Incidence of acute intestinal infections in Saint Petersburg during COVID-19 pandemic.

The results of a study of modern epidemiological and characteristics of acute intestinal infections against the backdrop of the COVID-19 pandemic are presented. The article reflects current trends in the frequency of detection of acute intestinal infections of viral and bacterial etiology, in particular, the growing prevalence of norovirus infection is shown. Particular attention is paid to the increase in the incidence of salmonellosis and campylobacteriosis. An increase in the incidence of salmonellosis in 2019 by 25.7% is shown, which is higher than the average long-term incidence rate by 28.1%. Age features of the incidence of viral and bacterial intestinal infections among children have been established. Given the widespread use of antibiotics or other drugs that change the intestinal microbial landscape (cytostatics, chemotherapy drugs), as well as a significant increase in the number of hospitalizations of patients, there is a high risk of developing antibiotic-associated diarrhea. Undoubted attention requires the problem of registration, diagnosis of clostridium infections, which make it difficult to obtain data on the prevalence of infection caused by Clostridium difficile in the Russian Federation and St. Petersburg. The article discusses in detail the possibilities for further improvement of measures to prevent the transmission of acute intestinal infections.Copyright © 2022 Authors. All rights reserved.

Incidence of acute intestinal infections in Saint Petersburg during COVID-19 pandemic.

The results of a study of modern epidemiological and characteristics of acute intestinal infections against the backdrop of the COVID-19 pandemic are presented. The article reflects current trends in the frequency of detection of acute intestinal infections of viral and bacterial etiology, in particular, the growing prevalence of norovirus infection is shown. Particular attention is paid to the increase in the incidence of salmonellosis and campylobacteriosis. An increase in the incidence of salmonellosis in 2019 by 25.7% is shown, which is higher than the average long-term incidence rate by 28.1%. Age features of the incidence of viral and bacterial intestinal infections among children have been established. Given the widespread use of antibiotics or other drugs that change the intestinal microbial landscape (cytostatics, chemotherapy drugs), as well as a significant increase in the number of hospitalizations of patients, there is a high risk of developing antibiotic-associated diarrhea. Undoubted attention requires the problem of registration, diagnosis of clostridium infections, which make it difficult to obtain data on the prevalence of infection caused by Clostridium difficile in the Russian Federation and St. Petersburg. The article discusses in detail the possibilities for further improvement of measures to prevent the transmission of acute intestinal infections.Copyright © 2022 Authors. All rights reserved.

Virucidal efficacy of household dishwashers

Not only since SARS-CoV-2, have transmission routes of viruses been of interest. Noroviruses e.g., can be transmitted via smear infection, are relatively stable in the environment and very resistant to chemical disinfection. Some studies determined the virucidal efficacy of laundering processes, but few studies focused on the virucidal efficacy of dishwashing processes. Here, especially consumer related conditions are of interest. Households for example are a hotspot of norovirus infection and thus a sufficient reduction of these and other viruses from dishes must be insured to avoid an infection via this route. The likelihood of such an event should not be underestimated, since it was shown that the washing machine can be a reservoir for the transmission of extended spectrum beta-lactamase producing bacteria in newborns. Although viruses do not replicate in these devices a transmission via contaminated cutlery e.g., cannot be excluded. Using a consumer related approach to determine the virucidal efficacy of dishwashers, we found a combination of a bleach containing dishwasher detergent, a cleaning temperature of 45 C for 45 min and a rinsing temperature of 50 C, to be sufficient to reduces viral titer of bovine corona virus, murine norovirus and modified vaccinia virus by 4.8, 4.2 and 3.8 logarithmic stages respectively.Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Protein losing enteropathy (PLE) secondary to norovirus infection in a 4 year old patient

Case Report: Protein losing enteropathy (PLE) occurs when proteins leak from the gastrointestinal (GI) system more rapidly than they are produced. Inflammation of the GI tract facilitates increased membrane permeability of gastric mucosa, leading to excess protein leakage. 1 PLE in children has been associated with CMV, rotavirus, COVID-19, HIV, C. difficile, and autoimmune diseases like Crohn's Disease. 2-6 Norovirus is a known cause of PLE in immunocompromised pediatric patients. 7-8 However, to our knowledge, there are no case reports about PLE precipitated by norovirus in immunocompetent pediatric patients. The purpose of this case report is to present a case of PLE precipitated by a norovirus infection in a 4- year-old previously healthy child. While the above gastrointestinal viruses have been proposed as precipitators for this disease, PLE precipitated by norovirus infection has not been well described. This case also highlights the importance of early diagnosis and management to avoid complications. Method(s): Our patient initially presented with two days of abdominal pain, diarrhea, emesis, reduced urine output, and swelling of the lower extremities. He was exposed to several sick family members-his sister had upper respiratory symptoms and his grandmother had gastrointestinal symptoms. Physical exam was notable for diminished breath sounds in the right lower lobe, abdominal distension with diffuse tenderness and dullness to percussion, significant scrotal and penile edema, and bilateral lower extremity pitting edema. Laboratory results revealed leukocytosis, hypoalbuminemia, hyponatremia, elevated aspartate aminotransferase (AST), and elevated serum alpha-1-antitrypsin, as well as low Immunoglobulins G and M. CD3 and CD4 levels were low reflecting cellular immune dysregulation seen in patients with PLE. IgA and Tissue Transglutaminase (TTF) were within normal limits. Ebstein Barr Virus and cytomegalovirus IgM antibodies were negative. COVID IgG was negative as well. His Polymerase chain reaction (PCR) gastrointestinal panel was positive for norovirus. A chest X-ray showed a large right pleural effusion. Abdominal CT revealed large ascites slightly more predominant in the upper abdomen, mesenteric lymphadenitis, and bilateral pleural effusions. Echocardiogram showed small anterior and apical pericardial effusions. Result(s): Based on the patient's elevated serum alpha-1 antitrypsin levels, hypoalbuminemia, low levels of immunoglobulins and lymphocytes, and clinical manifestations of ascites, bilateral pleural effusions, pericardial effusion, and dependent edema, along with a positive PCR for norovirus, the diagnosis of PLE secondary to Norovirus was made. Conclusion(s): This case demonstrates the importance of recognizing viruses like Norovirus as potential causes of PLE to avoid a delay in diagnosis and initiation of therapy, and to avoid unnecessary additional testing. Copyright © 2023 Southern Society for Clinical Investigation.

HOSPITILISATIONS FOR NOROVIRUS DECREASE DURING THE COVID-19 PANDEMIC

Background Gastrointestinal infections cause a significant burden to the Australian healthcare system each year, with acute gastroenteritis infections costing up to $359 million AUD ($258 million USD) in 2016. Viral causes of gastroenteritis, particularly Norovirus, account for the majority of these cases. Given the contagious nature of many causes of bacterial and viral gastroenteritis, it was hypothesized that widespread lockdowns and increased public health focus on regular hand hygiene would contribute to a reduction in hospital presentations with gastrointestinal infections. Melbourne, Victoria, Australia first went into lockdown in March 2020 and remained in various forms of lockdown until late 2020. Methods A retrospective study comparing rates of hospitalization for bacterial and viral gastroenteritis was performed at The Royal Melbourne Hospital between February-August in both 2019 and 2020. Rates of admission were compared between the two years, as well as the causative organism and the outcome of the presentation. Descriptive statistics were provided to summarise demographic characteristics. Outcomes between the two years were compared using paired t-tests for continuous variables and Pearson chi-square for categorical variables. All data analysis was performed using Stata 16.1 and p-values £0.05 were considered statistically significant. Results Demographic data are summarised in Table 1. 283 patients were hospitalized with gastroenteritis in 2019 pre-pandemic, compared to 147 in 2020 during the COVID-19 pandemic. There was a significant reduction in the number of patients admitted with positive fecal cultures from 2019 to 2020 (87 vs 57, p < 0.01). The number and percentage of patients presenting with Norovirus reduced by greater than 90% in 2020 compared to 2019 (Table 2) (Odds Ratio: 0.093 [Confidence Interval: 0.02-0.41], p<0.01). There was a reduction in the number of presentations with Salmonella, however, this did not reach statistical significance (p=0.50). The number of patients presenting with Clostridium difficile significantly increased in 2020 compared to 2019 (21 versus 25, p=0.01) (Table 2). Rates of antibiotic treatment and intensive care admission were greater in 2020 compared to 2019 however there was no significant difference in biomarkers, length of stay, or mortality (Table 2). Conclusion A significant decrease in the incidence of hospitalization secondary to acute gastrointestinal infections was observed during the COVID-19 pandemic. Norovirus presentations decreased by greater than 90% between 2019 and 2020. The rate of other GI infections was similar between pre-pandemic and pandemic time points. These findings suggest that public health measures, such as social distancing and hand hygiene, may be a useful adjunct to prevent Norovirus infections in the future and could result in significant healthcare savings.(Table Presented)TABLE 1: PATIENT DEMOGRAPHICS(Table Presented) TABLE 2: GASTROINTESTINAL CULTURE POSITIVE INFECTIONS 2019 VERSUS 2020