ABSTRACT
INTRODUCTION: Ceftazidime-avibactam has proven activity against multidrug-resistant (MDR) bacteria in clinical trials and real-world studies. This study was conducted to describe the patterns of use of ceftazidime-avibactam (including indications and associated antibiotics), and the effectiveness and safety of ceftazidime-avibactam in real-world clinical practice. METHODS: This non-interventional medical chart review study was conducted in 11 countries across the European and Latin American (LATAM) regions. Consecutive patients treated in clinical practice with at least one dose of ceftazidime-avibactam for an approved indication per country label since 01 January 2018 (or launch date in the country if posterior) were enrolled. Effectiveness analyses were conducted in patients treated with ceftazidime-avibactam for at least 72 h. RESULTS: Of the 569 eligible patients enrolled, 516 (90.7%) were treated for at least 72 h (354 patients from Europe and 162 patients from LATAM); 390 patients (75.7%) had switched from another antibiotic line for Gram-negative coverage. Infection sources were intra-abdominal, urinary, respiratory, bloodstream infections, and other infections (approximately 20% each). K. pneumoniae was the most common microorganism identified in the latest microbiological evaluation before starting ceftazidime-avibactam (59.3%). Two-thirds of microorganisms tested for susceptibility were MDR, of which 89.3% were carbapenem-resistant. The common MDR mechanisms for K. pneumoniae were carbapenemase (33.9%), oxacillinase 48 (25.2%), extended-spectrum beta-lactamase (21.5%), or metallo-beta-lactamase (14.2%) production. Without prior patient exposure, 17 isolates (mostly K. pneumoniae) were resistant to ceftazidime-avibactam. Treatment success was achieved in 77.3% of patients overall (88.3% among patients with urinary infection), regardless of first or second treatment line. In-hospital mortality rate was 23.1%. Adverse events were reported for six of the 569 patients enrolled. CONCLUSION: This study provides important real-world evidence on treatment patterns, effectiveness, and safety of ceftazidime-avibactam in clinical practice through its recruitment in the European and LATAM regions. Ceftazidime-avibactam is one of the antibiotics to consider for treatment of MDR bacteria. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03923426.
ABSTRACT
The current COVID-19 vaccines protect against severe disease, but are not effective in controlling replication of the Variants of Concern (VOCs). Here, we used the existing pre-clinical models of severe and moderate COVID-19 to evaluate the efficacy of a Spike-based DNA vaccine (pCTV-WS) for protection against different VOCs. Immunization of transgenic (K18-hACE2) mice and hamsters induced significant levels of neutralizing antibodies (nAbs) to Wuhan and Delta isolates, but not to the Gamma and Omicron variants. Nevertheless, the pCTV-WS vaccine offered significant protection to all VOCs. Consistently, protection against lung pathology and viral load to Wuhan or Delta was mediated by nAbs, whereas in the absence of nAbs, T cells controlled viral replication, disease and lethality in mice infected with either the Gamma or Omicron variants. Hence, considering the conserved nature of CD4 and CD8 T cell epitopes, we corroborate the hypothesis that induction of effector T-cells should be a main goal for new vaccines against the emergent SARS-CoV-2 VOCs.
ABSTRACT
The current COVID-19 vaccines protect against severe disease, but are not effective in controlling replication of the Variants of Concern (VOCs). Here, we used the existing pre-clinical models of severe and moderate COVID-19 to evaluate the efficacy of a Spike-based DNA vaccine (pCTV-WS) for protection against different VOCs. Immunization of transgenic (K18-hACE2) mice and hamsters induced significant levels of neutralizing antibodies (nAbs) to Wuhan and Delta isolates, but not to the Gamma and Omicron variants. Nevertheless, the pCTV-WS vaccine offered significant protection to all VOCs. Consistently, protection against lung pathology and viral load to Wuhan or Delta was mediated by nAbs, whereas in the absence of nAbs, T cells controlled viral replication, disease and lethality in mice infected with either the Gamma or Omicron variants. Hence, considering the conserved nature of CD4 and CD8 T cell epitopes, we corroborate the hypothesis that induction of effector T-cells should be a main goal for new vaccines against the emergent SARS-CoV-2 VOCs.
ABSTRACT
Objetivo: Este estado teve como objetivo determinar a qualidade de vida dos estudantes do ensino superior dos Institutos Politécnicos de Santarém e Leiriano período da pandemia COVID-19 .Métodos: A populacho é constituida 6483 estudantes que frequentam o ensino superior, dos dois Institutos. Um total de 775 participantes selecionados por amostragem de conveniencia participaram no estado. Estado de caráter quantitativo, descritivo-correlacional, visando descrever fenómenos e posteriormente identificar e explorar possíveis relaçöes entre as variáveis. Aplicouse o instrumento WHOQOL-Bref adaptado da WHO. O tratamento e análise dos dados foi realizado com recurso a estatística descritiva, correlacional e inferencial. Resultados: A autoavaliacáo dos estudantes relativamente a Qualidade de Vida é globalmente superior â autoaval iacáo com a sua satisfacáo com a saúde, sendo os estudantes do género feminino que apresentam valores medios inferiores aos estudantes do género masculino. Os dominios do WHOQOL-Bref referentes à Qualidade de Vida com valores superiores foram o dominio físico e meio ambiente, sendo os dominios das relaçöes sočiais e psicológico, os que apresentam valores menores. Conclusão: Os resultados apontam para a necessidade de intcrvcncäo na promocäo da Qualidade de Vida dos estudantes, com foco em fatores psicossociais, decorrente das condicionantes impostas no período de confinamento, pela pandemia COVID-19.Alternate :Objetivo: Este estadio tuvo como objetivo determinar la calidad de vida de los estudiantes de educación superior de los Institutos Politécnicos de Santarém y Leiria durante la pandemia del COVID-19. Métodos: La población está formada por 6483 estudiantes de educación superior, de ambos Institutos. Participaron en el estudio un total de 775 participantes seleccionados por muestreo de conveniencia. Estudio cuantitativo, descriptivo, correlacional, con el objetivo de describir fenómenos y posteriormente identificar y explorar posibles relaciones entre variables. Se aplicó el instrumento WHOQOL-Bref adaptado de la OMS. El tratamiento y análisis de los datos se realizó mediante estadística descriptiva, correlacional e inferencial. Resultados: La autoevaluación de los estudiantes con respecto a la calidad de vida es globalmente superior a la autoevaluación de su satisfacción con la salud, siendo las estudiantes las que tienen valores promedio más bajos que los estudiantes. Los dominios WHOQOL-Bref referentes a la Calidad de Vida con valores más altos fueron los dominios físico y ambiental, siendo los dominios de relaciones sociales y psicológicas los de menor valor. Conclusión: Los resultados apuntan a la necesidad de una intervención para promover la Calidad de Vida de los estudiantes, con foco en los factores psicosociales, debido a las condiciones impuestas durante el período de encierro, por la pandemia COVID-19.Alternate :Objective: This study aims to determine the quality of life of higher education students at the Polytechnic Institutes of Santarem and Leiria during the COVID-19 pandemic. Methods: The population consists of 6483 students attending higher education, from both Institutes. A total of 775 participants selected by convenience sampling, participated in the study. Study with a quantitative, descriptive, correlational character, aiming to describe phenomena and, in addition, identify and explore possible relationships between variables. The WHOQOL-Bref instrument adapted from WHO was applied. The data treatment and analysis were performed using descriptive, correlational, and inferential statistics. Results: Students' self-assessment about Quality of Life is globally superior to the self-assessment with their satisfaction with health, where the female students have lower average values than the male students. The WHOQOL-Bref domains referring to Quality of Life with higher values were the Physical and Environment domain, with the Social Relations and Psychological domains having the lowest values. Conclusion: The ults point to the need for intervention to promote the Quality of Life of students, focusing on psychosocial factors, due to the conditions imposed during the confinement period, by the pandemic COVID-19.
ABSTRACT
Coronaviruses (CoVs) are part of the Coronaviridae family, and the genera Gamma (γ) and Delta (δ) are found mostly in birds. Migratory birds have an enormous potential for dispersing pathogenic microorganisms. Ducks (order Anseriformes) can host CoVs from birds, with pathogenic expression and high economic impact. This study aimed to identify and characterize the diversity of CoVs in migratory ducks from Portugal. Duck stool samples were collected using cloacal swabs from 72 individuals (Anas platyrhynchos, Anas acuta, and Anas crecca). Among the 72 samples tested, 24 showed amplicons of the expected size. Twenty-three were characterized as Gammacoronavirus and one as Deltacoronavirus (accession numbers ON368935-ON368954; ON721380-ON721383). The Gammacoronaviruses sequences showed greater similarities to those obtained in ducks (Anas platyrhynchos) from Finland and Poland, Anas crecca duck from the USA, and mute swans from Poland. Birds can occupy many habitats and therefore play diverse ecological roles in various ecosystems, especially given their ability to migrate exceptional distances, facilitating the dispersal of microorganisms with animal and/or human impact. There are a considerable number of studies that have detected CoVs in ducks, but none in Portugal. The present study assessed the circulation of CoVs in wild ducks from Portugal, being the first description of CoVs for these animals in Portugal.
ABSTRACT
There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.
ABSTRACT
There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.
ABSTRACT
Capnocytophaga canimorsus is a gram-negative rod that is part of the commensal flora of dogs' mouths. Among splenectomized patients who maintain close contact with dogs, the bacteria can lead to infection and fulminant sepsis even without evidence of a skin breach. In this report, we describe the case of a 71-year-old woman who had undergone splenectomy 35 years ago. She came to our emergency department complaining of back pain, myalgia, asthenia, and a fever of 40.2ºC. No other symptoms were noted upon her admission. Blood workup revealed hyperlacticaemia, increased C-reactive protein, and lymphopenia. A urinalysis and chest radiography were ordered, with no abnormal findings, and the SARS-CoV-2 test was negative. The patient developed persistent hypotension and drowsiness that did not improve with intravenous fluids. Therefore, she was started on a norepinephrine infusion. Cultures were collected, and intravenous antibiotic therapy was started with amoxicillin/clavulanic acid 2.2 mg and azithromycin 500 mg. Besides all the diagnostic tests, no infectious cause was found. On the second day of hospitalization, she started to deteriorate, and antibiotic therapy was escalated to piperacillin/tazobactam 4.5 g, resulting in a good clinical response. On the third day after admission, thanks to a group discussion, we were able to identify C. canimorsus in the patient's blood cultures. A review of history revealed that the patient was in close contact with her pet dog. This case highlights the importance of a multidisciplinary discussion, including the microbiology team, in order to reach an uncommon diagnosis. When dealing with splenectomized individuals presenting with the septic shock of unclear origin, a history of close contact with dogs must lead clinicians to consider C. canimorsus as a causative agent.
ABSTRACT
Background The context of coronavirus on higher education caused upsetting consequences on students' lives. The restrictions on social mobility and the consequent reduction of interpersonal contacts brought them unprecedented stressful situations. The extent and quality of adaptation to these situations, due to the uniqueness of each person's resources, needs to be early known preventing eventual and serious psychological disorders. This study aimed to assess stress, anxiety, and depression among undergraduate students from both Santarém and Leiria Polytechnic Institutes. Methods A descriptive cross-sectional correlational study was performed in the period immediately after the first lockdown. Participants were 775 students (females = 73.5%), aged between 17 and 55 years. All of them completed measures of the Depression Anxiety and Stress Scale-21 (DASS-21;in the Portuguese version EADS, by Pais-Ribeiro, Honrado e Leal, 2004). Collected data were analyzed with IBM SPSS Statistics for Windows software, Version 27.0. Results According to DASS-21 scoring instructions (Lovibond & Lovibond, 1995), results showed that most participants had experienced a normal level of depression (72.5%), anxiety (79.7%) and stress (87.6%). However, about 4.7% and 1.8% of respondents, respectively, report a severe or extremely severe level of anxiety or depression. We also found significant differences for the three dimensions in terms of polytechnic institute attended, gender, age categories, and marital status. Conclusions The findings suggest that higher education institutions must understand this phenomenon experienced and develop strategies for improving students' mental health, especially in vulnerable groups. The importance of a transdisciplinary approach is emphasized and the involvement of all educational stakeholders is encouraged.
ABSTRACT
Background The epidemic of COVID-19 caused by the Coronavirus -SARS-CoV-2, was declared by the World Health Organization an International Public Health Emergency. The 2019–2020 coronavirus pandemic has affected educational systems worldwide, leading to the closure of educational institutions. This situation kept students socially distant, with little adaptation time, interfering with their quality of life. Methods The aim of this study is to evaluate the quality of life of higher education students in the face of the impact of the COVID-19 pandemic. 775 students were selected by convenience sampling. Study with a quantitative, descriptive, correlational approach. The WHOQOL-bref instrument adapted from WHO was applied. Data analysis was undertaken using the IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp. Results Students' self-assessment about Quality of Life is globally superior to the self-assessment with their satisfaction with health, where the female students have lower average values than the male students. The WHOQOL-bref domains referring to Quality of Life with higher values were the Physical and the Environment ones, with the Social Relations and Psychological domains having the lowest values. Conclusions The development of this study made it possible to achieve the objective set. The domain of social relations has low average values, with students from IPSantarem standing out, with lower self-assessment of QoL in this domain, compared to those from IPLeiria. In the psychological domain, the low average values in both institutes stand out, especially in IPLeiria, where the average is less than 50%, in both genders.
ABSTRACT
Background The social restraints during the COVID-19 mandatory lockdown led young and undergraduate adults living remarkable changes in their daily lives, challenging the feeling of loneliness and the own perception of social isolation. This study aimed to assess and compare the levels of psychological well-being among students from both Santarém and Leiria Polytechnic Institutes. Methods A descriptive cross-sectional correlational study was performed in the period immediately after the first lockdown. Participants were 775 students (females = 73.5%), aged between 17 and 55 years. All of them completed measures of the Psychological Well-Being Manifestation Scale (PWBMS;or EMMBEP, in the Portuguese version, by Monteiro, Tavares e Pereira, 2012) measuring six dimensions, components of the eudaimonic model of well-being. Collected data were analyzed with IBM SPSS Statistics for Windows software, Version 27.0. Results The results obtained revealed differences of quality in the scores of the six measured dimensions. If subjective experiences on Mental Balance and Sociability are the best indicators of the well-being, the perception of the lack of Social Involvement and low Happiness appear to be limitative factors to the perceived well-being. We also found significant differences in terms of polytechnic institute attended, gender, age categories, and marital status. Conclusions The obtained results provide the basis to design and develop a targeted intervention main program focused on the empowerment of higher education students. Build a literacy program with health education strategies, starting from their own perceptions and responses to the experienced situations, allows their easy engagement in the promotion of the psychological well-being.
ABSTRACT
Objetivo: Enumerar las pautas y recomendaciones para la prevención y el control de COVID-19 en instituciones de atención a larga estancia para ancianos. Método: Esta es una carta al editor que resume las principales pautas sobre la prevención y el control de COVID-19 en instituciones de atención a larga estancia para ancianos que se encuentran disponibles en documentos de agencias federales brasileñas. Resultados: Se recomienda en todas las instituciones realizar el diagnóstico situacional, la suspensión de visitas externas, la evaluación multidimensional de los residentes y la adopción de prácticas preventivas de salud como el ejercicio físico y la alimentación saludable con la distancia mínima entre los ancianos. Además, se destacan las medidas individuales, colectivas, ambientales y de higiene de los materiales y alimentos, con vigilancia y detección temprana de signos y síntomas sugestivos de la enfermedad, con el ingreso hospitalario justificado en presencia de signos clínicos de gravedad. Además, se refuerza la importancia de involucrar a los residentes y familiares en la detección de los riesgos de propagación de la enfermedad y en las estrategias de prevención, con el objetivo de optimizar la cultura de seguridad y capacitar a los residentes y miembros de la familia para garantizar una atención segura y de calidad. Conclusión: La difusión de información y directivas seguras es esencial para prevenir la difusión de Covid-19 en instituciones a larga estancia para mantener la salud y el bienestar de los ancianos y sus cuidadores.
Subject(s)
Humans , Aged , Communicable Disease Control/methods , COVID-19/prevention & control , Homes for the AgedABSTRACT
Accurate testing to detect SARS-CoV-2 RNA is key to counteract the virus spread. Nonetheless, the number of diagnostic laboratories able to perform qPCR tests is limited, particularly in developing countries. We describe the use of a virus-inactivating, denaturing solution (DS) to decrease virus infectivity in clinical specimens without affecting RNA integrity. Swab samples were collected from infected patients and from laboratory personnel using a commercially available viral transport solution and the in-house DS. Samples were tested by RT-qPCR, and exposure to infective viruses was also accessed by ELISA. The DS used did not interfere with viral genome detection and was able to maintain RNA integrity for up to 16 days at room temperature. Furthermore, virus loaded onto DS were inactivated, as attested by attempts to grow SARS-CoV-2 in cell monolayers after DS desalt filtration to remove toxic residues. The DS described here provides a strategy to maintain diagnostic accuracy and protects diagnostic laboratory personnel from accidental infection, as it has helped to protect our lab crew.