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Mertz C, Glowinski R, Cohen SH, Mertz S, Ye F, Hall MW, Peeples ME, King T, Wang H, Leber AL, Sanchez PJ, Ramilo O, Mejias A. SARS-CoV-2 RNAemia and clinical outcomes in children with COVID-19. J Infect Dis 2021; 225:208-213. [PMID: 34618885 DOI: 10.1093/infdis/jiab491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023] Open
Abstract
The burden of COVID-19 in children represents a fraction of cases worldwide, yet a subset of those infected are at risk for severe disease. We measured plasma SARS-CoV-2 RNA in a cohort of 103 children hospitalized with COVID-19 with diverse clinical manifestations. SARS-CoV-2 RNAemia was detected in 27 (26%) of these children, lasted for a median of 6 [2-9] days, and it was associated with higher rates of oxygen administration, admission to the intensive care unit, and longer hospitalization.
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Affiliation(s)
- C Mertz
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - R Glowinski
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - S H Cohen
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - S Mertz
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - F Ye
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - M W Hall
- Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - M E Peeples
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - T King
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - H Wang
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - A L Leber
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - P J Sanchez
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital , and The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, Division of Neonatology, Columbus, OH, USA.,Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - O Ramilo
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA.,Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - A Mejias
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA.,Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
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Leber AL, Hindler JF, Kato EO, Bruckner DA, Pegues DA. Laboratory-based surveillance for vancomycin-resistant enterococci: utility of screening stool specimens submitted for Clostridium difficile toxin assay. Infect Control Hosp Epidemiol 2001; 22:160-4. [PMID: 11310695 DOI: 10.1086/501884] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To study vancomycin-resistant enterococci (VRE) gastrointestinal colonization prevalence in high-risk hospitalized patients and to assess the cost and utility of this laboratory-based surveillance. SETTING Large university teaching hospital. DESIGN Quarterly prevalence culture survey of 50 stool specimens submitted for Clostridium difficile toxin A assay from October 1996 through June 1999 (n=526). Screening culture survey of all C difficile-positive stool specimens from July 1998 through June 1999 (n=140). PATIENTS Specimens for analysis were collected from patients who were admitted to the hospital and who had C difficile toxin A testing ordered. Patient samples were excluded from analysis if they were obtained from patients not hospitalized at UCLA Medical Center, if the C difficile toxin assay result was indeterminate, or if the patient was known to have previous VRE colonization or infection. RESULTS During quarterly surveillance, VRE was detected in 19.8%, C difficile toxin A in 9.5%, and both VRE and C difficile toxin A in 3.2% of stool specimens submitted for C difficile toxin assay. Patients whose stool specimens were positive for C difficile toxin A were significantly more likely than those whose specimens were negative to have VRE detected (odds ratio, 2.3; 95% confidence interval, 1.2-4.5). Based on these findings, in July 1998, we began routine screening of all C difficile-positive stool specimens for VRE. From July 1998 through June 1999, 58 (41.4%) of 140 patients with C difficile-positive specimens had VRE newly detected in the stool. The combined cost of the two laboratory-based surveillance strategies was approximately $62 per VRE-positive patient identified and $5,800 per year. CONCLUSION Quarterly surveillance of stool submitted for C difficile assay combined with screening all C difficile-positive stools is a cost-effective and efficient strategy for detecting VRE stool colonization among high-risk hospitalized patients. Such a laboratory-based surveillance should be included as part of a comprehensive program to limit nosocomial VRE transmission.
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Affiliation(s)
- A L Leber
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, USA
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Labarca JA, Leber AL, Kern VL, Territo MC, Brankovic LE, Bruckner DA, Pegues DA. Outbreak of Stenotrophomonas maltophilia bacteremia in allogenic bone marrow transplant patients: role of severe neutropenia and mucositis. Clin Infect Dis 2000; 30:195-7. [PMID: 10619754 DOI: 10.1086/313591] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
From March 1997 through November 1997, 8 allogenic bone marrow transplant (BMT) patients developed Stenotrophomonas maltophilia bacteremia on the hematology service at UCLA Medical Center (Los Angeles). Five of these patients had undergone transplantation during the same hospitalization that S. maltophilia bacteremia was detected (case patients). Compared with 7 concurrently hospitalized allogenic BMT patients (control patients), the 5 case patients were more likely to have been hospitalized in room A (P=.045), to have severe neutropenia on the culture date (P=.028), to have a longer duration of severe neutropenia (P=.05), to have severe mucositis (P=. 028), and to have received total parenteral nutrition (P=.028). Pulsed-field gel electrophoresis revealed that 2 of 3 isolates from case patients hospitalized in room A were identical. In allogenic BMT patients, severe neutropenia and severe mucositis may promote infection with S. maltophilia by impairing host defenses.
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Affiliation(s)
- J A Labarca
- UCLA School of Medicine, Los Angeles, CA 90095-1688, USA
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Leber AL. Intestinal amebae. Clin Lab Med 1999; 19:601-19, vii. [PMID: 10549428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Although the intestinal amebae that infect humans are not thought of as classic agents of food-borne disease, food plays an important role in the transmission of these protozoa. This is particularly true for areas of the world where the organisms are endemic. Transmission of most intestinal protozoa occurs by the fecal-oral route via contaminated food or water. Among the four genera of amebae that infect man, only Entamoeba histolytica and Blastocystis hominis are causes of disease. This article focuses on E. histolytica because of the organism's medical and economic impact on humans. In addition, the epidemiology, control, and laboratory diagnosis of these protozoa are addressed.
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Affiliation(s)
- A L Leber
- CompuNet Clinical Laboratories, Moraine, Ohio, USA
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Marshall SA, Jones RN, Wanger A, Washington JA, Doern GV, Leber AL, Haugen TH. Proposed MIC quality control guidelines for National Committee for Clinical Laboratory Standards susceptibility tests using seven veterinary antimicrobial agents: ceftiofur, enrofloxacin, florfenicol, penicillin G-novobiocin, pirlimycin, premafloxacin, and spectinomycin. J Clin Microbiol 1996; 34:2027-9. [PMID: 8818906 PMCID: PMC229178 DOI: 10.1128/jcm.34.8.2027-2029.1996] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The present multicenter study proposes broth microdilution quality control (QC) ranges for the antimicrobial agents ceftiofur, enrofloxacin, florfenicol, penicillin G-novobiocin, pirlimycin, premafloxacin, and spectinomycin, which are used in veterinary practice. Six separate laboratories tested replicates of National Committee for Clinical Laboratory Standards (NCCLS)-recommended QC organisms (Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus ATCC 29213, and Enterococcus faecalis ATCC 29212) on medium lots both common and unique to all laboratories. The proposed ranges were within 3 or 4 log2 dilution steps of the modal MICs for all organism-antimicrobial agent pairs, depending on their MIC distributions. With > or = 94.7% of all MIC results being within the proposed QC ranges, all combinations tested comply with NCCLS guidelines and all have been accepted by the NCCLS subcommittee developing susceptibility testing procedures for veterinary laboratories.
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Affiliation(s)
- S A Marshall
- Department of Pathology, University of Iowa College of Medicine, Iowa City 52242, USA
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