Microbiological Case Report: Epidemiological Characteristics and Update of Covid-19 Cases in St. Lucia

Coronavirus disease 2019 (COVID-19) is a potentially severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2.The virus was identified as the cause of an outbreak of pneumonia of unknown cause in Wuhan City, Hubei Province, China, in December 2019. The clinical presentation is that of a respiratory infection with a symptom severity ranging from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal [1,2].

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Corona Virus dan Manajemen Mutu Pelayanan Klinis di Rumah Sakit

The Journal of Hospital Accreditation ◽

10.35727/jha.v2i1.62 ◽

2020 ◽

Vol 2 (1) ◽

pp. 1-2

Author(s):

Hanevi Djasri

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Respiratory Infection ◽

Clinical Guidelines ◽

Acute Respiratory Infection ◽

Distress Syndrome ◽

Corona Virus ◽

Severe Acute Respiratory Infection

Badan Kesehatan Dunia (WHO) telah mengeluarkan pedoman tatalaksana infeksi saluran pernapasan akut berat (severe acute respiratory infection/SARI) yang diduga karena COVID-19. Pedoman tersebut ditujukan untuk para dokter yang merawat pasien di rumah sakit untuk memberikan kemudahan akses terhadap panduan terkini dalam rangka memastikan tatalaksana terbaik bagi pasien. Pedoman tersebut memuat: 1) proses triage untuk mengenali dan menyortir pasien dengan SARI; 2) tindakan segera untuk pencegahan dan pengendalian infeksi dengan tepat; 3) pemberian terapi dan pemantauan; 4) pengumpulan spesimen untuk diagnosis laboratorium; 5) tatakelola gagal napas hipoksemia dan sindrom gangguan pernapasan akut acute respiratory distress syndrome/ARDS); 6) manajemen syok septik; 7) pencegahan komplikasi; 8) perawatan khusus anti COVID-19; dan pertimbangan khusus untuk pasien hamil. Sebagai pengelola rumah sakit, ketersediaan pedoman internasional ini perlu dicermati, diadopsi menjadi pedoman klinis (clinical guidelines), diterapkan dan dievaluasi sebagai bagian dari manajemen mutu pelayanan klinis. Dalam standar akreditasi rumah sakit di Indonesia, penyusunan dan penerapan pedoman klinis memang disyaratkan dalam bentuk Panduan Praktik Klinis (PPK), terlebih untuk tatalaksana pasien dengan risiko tinggi. Standar akreditasi juga meminta agar PPK juga menjadi dasar untuk melakukan evaluasi mutu dan keselamatan asuhan pasien yang diberikan oleh setiap klinisi.

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Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV

International Journal of STD & AIDS ◽

10.1177/0956462419882587 ◽

2020 ◽

Vol 31 (2) ◽

pp. 100-108 ◽

Cited By ~ 1

Author(s):

AC Pecego ◽

RT Amâncio ◽

DM Costa ◽

FA Bozza ◽

MM Siqueira ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Cd4 Cell Count ◽

Risk Of Death ◽

Severe Acute Respiratory Infection ◽

Living With Hiv ◽

Epidemiological Characteristics

People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospitalized with fever and cough. Those with symptom onset up to 10 days were classified as severe acute respiratory infection and 11–30 days as non-severe acute respiratory infection. Blood, urine samples and nasopharyngeal swabs were collected. Data were extracted from patient charts during their hospital stay. Forty-nine patients were included, median CD4 cell count: 80 cells/mm3, median time since HIV diagnosis and hospital admission: 84 months and 80% were antiretroviral therapy exposed. Twenty-seven patients were classified as SARI. Etiology was identified in 69%, 47% were polymicrobial. Respiratory virus (9 SARI vs. 13 non-SARI), bacteria (5 SARI vs. 4 non-SARI), Mycobacterium tuberculosis (6 SARI group vs. 7 non-SARI group), Pneumocystis jirovecii (4 SARI vs. 1 non-SARI), Cryptococcus neoformans (1 SARI vs. 3 non-SARI), and influenza A (1 SARI vs. 2 non-SARI). Dyspnea was statistically more prevalent in SARI (78% vs. 36%, p = 0.011) but the risk of death was higher in the non-SARI (4% vs. 36%, p = 0.0067). In the severely immunocompromised PLWH, severe acute respiratory infection can be caused by multiple pathogens and codetection is a common feature.

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