CSCO ablation expert workshop report: Recommendations for the management of tumor ablation during the coronavirus disease 2019 epidemic.

The coronavirus disease 2019 (COVID-19) has become a global pandemic since its outbreak in December 2019, which posed a threat to the safety and well-being of people on a global scale. Cancer patients are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and their critical morbidity and case fatality rates are high. The ablation expert committee of the Chinese Society of Clinical Oncology compiled corresponding expert recommendations. These recommendations summarize the preventive measures and management of tumor ablation treatment in medical institutions, including outpatient clinics, oncology wards, ablation operation room, and postablation follow-ups in accordance with the guidelines and protocols imposed by the National Health Commission of the People's Republic of China and the experience in management and prevention according to various hospitals. This consensus aims to reduce and prevent the spread of SARS-CoV-2 and its cross-infection between cancer patients in hospitals and provide regulatory advice and guidelines for medical personnel.

HIV-associated comorbidities as mediators of the association between people living with HIV and hospital-acquired infections.

BACKGROUND: Hospital-acquired infections (HAIs) lead to poor health outcomes in hospitalized patients and may be disproportionately affecting the aging population of people living with HIV (PLWH). This study determined the association between HIV and HAIs, and analyzed the potential mediating effects of comorbidities. METHODS: The Louisiana Hospital Inpatient Discharge Database for the years 2011-2015 was used. All patients with at least 1 HAI diagnosis within this source population were included as cases in the case-control study, and a 1:1 ratio of controls was randomly selected from the same hospitals. RESULTS: Of the 1,852,769 eligible hospital discharges that occurred from 2011 through 2015, there were 7,422 patients with at least 1 HAI. Marginal logistic regressions of the case-control sample showed a strong association between HIV and central line-associated bloodstream infections (CLABSIs), but an inverse association between HIV and any HAI. However, the mediation analyses revealed that having at least 1 comorbidity mediates the association between HIV and CLABSIs. DISCUSSION: The unexpected inverse association between HIV and HAI could be attributed to the sample size of the exposed group of patients, or it could be explained by the mechanisms of treatment for HIV patients. CONCLUSIONS: This study found that people living with HIV are at an increased risk of developing a CLABSI, which is consistent with the published literature. The mediation analyses indicated that having at least 1 comorbidity mediated the association between HIV and CLABSI diagnosis.

Infections after lung transplantation: time of occurrence, sites, and microbiologic etiologies.

BACKGROUND/AIMS: Infections are major causes of both early and late death after lung transplantation (LT). The development of prophylaxis strategies has altered the epidemiology of post-LT infections; however, recent epidemiological data are limited. We evaluated infections after LT at our institution by time of occurrence, site of infections, and microbiologic etiologies. METHODS: All consecutive patients undergoing lung or heart-lung transplantation between October 2008 and August 2014 at our institution were enrolled. Cases of infections after LT were initially identified from the prospective registry database, which was followed by a detailed review of the patients' medical records. RESULTS: A total of 108 episodes of post-LT infections (56 bacterial, 43 viral, and nine fungal infections) were observed in 34 LT recipients. Within 1 month after LT, the most common bacterial infections were catheter-related bloodstream infections (42%). Pneumonia was the most common site of bacterial infection in the 2- to 6-month period (28%) and after 6 months (47%). Cytomegalovirus was the most common viral infection within 1 month (75%) and in the 2- to 6-month period (80%). Respiratory viruses were the most common viruses after 6 months (48%). Catheter-related candidemia was the most common fungal infection. Invasive pulmonary aspergillosis developed after 6 months. Survival rates at the first and third years were 79% and 73%, respectively. CONCLUSIONS: Although this study was performed in a single center, we provide valuable and recent detailed epidemiology data for post-LT infections. A further multicenter study is required to properly evaluate the epidemiology of post-LT infections in Korea.

Role of infection control in prevention of hepatitis B virus (HBV) in hemodialysis (HD) patients.

Hemodialysis (HD) patients are particularly vulnerable to Hepatitis B virus (HBV) and have less sustained and lower antibody response to HBV vaccination. Among blood-borne pathogens, HBV can stay alive on environmental surfaces for over a week. The incidence of HBV was extremely high among HD patients. HBV vaccination, screening of blood products and infection control measures lead to significant decrease of HBV among HD patients. The infection control measures include; Medication safety and injection practices, environmental cleaning and disinfection, reuse of dialyzers for same patients, hand hygiene, isolation and barrier precautions, HBV vaccination and routine serology checking, assuring HBV immune status for HD unit staff, transmission based precautions and outbreak management.