CBP and CT or CZA treatment. CT or CZA use is not associated with an increased rate of CDI compared to CBP.

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