Testing Denmark: a Danish Nationwide Surveillance Study of COVID-19

To date, including 318,522 participants, this is the largest population-based study with broad national participation where tests and questionnaires have been sent to participants’ homes. We found that more emphasis from national and local authorities toward the risk of infection should be placed on age of tested individuals, type of occupation, as well as exposure in local communities and households.

The effect of the COVID-19 pandemic on the epidemiology of positive blood cultures in Swiss intensive care units: a nationwide surveillance study

Background Evidence about the impact of the pandemic of COVID-19 on the incidence rates of blood cultures contaminations and bloodstream infections in intensive care units (ICUs) remains scant. The objective of this study was to investigate the nationwide epidemiology of positive blood cultures drawn in ICUs during the first two pandemic waves of COVID-19 in Switzerland. Methods We analyzed data on positive blood cultures among ICU patients, prospectively collected through a nationwide surveillance system (ANRESIS), from March 30, 2020, to May 31, 2021, a 14-month timeframe that included a first wave of COVID-19, which affected the French and Italian-speaking regions, an interim period (summer 2020) and a second wave that affected the entire country. We used the number of ICU patient-days provided by the Swiss Federal Office of Public Health as denominator to calculate incidence rates of blood culture contaminations and bloodstream infections (ICU-BSI). Incidence rate ratios comparing the interim period with the second wave were determined by segmented Poisson regression models. Results A total of 1099 blood culture contaminations and 1616 ICU-BSIs were identified in 52 ICUs during the study. Overall, more episodes of blood culture contaminations and ICU-BSI were observed during the pandemic waves, compared to the interim period. The proportions of blood culture contaminations and ICU-BSI were positively associated with the ICU occupancy rate, which was higher during the COVID-19 waves. During the more representative second wave (versus interim period), we observed an increased incidence of blood culture contaminations (IRR 1.57, 95% CI 1.16–2.12) and ICU-BSI (IRR 1.20, 95% CI 1.03–1.39). Conclusions An increase in blood culture contaminations and ICU-BSIs was observed during the second COVID-19 pandemic wave, especially in months when the ICU burden of COVID-19 patients was high.

Nationwide surveillance of methicillin-resistant Staphylococcus aureus isolated from bloodstream infections in Japan

Objectives: Some single-center studies have reported that methicillin-resistant Staphylococcus aureus (MRSA) carrying the staphylococcal cassette chromosome mec (SCCmec) type IV has been increasing in bloodstream infections (BSIs) in Japan. Therefore, we conducted nationwide surveillance for MRSA BSI in Japan to verify that there is a change all over Japan. Methods: We recruited 51 Japanese hospitals from the Japanese Association for Infectious Diseases. MRSA strains, which were detected in two or more sets of blood, were collected between January and September 2019. They were analyzed by antimicrobial susceptibility testing at Nagasaki University Hospital. Whole-genome sequencing was also performed to determine SCCmec typing and multilocus typing and detect drug-resistance and virulence genes. Results: 270 MRSA strains were collected from 44 hospitals. The major clones were ST8 with SCCmec type IV (ST8-IV) (30.7%), ST1-IV (29.6%), ST2725-IV (9.5%), ST764-II (8.1%), and ST5-II (7.8%). However, there were regional differences among the most major clones. The most common clones in western, eastern, and northern Japan were ST1-IV, ST8-IV, and ST5-II, respectively. ST8-IV, ST1-IV, and ST2725-IV exhibited lower drug resistance against clindamycin and minocycline than ST764-II and ST5-II, but erm(A) was detected in 93.8% and 100% of ST1-IV and ST2725-IV, respectively. Based on drug-resistance and virulence genes, characteristics were different between ST8-IV and clonal complex 1-IV comprising ST1-IV and ST2725. In addition, the two major types were expected to be ST8-IV. Conclusions: This study revealed that SCCmec type IV clones replaced SCCmec type II in MRSA BSI.

Epidemiologic characteristics of Campylobacter infections in high-income countries: a systematic review

Introduction. The Campylobacter is the most common bacterial cause of foodborne illnesses in high-income countries. In contrast to other infectious diseases, the number of Campylobacter cases has increased in developed countries over the last ten years. A systematic review has been conducted to identify the factors contributing to incidence of Campylobacter infection in developed countries and to estimate it by age, sex, geography, and season.Materials and methods. The review was limited to studies published in English from 2010-2021; eight nationwide surveillance and register-based cohort studies, which met the selection criteria, were included in the review.Results. While the highest incidence of Campylobacter infection was reported among young children living in rural areas, the highest number of Campylobacter cases among adults was recorded in urban settings. Nevertheless, population-wise, children and older adults are most affected, while the incidence rates are higher in males than in females, with cases peaking every summer.Conclusion. Campylobacter infection is a public health concern in high-income countries, being difficult to eradicate and having become an urgent challenge to the existing well-developed surveillance systems. Additionally, the threat of antibiotic resistance in Campylobacter is growing at an alarming rate. The reasons behind Campylobacter affecting more men than women as well as the age and geographic distribution of the infection still need thorough research.

Increase in the proportion of Plasmodium falciparum with kelch13 C580Y mutation and decline in pfcrt and pfmdr1 mutant alleles in Papua New Guinea

Background The C580Y mutation in the Plasmodium falciparum kelch13 gene is the most commonly observed variant in artemisinin-resistant isolates in the Greater Mekong Subregion (GMS). Until 2017, it had not been identified outside the GMS, except for Guyana/Amazonia. In 2017, three parasites carrying the C580Y mutation were identified in Papua New Guinea (PNG). As the C580Y allele rapidly spread in the GMS, there is concern that this mutant is now spreading in PNG. Methods In 2020, a cross-sectional survey was conducted at two clinics in Wewak, PNG. Symptomatic patients infected with P. falciparum were treated with artemether plus lumefantrine following a national treatment policy. Blood samples were obtained before treatment, and polymorphisms in kelch13, pfcrt, and pfmdr1 were determined. Parasite positivity was examined on day 3. The results were compared with those of previous studies conducted in 2002, 2003, and 2016–2018. Results A total of 94 patients were included in this analysis. The proportion of C580Y was significantly increased (2.2% in 2017, 5.7% in 2018, and 6.4% in 2020; p = 4.2 × 10–3). A significant upward trend was observed in the wild-type proportion for pfcrt (1.9% in 2016 to 46.7% in 2020; p = 8.9 × 10–16) and pfmdr1 (59.5% in 2016 to 91.4% in 2020; p = 2.3 × 10–6). Among 27 patients successfully followed on day 3, including three with C580Y infections, none showed positive parasitaemia. Conclusions Under the conditions of significant increases in pfcrt K76 and pfmdr1 N86 alleles in PNG, the increase in kelch13 C580Y mutants may be a warning indicator of the emergence of parasites resistant to the currently used first-line treatment regimen of artemether plus lumefantrine. Therefore, nationwide surveillance of molecular markers for drug resistance and assessment of its therapeutic effects are important.

Nationwide surveillance for Telmisartan alone or with combination at real world therapy in Indian patients with hypertension (START)

Background: Angiotensin receptor blockers (ARBs) are amongst the most preferred class of antihypertensive as reported at various evidences or guidelines. However, choice amongst ARBs differs between practicing physicians in real-life scenario. This survey aimed to understand the usage preferences of telmisartan therapy alone and in combination for treating hypertension (HT) among practitioners at various clinical settings in real-life scenario in India.Methods: A cross‑sectional survey was conducted with a pre-validated survey questionnaire consisting of 15 questions pertaining to the telmisartan and its combination usage in HT management. Total 498 registered medical practitioners (mostly physicians and cardiologists) had participated in survey. They were approached for seeking their perception, opinions, and prescribing behaviour. Categorical data was summarized by number (n) and percentage (%) in each category. Data were summarised in frequency tables.Results: Key findings from the data analysed were as follows: Around 20-40% of patients been reported to have co-morbid hypertension and diabetes as reported by the majority of the physicians. Preferred class of drug in patients with hypertension with diabetes reported to be ARB. Around 90.36% of doctors reported that telmisartan was the most preferred ARB in patients with hypertension associated with high cardiovascular risk. Around 90.76% of doctors reported for their preference for telmisartan in patients with hypertension for 24-hr BP control. Around 82.93% of doctors preferred telmisartan in patients with hypertension and stroke/post-MI status.Conclusions: Indian healthcare practitioners prefer telmisartan as the most preferred ARB either alone or in a combination in patients with hypertension, including those with comorbidities.