RESUMEN
With the spread of coronavirus disease, reports have indicated that young patients are usually asymptomatic with a short convalescence period. The current study compared the time to resolution of infection in symptomatic and asymptomatic patients. Seventy-six patients aged 44.4 ± 23.3 years were admitted to the coronavirus disease 2019 (COVID-19) unit during the study period. Data were collected from patient records. Throat and nasal swabs for COVID-19 were collected for reverse transcriptase-polymerase chain reaction (RT-PCR). Time to resolution of infection was defined as the number of days from the date of the first COVID-19 positive outcome to the second consecutive negative PCR results. Most patients showed COVID-19 signs and symptoms (71.1%) between 1 and 6 days, and the rest were asymptomatic. No association was found between the time to resolution of infection and the presence of COVID-19 signs and symptoms (symptomatic: median [Md] 10.0, 95% confidence interval [CI] 8.4-11.6; asymptomatic: Md 15.0, 95% CI 10.5-15.5; P = 0.54). Age was not correlated with the number of COVID-19 signs and symptoms (r = 0.13, P = 0.37) or with the time to resolution of infection (r = 0.06, P = 0.58). In patients with mild to moderate symptoms, the time to resolution of infection from COVID-19 is not different from that in asymptomatic patients.
Asunto(s)
COVID-19 , Adulto , Anciano , COVID-19/diagnóstico , Prueba de COVID-19 , Hospitalización , Humanos , Israel/epidemiología , Persona de Mediana Edad , SARS-CoV-2 , Adulto JovenRESUMEN
Using whole-genome sequencing and cloning of the target gene, we identified blaOXA-900 carbapenemase, a novel blaOXA belonging to a distant and distinct sub-family of blaOXA-48-like. The plasmid-mediated gene was identified in a C. freundii isolate with elevated carbapenem MICs that evaded detection by commercial DNA-based methods. The novel gene, an OXA-48 family carbapenem-hydrolyzing class D ß-lactamase, OXA-900, likely originates from marine environmental Shewanella. Since this plasmid-mediated gene has entered a member of the Enterobacterales and evades detection by commonly used tests, it may gain wide dissemination among Enterobacterales.
RESUMEN
BACKGROUND: Staphylococcus aureus colonization typically precedes infection but risk factors for colonization in children are not well defined. Our previous study suggested that S. aureus carriage in children is associated with parental carriage. Here we wished to distinguish the different components that play a role in the risk to a child of a S. aureus-carrying parent. METHODS: Between 2002 and 2005, children (0-40 months) and their parents were screened for carriage of S. aureus and Streptococcus pneumoniae during 1 of 6 surveys. Data were collected from the parents and the medical files. Multivariate analysis of possible associated factors and effect modifiers was carried out. Pulse-field gel electrophoresis was performed to determine strain relatedness. RESULTS: A total of 4648 children were screened. S. aureus was isolated from 342 (7.6%) children and 992 (22%) parents. Pairs of parent-child carriers were found in 155 cases, over twice the rate expected by chance (1.66%, P<0.0001). The variable that was most significantly associated with carriage in children was having a parent carrier (OR: 3.35; 95% CI: 2.59-4.33), whereas close contact with peers (as assessed by day care centers attendance or having young siblings) was not associated with carriage. Children<3 months had the highest carriage rate and children aged 6 to 12 months had the lowest (25.4% and 4.3%, respectively, P<0.0001). Breast-feeding was not associated with higher or lower carriage. In 30 of 150 strains studied, >70% parent-child strains were genetically identical. CONCLUSIONS: Parental S. aureus colonization, but not DCC attendance or having young siblings, is an independent predictor for staphylococcal carriage in young children.
Asunto(s)
Portador Sano/epidemiología , Padres , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Adulto , Técnicas de Tipificación Bacteriana , Portador Sano/microbiología , Preescolar , Análisis por Conglomerados , Dermatoglifia del ADN , ADN Bacteriano/genética , Electroforesis en Gel de Campo Pulsado , Femenino , Genotipo , Humanos , Lactante , Recién Nacido , Masculino , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/clasificación , Staphylococcus aureus/genética , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/aislamiento & purificación , Adulto JovenRESUMEN
Kingella kingae organisms isolated from the blood of 3 children with invasive infections were identical by pulsed field gel electrophoresis and random amplified polymorphic DNA-polymerase chain reaction analysis to those recovered from the patients' pharynx, demonstrating the likely role of upper respiratory tract colonization in the pathogenesis of the disease caused by this bacterium.
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Kingella kingae/aislamiento & purificación , Infecciones por Neisseriaceae/microbiología , Faringe/microbiología , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Cefalexina/uso terapéutico , Electroforesis en Gel de Campo Pulsado , Femenino , Humanos , Lactante , Kingella kingae/genética , Masculino , Infecciones por Neisseriaceae/tratamiento farmacológico , Técnica del ADN Polimorfo Amplificado AleatorioRESUMEN
The rate of Streptococcus pneumoniae carriage among adults was compared with that among children (age, < or =6 years) in the same population. Nasopharyngeal culture results for 1300 adults and 404 children were analyzed. S. pneumoniae was carried by only 4% of the adults, compared with 53% of children in the same community. Young age, day care center attendance, having young siblings, and no antibiotic use during the month before screening were associated with the high carriage rate among children, whereas the only risk factor associated with carriage among adults was the presence of a respiratory infection on the screening day. S. pneumoniae serotype distribution and antibiotic resistance patterns differed between adults and children. Isolates of the same serotype--even of the same clone--differed in their antibiotic susceptibility patterns between children and adults. In a subanalysis of 151 pairs of children and their parents and of 32 pairs of siblings, intrafamilial transmission of S. pneumoniae could not be demonstrated.
Asunto(s)
Antibacterianos/farmacología , Portador Sano , Nasofaringe/microbiología , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/efectos de los fármacos , Adolescente , Adulto , Anciano , Niño , Farmacorresistencia Bacteriana , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Características de la Residencia , Serotipificación , Streptococcus pneumoniae/clasificaciónRESUMEN
OBJECTIVES: to determine the incidence and the dynamics of asymptomatic bacteriuria in ambulatory nursing home residents, and to characterise bacteria according to their phenotype and genotype. DESIGN: an 18 months prospective longitudinal study. SUBJECTS: 42 nursing home residents (31 female, 11 males) without indwelling catheters. METHODS: urine was sampled every 3 months. Antibiograms, biotyping and ribotyping were performed. RESULTS: the cumulative percent of infection for females and males was 75% and 27% respectively. Osteoporosis was associated with bacteriuria. Ribotypes of consecutive Escherichia coli isolates indicated that each patient harboured a different strain. CONCLUSIONS: asymptomatic bacteriuria in the elderly is a dynamic and transient phenomenon. Osteoporosis is common among this population. Ribotyping is a powerful tool in the elucidation of the epidemiology of this bacteriuria.