Comparative immunogenicity and neutralizing antibody responses post heterologous vaccination with CoronaVac (Sinovac) and Vaxzevria (AstraZeneca) in HIV-infected patients with varying CD4+ T lymphocyte counts

The immune response to heterologous coronavirus disease (COVID-19) vaccination in people living with HIV (PLWH) is still unclear. Herein, our prospective cohort study aimed to compare the immune response of heterologous vaccination with CoronaVac (Sinovac) and Vaxzevria (AstraZeneca) between PLWH having CD4 counts ≤ 200 cells/µL (low CD4+) and > 200 cells/µL (high CD4+). Anti-receptor-binding domain (RBD) immunoglobulin G (IgG) levels and the percentage inhibition of neutralizing antibodies (nAbs) were analyzed at 2 and 12 weeks after immunization. Participants in the low and high CD4+ groups had mean CD4+ counts of 139 and 575 cell/µL, respectively. Two and 12 weeks after immunization, in the low CD4 group, the median anti-RBD-IgG levels were 159 IU/mL and 143 IU/mL, respectively, whereas the nAb level was 71% and decreased to 47.2%, respectively. Contrarily, the median anti-RBD-IgG levels in the high CD4+ group were 273 IU/mL and 294 IU/mL, respectively, whereas the nAb levels were 89.3% and relatively stable at 81.6%. However, although immune responses between the two study groups were not significantly different, a decline in nAb levels was observed at 12 weeks in the low CD4+ group. Therefore, a COVID-19 booster vaccine dose is suggested for immunoprotection.

A Rare Case of Bilateral Renal Abscess from Staphylococcal Infection in a Young Healthy Patient

Bilateral renal abscess is a rare infectious disease. Most patients have some risk factors for comorbidities, such as diabetes or an abnormal urinary tract, causing abscess formation. The incidence of the disease is infrequent in young healthy adults. Here, we report a case of a previously healthy non-diabetic young man who presented with abdominal pain with a high-grade fever. With clinically persistent abdominal pain, computerized tomography of the whole abdomen was done. The result showed bilateral renal abscess. The culture from the abscess reported Staphylococcus aureus. The patient's clinical abdominal pain and fever resolved after receiving antibiotics for 4 weeks.

Epidemiological, Clinical, and Histopathological Characteristics of Patients with Sporotrichoid Lymphocutaneous Infection in Southern Thailand: A 10-year Retrospective Study

Sporotrichoid lymphocutaneous infection is caused by a variety of pathogens. However, in most cases, the causative pathogen cannot be identified on the basis of clinical and histopathological features. We examined the clinical manifestations, histopathologic findings, causative pathogens, treatment, and prognostic factors of sporotrichoid lymphocutaneous infection, specifically in the context of Thailand. The electronic medical records of patients with sporotrichoid lymphocutaneous infection who visited Songklanagarind Hospital from January 2000 to December 2010 were reviewed. A total of 53 patients were included; 41 (77.4%) were female, 12 (22.6%) were male, and the mean (SD) age was 52.9 (± 15.9) years. Nodules, plaques, and papules were the most commonly observed morphologies. Upper extremities were the most commonly infected sites. Mammal-caused injuries were associated with fungal infection but not at a statistically significant level. The most common histopathologic finding was suppurative granuloma. The identified causative pathogens were mainly dematiaceous fungus and occasionally nontuberculous Mycobacterium. Itraconazole was the medication of choice for empiric and specific treatment of the patients with confirmed fungal infection. Dematiaceous fungi were the most common identified pathogens causing sporotrichoid lymphocutaneous infection in southern Thailand. Empirical itraconazole is useful, especially in patients who report contact injury caused by pets at the primary lesion site. Skin biopsy for tissue histopathology and culture is essential.

Suspected Cat-to-Human Transmission of SARS-CoV-2, Thailand, July-September 2021

A veterinarian in Thailand was diagnosed with COVID-19 after being sneezed on by an infected cat owned by an infected patient. Genetic study supported the hypothesis of SARS-CoV-2 transmission from the owner to the cat, and then from the cat to the veterinarian.

Outcomes of Adjunctive Therapy with Intravenous Cefoperazone-Sulbactam for Ventilator-Associated Pneumonia Due to Carbapenem-Resistant Acinetobacter baumannii

Introduction

The efficacy of adjunctive therapy with cefoperazone-sulbactam (CEP-SUL) for ventilator-associated pneumonia (VAP) due to carbapenem-resistant A. baumannii (CRAB) is unclear.

Methods

We retrospectively analyzed the therapeutic effect of adding CEP-SUL to standard regimens for VAP due to CRAB. Patients with VAP due to CRAB strains that were susceptible to CEP-SUL were enrolled into the study. The patients were divided into two groups: those who receive cefoperazone-sulbactam (CEP-SUL⁺), and those who did not receive cefoperazone-sulbactam (CEP-SUL). Mortality rates and resource utilization of these two groups were compared. Factors associated with mortality were explored.

Results

Eighty patients were enrolled into the study, 52 CEP-SUL⁺ and 28 CEP-SUL^-. The baseline characteristics of the two groups were comparable, except for median Acute Physiology and Chronic Health Evaluation (APACHE) II score which was significantly higher for CEP-SUL⁺. Thirty-day, and in-hospital mortality rates for CEP-SUL⁺ were significantly lower than CEP-SUL^- with values of 35%, 39% and 61%, 68%, for CEP-SUL⁺ and CEP-SUL^-, respectively. The survival rate for CEP-SUL⁺ was significantly higher compared with CEP-SUL^- (P < 0.001). The number of hospital days, ventilator days since diagnosis of VAP and hospital costs were lower for CEP-SUL⁺.

Conclusion

Overall results suggested that patients with VAP due to CRAB strains who received adjunctive therapy with CEP-SUL had lower mortality rates and resource utilization compared with CEP-SUL^-.