Case Of Co-infection Research Articles

Frequency of respiratory virus-associated infection among children and adolescents from a tertiary-care hospital in Mexico City

Acute respiratory infections (ARIs) are a major cause of morbidity and mortality among children. The causative pathogens show geographic and seasonal variations. We retrospectively evaluated the frequency and seasonality of respiratory pathogens in children and adolescents (age: 0–19 years) with ARIs treated between January 1, 2021, and March 31, 2022, at a single center in Mexico. Out of 2400 patients, 1,603 were diagnosed with SARS-CoV-2 infection and 797 were diagnosed with other common respiratory pathogens (CRPs). Of the 797 patients, 632 were infected with one CRP and 165 with > 2 CRPs. Deaths occurred only in SARS-CoV-2-infected patients. Rhinovirus/Enterovirus, respiratory syncytial virus B, and parainfluenza virus 3 were the most prevalent in cases with single and multiple infections. CRP showed a high frequency between autumn and winter of 2021, with higher incidence of hospitalization compared to COVID-19. The main comorbidities were immunosuppression, cardiovascular disease (CD), and asthma. The frequency of CRPs showed a downward trend throughout the first half of 2021. CRPs increased in single- and co-infection cases between the fourth and fifth waves of COVID-19, probably due to decreased nonpharmaceutical interventions and changes in diagnostic tests. Age, cyanosis (symptom), and immunosuppression (comorbidity) were found to differentiate between SARS-CoV-2 infection and CRP infection.

Severe Parasite Co-Infection in a Captive Bactrian Camel: Case Report

The aim of this study was to document a case of parasite co-infection in a captive Bactrian camel and to supply morphometric data of the found pathogens. It concerned a 20-year-old male animal inhabiting Sofia Zoo, Bulgaria. A decreased appetite and gastrointestinal disorders were observed in it during the summer of 2022. Improvement in the animal’s condition was achieved after the administration of antibiotics, sulfonamides, and other symptomatic medicines. However, two weeks after treatment, clinical symptoms reappeared. Then, a diarrheal fecal sample from the animal was subjected to parasitological examination by direct smear and flotation and sedimentation techniques. Multiple infections by helminths (Trichostrongylus sp., Haemonchus sp., Oesophagostomum sp., Trichuris sp., and Dicrocoelium sp.), ciliates (Buxtonella cameli), and protozoa (Eimeria cameli) were found, with E. cameli being reported for the first time in zoo conditions. Deworming led to the recovery of the general condition and appearance of the animal’s feces, but two weeks later, it died suddenly. We considered that the parasitic infection was not the direct cause of the fatal outcome, and its presence, other health disorders, and the advanced age of the animal were among the contributing factors. This case reveals the need to combine planned preventive deworming with routine parasitological diagnostics to take timely and targeted actions to protect the health of animals inhabiting zoo facilities.

Seroprevalence of Viral Hepatitis C on Donations of Blood at Moulay Ismail Military Hospital in Meknes

Introduction: Hepatitis C is an infection with hepatocellular tropism, transmitted by the hepatitis C virus via fecal-oral, parenteral or mother-to-child transmission. Her active chronic carriage may be the cause of cirrhosis. Objective: The purpose of this study was to determine the seroprevalence of HCV in blood donations collected at the Moulay Ismail military hospital in Meknes in order to protect the recipients. Material and Methods: This is a retrospective study of 8639 military blood donors. All donors have gone through a pre-screening stage involving an anamnesis and pre-donation clinical examination associated with a biological screening performed by the 4th generation recombinant ELISA and confirmed on the Abott Architect system. Result: The study is focused on 8639 blood donors, mostly male, with extreme ages of 18 to 56 years. We found an HCV seroprevalence of 0.17%. No case of co-infection has been recorded. Discussion and conclusion: The HCV seroprevalence rate in our series remains relatively low in comparison with the data of the literature, this could be related to the campaigns of sensitization, to the exposure of the preventive measures for the military population as well as to the success of the pre-selection stage at Moulay Ismail hospital in Meknes.

Co-infection dynamics of COVID-19 and HIV/AIDS

Although there are many results that can be used to treat and prevent Coronavirus Disease 2019 (COVID-19) and Human Immunodeficiency Virus (HIV), these diseases continue to be public health concerns and cause socioeconomic consequences. Following compromised immunity, COVID-19 is considered to be a challenge for people with HIV. People with advanced HIV are considered a vulnerable population at high risk in several case studies that discuss COVID-19 and HIV co-infection. As there is no cure for HIV and there is a chance of contracting COVID-19 again, co-infection continues to pose a problem. The purpose of this study is to investigate the impact of intervention strategies and identify the role of different parameters in risking people living with HIV to death when they get infected with COVID-19. This is achieved through the development and rigorous analysis of a mathematical model that considers a population at risk of death due to COVID-19 and HIV. The model formulation provides a detailed explanation of the transmission dynamics of COVID-19 and HIV co-infection. The solution’s invariant region, positivity, and boundedness were established. The reproduction numbers of the sub-models and the co-infection model were determined. The existence and stability of equilibria, including backward bifurcation for the COVID-19 sub-model, were examined. The epidemiological significance of backward bifurcation is that the condition {mathscr {R}}_0 less than 1 for eliminating COVID-19, though necessary, is no longer sufficient. Parametric estimation and curve fitting were performed based on data from Ethiopia. Numerical simulations were employed to support and clarify the analytical findings and to show some parameter effects on COVID-19 and HIV co-infection. Accordingly, the simulations indicated that parameters gamma _c, gamma _h, epsilon, and kappa, related to HIV patients’ exposure to other diseases and the increase in infectiousness, have a positive role in increasing the number of co-infections. On the other hand, an increase in COVID-19 vaccination (xi) shows the suppression of co-infection cases. In addition, treating co-infected individuals for COVID-19, increasing treatment rates alpha and varphi, reduces the death risk of HIV-infected individuals due to the co-infection burden. It was implied that improving vaccine delivery programs and other medical interventions have important contributions to lowering the risk of COVID-19 infection-related fatalities in HIV patients.

Epidemiology and clinical severity of the serotypes of human parainfluenza virus in children with acute respiratory infection

BackgroundAcute respiratory infections (ARI) are a threat to human health and survival, resulting in many paediatric hospitalisations. However, the epidemiological and clinical severity characteristics of the human parainfluenza virus (PIV), one of the most prevalent respiratory viruses, are not well understood in children.MethodsTo identify the epidemiological features of PIV infection, in 2019, hospitalised children with ARI were screened using multiplex polymerase chain reaction (PCR) for PIV and 10 other common respiratory pathogens. Subtyping of randomly selected PIV-positive samples was performed using reverse transcription-PCR. Demographics, epidemiology, clinical manifestations, diagnosis, and outcomes were compared between PIV subtypes.ResultsThe annual detection rate for PIV was 14.9%, with a peak from April to September. Children under one year of age had the highest rate of PIV infection (45.5%) compared to other age groups. Of the 121 sequenced samples, 58.7%, 36.4% and 4.9% were positive for PIV-3, PIV-1 and PIV-2, respectively, and no PIV-4 was detected. Severe infections were associated with pre-existing underlying diseases and co-infections, but not with PIV serotype. After excluding cases of co-infection, we found that PIV-2 infection was associated with upper respiratory tract infections, whereas PIV-1 and PIV-3 mainly caused lower respiratory tract infections. Apart from the proportion of patients with fever, there were no significant differences among the three subtypes in terms of clinical symptoms, severity, and outcome.ConclusionHere, PIV was the main pathogen causing ARI in hospitalised children. Appropriate attention should be paid to children with underlying diseases and co-infections to prevent the worsening of severe PIV infection.

Epidemiological Profile of Tuberculosis in Tunisia

Abstract Introduction Tuberculosis (TB) is still a public health problem causing significant morbidity in several countries. In 2020, TB was the second global leading cause of death from an infectious disease, behind COVID-19. Despite the continuous efforts of the national tuberculosis control program, Tunisia remains a country with intermediate tuberculosis endemicity. The objective of this study was to describe the incidence of tuberculosis from 2018 to 2021 and its epidemiological profile in Tunisia. Methods This is a descriptive study of the national tuberculosis surveillance data within the framework of the national tuberculosis control programme. All new confirmed cases notified and registered for treatment were included. Data was entered through a registration and notification platform (WEB TBS), which is available in all governorates. Data collected included age, gender, governorate, clinical form. Data analysis was using SPSS-21. Results The incidence rate decreased from 28/100,000 inhabitants in 2018 to 22.46/100,000 inhabitants in 2021. In 2021, 2647 new cases were recorded. The majority were aged between 15 and 64 years old (80.4%). More than half were females (52.4%). There was an increasing trend of extra-pulmonary tuberculosis. It affected 64.6% of cases in 2021, mainly lymph node forms (68.5%). The incidence varied considerably by region; from 59.3/ 100,000 inhabitants in Ariana to 7.3/ 100,000 inhabitants in Monastir (2021). The number of reported cases of co-infection (TB-HIV) increased from 0.09 to 0.14/100,000 inhabitants. Conclusions Despite the overall decline, there is still a long way to go to reach the target of ending TB by 2030. More adherence to control activities is needed in the most affected regions, including early case detection, patient monitoring and epidemiological investigations. There is also an urgent need to develop an effective strategy to control lymph node tuberculosis, which becomes an increasing burden on the national program. Key messages • From 2018 to 2021, there was a national decline in TB incidence, but some regions remain highly endemic. • With the increase of extra-pulmonary tuberculosis, appropriate preventive and control measures should be taken.

Current characteristics of the HIV/syphilis co-infection epidemic

Syphilis, alongside with HIV infection, remains a pressing public health issue due to its widespread prevalence among high-risk groups: men who have sex with men (MSM), transgender women, and female sex workers (FSW). The MSM group shows a disproportionately high prevalence rate of HIV infection, with cases of syphilis/HIV co-infection also on the rise in this population. The increase in these co-infection cases deserves special attention. According to the literature, the rate of HIV infection among syphilis patients averages 15.7%. In addition, it varies significantly, going from 3% in the general population to 90% among MSM. Epidemiological surveillance data showed an increase in cases of HIV/syphilis co-infection in the MSM group, with the proportion of co-infection patients varying from 30 to 60% depending on the region. This syndemia can be explained by the fact that syphilis can contribute to HIV transmission and acquisition. The risk of HIV infection is 2 to 5 times higher among people with syphilis. At the same time, STDs are more and more difficult to control as the Internet and dating applications have made it easier to find potential sex partners. Given the high prevalence rate of syphilis among MSM, screening, diagnosis and treatment of STDs in this population should be a health care priority. Early detection and timely treatment of these socially significant diseases play an important role in epidemic prevention measures.

Widespread occurrence of Tilapia parvovirus in farmed Nile tilapia Oreochromis niloticus from India.

Tilapia parvovirus (TiPV) has been associated with heavy mortalities in tilapia as a single infection or in co-infection with Tilapia lake virus (TiLV). In this study, TiPV was detected in farmed Nile tilapia, Oreochromis niloticus, from two geographical regions of India, Maharashtra and Uttar Pradesh. TiPV-specific polymerase chain reaction (PCR) reported earlier was used in the screening. Tilapia collected from Maharashtra showed characteristic clinical signs, and TiPV was detected along with TiLV and/or Aeromonas spp. However, fish from Uttar Pradesh were apparently healthy and only TiPV could be detected in these samples. A high prevalence of TiPV was recorded from both the geographical locations, Maharashtra and Uttar Pradesh (59.6% and 95.0% respectively). The virus could be detected in tissues such as the spleen, liver, kidney, brain and mucus. The spleen appeared to be the best tissue for detecting TiPV in apparently healthy tilapia. The presence of TiPV was further confirmed through sequencing the PCR products, isolation of the virus in the cell line and electron microscopy. Sequences of the NS1 gene of the two TiPV isolates showed similarity to the earlier reported TiPV isolates. The virus could be successfully propagated in O. niloticus Liver (OnL) cell line, and cytopathic effect was observed as early as 3 days post-infection. Furthermore, the presence of non-enveloped icosahedral to round virus particles measuring about 26-35 nm could be demonstrated in the cytoplasm and nucleus of infected OnL cells in transmission electron microscopy. With this confirmation of the presence of the virus, India is the third country to report TiPV after China and Thailand. The detection of TiPV in co-infection cases with TiLV and in apparently healthy Nile tilapia suggests its wide distribution and potential synergistic effect in co-infection cases. Therefore, this emerging virus needs holistic attention to understand its virulence, host-specificity and epidemiological risk factors.

Bacterial Co-Infection in Patients with Coronavirus: A Rapid Review to Support COVID-19 Antimicrobial Prescription

The goal of this study was to determine the most common microorganisms present in COVID-19 patients with co-infections at the General Hospital of Mexicali. Bacterial co-infections have been reported in two previous global pandemics caused by viruses. In a retrospective observational study, we obtained information from 1979 patients. All had symptoms of respiratory disease, and we performed real-time Polymerase Chain Reaction tests on nasopharyngeal swab samples. Of the 1979 patients, 316 were negative; so, they were excluded. One thousand and sixty-three patients had positive results for COVID-19; one hundred and seventy-two (10.34%) had respiratory co-infections. These data were corroborated by positive growth results in culture media and identified using the MALDI-TOF MS System. Vitek 2® Compact, an automated identification system, determined the antimicrobial susceptibility testing results. We analyzed and determined the microorganisms in co-infected patients. Different microorganisms were found, including bacteria and fungi. The most prevalent of all the organisms was Acinetobacter baumannii, which was present in 64 patients (37.2%). We recommend improving the diagnostic and surveillance protocols for possible cases of co-infections in patients with COVID-19. Unlike co-infections in pandemic influenza, the spectrum of microorganisms that cause COVID-19 is too broad and varied to recommend empiric antibiotic therapy.

ОПЫТ ОРГАНИЗАЦИИ РАБОТЫ ТУБЕРКУЛЕЗНОГО СТАЦИОНАРА В КЕМЕРОВСКОЙ ОБЛАСТИ В ПЕРИОД ПАНДЕМИИ COVID-19

The purpose of the study: to study the features of the organization of the work of the TB hospital in the city of Kemerovo during the COVID-19 pandemic. Materials and methods. The analysis of the work of inpatient departments of the Kuzbass Clinical Phthisiopulmonological Medical Center named after V.I. I.F. Kopylova in 2020. Research results. Regional regulatory documents on the organization of anti-tuberculosis activities from March 2020 to December 2020 were analyzed. A continuous ob-servation of 81 cases of co-infection with COVID-19/tuberculosis was carried out. Despite the diffi-culties in the new conditions in the course of the administrative management of the activities of the phthisiopulmonological center, the effectiveness of the use of anti-epidemic measures was noted. Conclusion. The rapid deployment of a system of administrative and organizational measures made it possible to prevent the massive spread of COVID-19 among patients in the TB hospital.

Study a natural co-infection case of Largemouth bass ranavirus, Aeromonas vickert, and Aeromonas hydrophila in Micropterus salmoides

The largemouth bass (LMB) is a significant aquaculture species widely cultivated in China. High-density culture has led to an increased susceptibility of LMB to infection by the opportunistic bacterium Aeromonas. This study investigates a case of natural co-infection with the Largemouth bass ranavirus (LMBV), Aeromonas veronii, and Aeromonas hydrophila in Sichuan Province, China. To identify the causative agents of the infection, two bacterial strains were isolated from diseased LMB specimens and identified through 16S rRNA sequencing as Aeromonas vickert and Aeromonas hydrophila, both of which are gram-negative bacteria. The infection of LMBV was confirmed through polymerase chain reaction (PCR) analysis of tissue samples from the infected fish. After two blind passes of the virus fluid, the typical cytopathological effect (CPE) can be observed. Phylogenetic analysis of the virus sequences showed the highest similarity with LMBV isolates (ON418985 and MW630113) from Guangdong Province, China. This study offers important insights into diagnosing mixed infections in LMB and provides a reference for future research.

Molecular Characteristics of Barley Yellow Dwarf Virus-PAS-The Main Causal Agent of Barley Yellow Dwarf Disease in Poland.

Barley yellow dwarf is a threat to cereal crops worldwide. Barley yellow dwarf virus-PAS (BYDV-PAS) was detected for the first time in Poland in 2015, then in 2019. In the spring of 2021, in several locations in Poland, winter wheat and barley plants with dwarfism and leaf yellowing were collected. Reverse transcription-polymerase chain reaction results revealed BYDV presence in 47 samples and excluded wheat streak mosaic virus infections. Next, immuno-captured polymerase chain reactions confirmed only one case of co-infection caused by BYDV and wheat dwarf virus. Moreover, restriction fragment length polymorphism analysis showed that BYDV-PAS was predominant. The preliminary results were confirmed using sequencing. Infected cereal plants originated mainly from northwestern Poland. The complete coding sequence of coat protein (CP) and a fragment of RNA-dependent RNA polymerase (RdRp) genes of 14 Polish isolates were determined and deposited in the GenBank database. The nucleotide and deduced amino acid sequences of local isolates were compared with others reported to date, indicating their high similarity, from 75.4% to 99.5% and from 81.1% to 100% nucleotide sequence identity, in RdRp and CP, respectively. Phylogenetic analysis, based on the CP gene, revealed the presence of 3 main groups. The Polish isolates clustered together within the Ia group.

Assessment of Fasciola and Paramphistomes co-infection in large ruminants through faecal egg counts around Taiping, Malaysia.

Emerging cases of Fasciola and Paramphistomes co-infection have been reported, especially in tropical regions. Thisis due to Fasciola and Paramphistomes sharing biological factors which influence the pattern of transmission, especially in faecal egg shedding due to interaction and competition in the definitive host. Most reports surveyed the occurrence of fasciolosis in ruminants with a lack of observation of faecal egg distribution. Therefore, present study is aimed to assess the distribution of Fasciola and Paramphistomes faecal egg count (fec) in co-infected large ruminants in Larut, Matang, and Selama areas (Taiping). A total of 371 faecal samples were collected at random from 23 ruminant herds. Flukefinder® sedimentation was used to quantify the Fasciola and Paramphistomes eggs. Descriptive analyses were performed to determine the prevalence of co-infections, and Spearman correlation analysis was used to correlate the fec. Overall, the prevalence of Fasciola and Paramphistomes co-infection was 23.7% (n=89/371) in Taiping. Prevalence of paramphistomosis was always higher than fasciolosis in overall and single infection, with 46.9% (n=174/371) and 22.9% (n=85/371) compared to 36.9% (n=137/371) and 12.9% (n=48/371) respectively. Egg per gram (epg) of both parasites were positively skewed with a median of 1.5 epg in fasciolosis and 10.5 epg in paramphistomosis. Spearman correlation analysis of the epg in co-infected bovine was found to have a moderately positive correlation with rs=0.39 (p-value<0.01). The recent study observed a moderate prevalence of Fasciola and Paramphistomes coinfection in a large ruminant population from Taiping, with the prevalence of paramphistomosis being higher than fasciolosis. Hence, this suggests that infection with one of these parasites increases the chance of infection with another. There is a need to integrate fec in parasite surveillance to monitor the trend of parasite transmission. Findings in the present study could tailor control strategies, especially for fasciolosis to limit the economic loss and prevent zoonotic transmission.

A case of severe COVID-19 and influenza co-infection

Aim. To analyze a case of severe COVID-19 and influenza co-infection in a 48-year-old female patient. Materials and methods. The clinical course, specifics of diagnosis and therapy of the 48-year-old patient S., who was treated for severe co-infection of COVID-19 and influenza at Municipal non-profit Enterprise “Regional Infectious Clinical Hospital” Zaporizhzhіa Regional Council from 29.01.2023 to 17.02.2023, were analyzed. The diagnosis of COVID-19 was confirmed by the detection of SARS-CoV-2 Ag in nasopharyngeal swabs by the immunochromatographic method, and the diagnosis of influenza – by the influenza A viral RNA detection by the polymerase chain reaction method. Current regulatory documents were used when examining and treating the patient. Results. It has been recognized that the unvaccinated 48-year-old female patient was at a risk group due to comorbid pathology (stage 2 hypertension, type 2 diabetes mellitus, grade 2 obesity) developed a severe course of COVID-19 and influenza type A co-infection. The course of co-infection was complicated by severe acute respiratory distress syndrome already on the 6th day of the disease. The diagnosis of COVID-19 was confirmed by a rapid SARS-CoV-2 antigen test. Treatment for COVID-19 was started immediately with the use of remdesivir, dexamethasone, and anticoagulants. However, despite the patient was given the treatment, his condition worsened due to the rapid progression of acute respiratory failure. The presence of clear clinical and laboratory signs of “cytokine storm” required the use of tocilizumab on the 7th day of the disease. Oseltamivir was commenced after receiving laboratory confirmation of influenza A by the PCR method on the 8th day of the disease. A complete etiologic interpretation of the diagnosis made it possible to prescribe a combination antiviral treatment which coupled with the timely additional initiation of tocilizumab, allowed obtaining certain positive dynamics after only five days of treatment with further improvement of the patient’s condition. Conclusions. Our clinical observation has demonstrated the severe course of COVID-19 and influenza co-infection in the unvaccinated high-risk 48-year-old female patient due to the presence of comorbid pathology. The complete etiologic interpretation of the co-infection has made it possible to prescribe the combination antiviral treatment, which coupled with the additional correction of the immunotropic treatment has enabled to obtain the positive dynamics after only 5 days with further improvement of the patient’s condition

A-282 Coinfection Rates of SARS-CoV-2, Influenza, and Respiratory Syncytial Virus

Abstract Background In late 2022, a severe spike of respiratory syncytial virus (RSV) cases in the United States alongside seasonal influenza and the ongoing SARS-CoV-2 crisis underscored the potential consequences for respiratory coinfections. Coinfections of respiratory viruses can complicate treatment and increase the likelihood of severe cases. It is not well understood how prevalent respiratory coinfections were during this time in the general and pediatric populations. In this retrospective analysis we examine respiratory molecular diagnostic testing results to estimate the rates of coinfection in the study population. Methods Respiratory sample results from a clinical laboratory for a 107-day period in autumn 2022 were analyzed. Assays were performed on two platforms: the Roche cobas® SARS-CoV-2 &amp; Influenza A/B Test and the Cepheid Xpert® Xpress CoV-2/Flu/RSV plus assay. Overall positivity and coinfection rates were calculated. Coinfection results of the pediatric population were further investigated. Results A total of 26 657 respiratory testing results were analyzed. Cases of coinfection of SARS-CoV-2, influenza A, influenza B, and RSV were seen. Positivity ranged from 0.03% to 21.86% and coinfection rates ranged from 0.00% to 2.28% depending upon the pathogen. Overall, 9800 samples (36.76%) came from pediatric patients (age ≤21). Pediatric positivity ranged from 0.04% to 24.70% and coinfection rates ranged from 0.00% to 6.00% depending on the pathogen (Table). Conclusion Overall, coinfections were observed in 0.55% of samples comprising 1.33% of all positive results. In this study population, pediatric samples accounted for a disproportionately high percentage of positive results for influenza A, RSV, and SARS-CoV-2 coinfections when compared to the overall percentages from the complete study population.

Severity of influenza-associated hospitalisations by influenza virus type and subtype in the USA, 2010–19: a repeated cross-sectional study

Influenza burden varies across seasons, partly due to differences in circulating influenza virus types or subtypes. Using data from the US population-based surveillance system, Influenza Hospitalization Surveillance Network (FluSurv-NET), we aimed to assess the severity of influenza-associated outcomes in individuals hospitalised with laboratory-confirmed influenza virus infections during the 2010-11 to 2018-19 influenza seasons. To evaluate the association between influenza virus type or subtype causing the infection (influenza A H3N2, A H1N1pdm09, and B viruses) and in-hospital severity outcomes (intensive care unit [ICU] admission, use of mechanical ventilation or extracorporeal membrane oxygenation [ECMO], and death), we used FluSurv-NET to capture data for laboratory-confirmed influenza-associated hospitalisations from the 2010-11 to 2018-19 influenza seasons for individuals of all ages living in select counties in 13 US states. All individuals had to have an influenza virus test within 14 days before or during their hospital stay and an admission date between Oct 1 and April 30 of an influenza season. Exclusion criteria were individuals who did not have a complete chart review; cases from sites that contributed data for three or fewer seasons; hospital-onset cases; cases with unidentified influenza type; cases of multiple influenza virus type or subtype co-infection; or individuals younger than 6 months and ineligible for the influenza vaccine. Logistic regression models adjusted for influenza season, influenza vaccination status, age, and FluSurv-NET site compared odds of in-hospital severity by virus type or subtype. When missing, influenza A subtypes were imputed using chained equations of known subtypes by season. Data for 122 941 individuals hospitalised with influenza were captured in FluSurv-NET from the 2010-11 to 2018-19 seasons; after exclusions were applied, 107 941 individuals remained and underwent influenza A virus imputation when missing A subtype (43·4%). After imputation, data for 104 969 remained and were included in the final analytic sample. Averaging across imputed datasets, 57·7% (weighted percentage) had influenza A H3N2, 24·6% had influenza A H1N1pdm09, and 17·7% had influenza B virus infections; 16·7% required ICU admission, 6·5% received mechanical ventilation or ECMO, and 3·0% died (95% CIs had a range of less than 0·1% and are not displayed). Individuals with A H1N1pdm09 had higher odds of in-hospital severe outcomes than those with A H3N2: adjusted odds ratios (ORs) for A H1N1pdm09 versus A H3N2 were 1·42 (95% CI 1·32-1·52) for ICU admission; 1·79 (1·60-2·00) for mechanical ventilation or ECMO use; and 1·25 (1·07-1·46) for death. The adjusted ORs for individuals infected with influenza B versus influenza A H3N2 were 1·06 (95% CI 1·01-1·12) for ICU admission, 1·14 (1·05-1·24) for mechanical ventilation or ECMO use, and 1·18 (1·07-1·31) for death. Despite a higher burden of hospitalisations with influenza A H3N2, we found an increased likelihood of in-hospital severe outcomes in individuals hospitalised with influenza A H1N1pdm09 or influenza B virus. Thus, it is important for individuals to receive an annual influenza vaccine and for health-care providers to provide early antiviral treatment for patients with suspected influenza who are at increased risk of severe outcomes, not only when there is high influenza A H3N2 virus circulation but also when influenza A H1N1pdm09 and influenza B viruses are circulating. The US Centers for Disease Control and Prevention.

Aspergillus coinfection in critically Ill patients with severe dengue

In 2014–2015, a significant outbreak of dengue fever occurred in southern Taiwan, with a subsequent decline in dengue incidence. Despite this, there is emerging concern about virus-associated aspergillosis, yet limited research has explored coinfections involving dengue and aspergillosis. We conducted a retrospective study at a single center in Southern Taiwan, specifically focusing on dengue patients admitted to the intensive care unit during the period between July and November 2015. Among the 142 dengue patients studied, only 8.06 % (10/142) underwent serum galactomannan testing, with a single patient undergoing bronchoalveolar lavage (BAL) galactomannan assay. Out of those tested, 20 % (2/10) returned positive serum galactomannan results. Herein, we present two consecutive cases of coinfection involving dengue and pulmonary aspergillosis in immunocompetent patients.

Epidemiological survey of tick-borne pathogens in dogs in Anhui Province, China

Tick-borne diseases have continued to increase worldwide in both developing and many developed countries due to the widespread of different tick species and tick’s adaptability to different climatic weather. In order to investigate the prevalence of the tick-borne pathogens, EDTA-anticoagulated whole blood samples were aseptically collected from 765 pet dogs in twenty veterinary clinics located in sixteen prefecture-level cities in Anhui Province, China, and the samples were examined and analyzed for tick-borne pathogens using both microscopy and PCR. Our result analysis revealed 17(2.22%) positive samples to Babesia spp and 4(0.52%) positive samples to Hepatozoon spp, of which case of co-infection was recorded in Lu’An and Chuzhou. The BLAST analysis results of the 18S rRNA gene revealed that the dogs were infected with Babesia gibsoni and Hepatozoon canis. All samples were negative for Anaplasma spp., Ehrlichia spp., and Rickettsia spp. This is the first molecular report of B. gibsoni and H. canis in dogs in Anhui, China.

Typhoid Dengue Co-infection: 2 Case Reports

Dengue and typhoid fever are different entities with overlapping signs and symptoms. The resemblance of symptoms makes clinical diagnosis and treatment difficult. Both are major health problems mainly during monsoon. If they are not diagnosed timely and treated, outcome can be fatal. We report 2 cases of dengue virus co-infection with typhoid fever during this outbreak of dengue. The aim of this report was to create awareness about this co-infection Bangladesh J Medicine 2023; 34(3): 239-240

Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different?

Similar to influenza, coinfections and superinfections are common and might result in poor prognosis. Our study aimed to compare the characteristics and risks of coinfections and superinfections in severe COVID-19 and influenza virus pneumonia. The data of patients with COVID-19 and influenza admitted to the intensive care unit (ICU) were retrospectively analyzed. The primary outcome was to describe the prevalence and pathogenic distribution of coinfections/ICU-acquired superinfections in the study population. The secondary outcome was to evaluate the independent risk factors for coinfections/ICU-acquired superinfections at ICU admission. Multivariate analysis of survivors and non-survivors was performed to investigate whether coinfections/ICU-acquired superinfections was an independent prognostic factor. In the COVID-19 (n = 123) and influenza (n = 145) cohorts, the incidence of coinfections/ICU-acquired superinfections was 33.3%/43.9 and 35.2%/52.4%, respectively. The most common bacteria identified in coinfection cases were Enterococcus faecium, Pseudomonas aeruginosa, and Acinetobacter baumannii (COVID-19 cohort) and A. baumannii, P. aeruginosa, and Klebsiella pneumoniae (influenza cohort). A significant higher proportion of coinfection events was sustained by Aspergillus spp. [(22/123, 17.9% in COVID-19) and (18/145, 12.4% in influenza)]. The COVID-19 group had more cases of ICU-acquired A. baumannii, Corynebacterium striatum and K. pneumoniae. A. baumannii, P. aeruginosa, and K. pneumoniae were the three most prevalent pathogens in the influenza cases with ICU-acquired superinfections. Patients with APACHE II ≥18, CD8+ T cells ≤90/μL, and 50 < age ≤ 70 years were more susceptible to coinfections; while those with CD8+ T cells ≤90/μL, CRP ≥120 mg/L, IL-8 ≥ 20 pg./mL, blood glucose ≥10 mmol/L, hypertension, and smoking might had a higher risk of ICU-acquired superinfections in the COVID-19 group. ICU-acquired superinfection, corticosteroid administration for COVID-19 treatment before ICU admission, and SOFA score ≥ 7 were independent prognostic factors in patients with COVID-19. Patients with COVID-19 or influenza had a high incidence of coinfections and ICU-acquired superinfections. The represent agents of coinfection in ICU patients were different from those in the general ward. These high-risk patients should be closely monitored and empirically treated with effective antibiotics according to the pathogen.