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Chan WS, Ho CWY, Chan TC, Hung J, To MY, Leung SM, Lai KC, Wong CY, Leung CP, Au CH, Wan TSK, Zee JST, Ma ESK, Tang BSF. Clinical Evaluation of the BIOFIRE SPOTFIRE Respiratory Panel. Viruses 2024; 16:600. [PMID: 38675941 PMCID: PMC11055108 DOI: 10.3390/v16040600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/08/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The BIOFIRE SPOTFIRE Respiratory (R) Panel is a novel, in vitro diagnostic PCR assay with 15 pathogen targets. The runtime is about 15 min which is the shortest among similar panels in the market. We evaluated the performance of the SPOTFIRE R Panel with 151 specimens, including 133 collected from the upper respiratory tract (URT), 13 from the lower respiratory tract (LRT) and 5 external quality assessment program (EQAP) samples. The respiratory specimens were enrolled throughout the first two post-COVID-19 influenza seasons in Hong Kong (March to December 2023). For URT specimens, full concordance was observed between the SPOTFIRE R Panel and the standard-of-care FilmArray Respiratory 2.1 plus Panel (RP2.1plus) for 109 specimens (109/133, 81.95%). After discrepant analysis, the SPOTFIRE R Panel identified more pathogens than the RP2.1plus in 15 specimens and vice versa in 3 specimens. The per-target negative and positive percentage agreement (NPA and PPA) were 92.86-100% except the PPA of adenovirus (88.24%). For LRT and EQAP samples, all results were fully concordant. To conclude, the performance of the SPOTFIRE R Panel was comparable to the RP2.1plus.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Bone Siu-Fai Tang
- Department of Pathology, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China; (W.-S.C.); (C.-H.A.)
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Vaid A, Rastogi N, Doherty TM, San Martin P, Chugh Y. Review of the unmet medical need for vaccination in adults with immunocompromising conditions: An Indian perspective. Hum Vaccin Immunother 2023; 19:2224186. [PMID: 37402477 DOI: 10.1080/21645515.2023.2224186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 07/06/2023] Open
Abstract
Immunocompromised (IC) populations are at increased risk of vaccine-preventable diseases (VPDs). In India, the concern of VPDs in IC populations is particularly acute due to the prevalence of crowded living situations, poor sanitation and variable access to healthcare services. We present a narrative review of IC-related disease and economic burden, risk of VPDs and vaccination guidelines, based on global and India-specific literature (2000-2022). IC conditions considered were cancer, diabetes mellitus, chronic kidney disease, respiratory disorders, disorders treated with immunosuppressive therapy, and human immune deficiency virus (HIV). The burden of IC populations in India is comparable to the global population, except for cancer and HIV, which have lower prevalence compared with the global average. Regional and socioeconomic inequalities exist in IC prevalence; VPDs add to the burden of IC conditions, especially in lower income strata. Adult vaccination programs could improve health and reduce the economic impact of VPDs in IC populations.
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Affiliation(s)
- Ashok Vaid
- Medical Oncology and Hematology, Medanta Cancer Institute, Gurugram, India
| | - Neha Rastogi
- Pediatric Hematology, Oncology and BMT, Medanta Cancer Institute, Gurugram, India
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Wu X, Sun T, Cai Y, Zhai T, Liu Y, Gu S, Zhou Y, Zhan Q. Clinical characteristics and outcomes of immunocompromised patients with severe community-acquired pneumonia: A single-center retrospective cohort study. Front Public Health 2023; 11:1070581. [PMID: 36875372 PMCID: PMC9975557 DOI: 10.3389/fpubh.2023.1070581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/25/2023] [Indexed: 02/17/2023] Open
Abstract
Background Immunocompromised patients with severe community-acquired pneumonia (SCAP) warrant special attention because they comprise a growing proportion of patients and tend to have poor clinical outcomes. The objective of this study was to compare the characteristics and outcomes of immunocompromised and immunocompetent patients with SCAP, and to investigate the risk factors for mortality in these patients. Methods We conducted retrospective observational cohort study of patients aged ≥18 years admitted to the intensive care unit (ICU) of an academic tertiary hospital with SCAP between January 2017 and December 2019 and compared the clinical characteristics and outcomes of immunocompromised and immunocompetent patients. Results Among the 393 patients, 119 (30.3%) were immunocompromised. Corticosteroid (51.2%) and immunosuppressive drug (23.5%) therapies were the most common causes. Compared to immunocompetent patients, immunocompromised patients had a higher frequency of polymicrobial infection (56.6 vs. 27.5%, P < 0.001), early mortality (within 7 days) (26.1 vs. 13.1%, P = 0.002), and ICU mortality (49.6 vs. 37.6%, P = 0.027). The pathogen distributions differed between immunocompromised and immunocompetent patients. Among immunocompromised patients, Pneumocystis jirovecii and cytomegalovirus were the most common pathogens. Immunocompromised status (OR: 2.043, 95% CI: 1.114-3.748, P = 0.021) was an independent risk factor for ICU mortality. Independent risk factors for ICU mortality in immunocompromised patients included age ≥ 65 years (odds ratio [OR]: 9.098, 95% confidence interval [CI]: 1.472-56.234, P = 0.018), SOFA score [OR: 1.338, 95% CI: 1.048-1.708, P = 0.019), lymphocyte count < 0.8 × 109/L (OR: 6.640, 95% CI: 1.463-30.141, P = 0.014), D-dimer level (OR: 1.160, 95% CI: 1.013-1.329, P = 0.032), FiO2 > 0.7 (OR: 10.228, 95% CI: 1.992-52.531, P = 0.005), and lactate level (OR: 4.849, 95% CI: 1.701-13.825, P = 0.003). Conclusions Immunocompromised patients with SCAP have distinct clinical characteristics and risk factors that should be considered in their clinical evaluation and management.
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Affiliation(s)
- Xiaojing Wu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ting Sun
- Capital Medical University, China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Ying Cai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Tianshu Zhai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yijie Liu
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Sichao Gu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yun Zhou
- Department of Laboratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Qingyuan Zhan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Capital Medical University, China-Japan Friendship School of Clinical Medicine, Beijing, China
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Vart P, Duivenvoorden R, Adema A, Covic A, Finne P, Braak NHT, Laine K, Noordzij M, Schouten M, Jager KJ, Gansevoort RT. Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy. Sci Rep 2022; 12:17978. [PMID: 36289317 PMCID: PMC9606116 DOI: 10.1038/s41598-022-22657-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/18/2022] [Indexed: 01/24/2023] Open
Abstract
In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (pinteraction = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (pinteraction = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk.
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Affiliation(s)
- Priya Vart
- grid.4494.d0000 0000 9558 4598Department Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ,grid.4494.d0000 0000 9558 4598Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Raphaël Duivenvoorden
- grid.10417.330000 0004 0444 9382Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Aaltje Adema
- grid.414846.b0000 0004 0419 3743Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Adrian Covic
- grid.411038.f0000 0001 0685 1605Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania ,Dr Ci Parhon Hospital, Iasi, Romania
| | - Patrik Finne
- grid.15485.3d0000 0000 9950 5666Helsinki University Central Hospital and Helsinki University, Helsinki, Finland
| | | | - Kaisa Laine
- grid.415303.0Satakunta Central Hospital, Pori, Finland
| | - Marlies Noordzij
- grid.4494.d0000 0000 9558 4598Department Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Marcel Schouten
- grid.413202.60000 0004 0626 2490Tergooi Medical Center, Hilversum, The Netherlands
| | - Kitty J. Jager
- grid.509540.d0000 0004 6880 3010ERA Registry, Amsterdam UMC Location University of Amsterdam, Medical Informatics, Meibergdreef 9, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - Ron T. Gansevoort
- grid.4494.d0000 0000 9558 4598Department Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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Loubet P, Rouvière J, Merceron A, Launay O, Sotto A. Patients' Perception and Knowledge about Influenza and Pneumococcal Vaccination during the COVID-19 Pandemic: An Online Survey in Patients at Risk of Infections. Vaccines (Basel) 2021; 9:vaccines9111372. [PMID: 34835303 PMCID: PMC8623007 DOI: 10.3390/vaccines9111372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The objective of our study was to assess, in an at-risk population, perception and knowledge about influenza and pneumococcal vaccinations. METHODS An anonymous web-based survey was submitted to patients recruited in France, from both an Ipsos internal panel and AVNIR patient associations. The study was conducted between July and October 2020, in the context of the COVID-19 pandemic. RESULTS Overall, 2177 questionnaires from patients at risk of infection were analyzed. Almost all respondents (86%, 1869/2177) declared themselves to be favorable to vaccination. Nearly half of the patients (49%, 1069/2177) were aware of which vaccine was recommended for their specific situation. This percentage was significantly (p < 0.001) higher for members of a patient association and for people affected by multiple chronic conditions and varied according to the type of condition. Almost two-thirds of patients (1373/2177) declared having been vaccinated during the 2019/2020 influenza season, and 41% (894/2177) were certain about being up to date with the pneumococcal vaccination. The main barriers to vaccination for influenza are the fear of side effects, doubt regarding the efficacy of the vaccine and for pneumococcal vaccination, and the absence of suggestions by the healthcare professionals (HCPs), as 64% of respondents were not recommended to obtain pneumococcal vaccination. To improve vaccine coverage, information is of prime importance and GPs are recognized as the main HCP to inform about vaccination. Nearly two-thirds (62%, 1360/2177) of patients declared that the COVID-19 pandemic convinced them to have all the recommended vaccines. CONCLUSION Our study highlighted the nonoptimal vaccine coverage in at-risk populations despite a highly positive perception of vaccines and confirmed that physicians are on the front lines to suggest and recommend these vaccinations, especially in the current pandemic context, which may be used to promote other vaccines.
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Affiliation(s)
- Paul Loubet
- INSERM U1047, Department of Infectious and Tropical Diseases, CHU Nîmes, Université Montpellier, 30900 Nîmes, France;
- Correspondence: ; Tel.: +33-4-66-68-41-49
| | | | | | - Odile Launay
- Faculté de Médecine Paris Descartes, Université de Paris, AP-PH, Inserm, CIC Cochin Pasteur, 75231 Paris, France;
| | - Albert Sotto
- INSERM U1047, Department of Infectious and Tropical Diseases, CHU Nîmes, Université Montpellier, 30900 Nîmes, France;
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