ResearchPad - poster-abstracts https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[1429Nasopharyngeal Carriage of Potential Bacterial and Viral Pathogens in Hospitalized Patients with Respiratory Symptoms]]> https://www.researchpad.co/article/elastic_article_10149 <![CDATA[Comparison of the Reproductive Numbers of Middle East Respiratory Syndrome Coronavirus Nosocomial Outbreaks in Saudi Arabia and Korea]]> https://www.researchpad.co/article/N9fd6898f-3705-493c-8a76-295540b41d88 ]]> <![CDATA[Quality of Life Among Survivors of Middle East Respiratory Syndrome Corona Virus]]> https://www.researchpad.co/article/N0dbeeb57-afcd-47b8-a990-49b7e4b2bb05 ]]> <![CDATA[Clinical Significance of Human Coronavirus in Bronchoalveolar Lavage Samples From Hematopoietic Cell Transplantation Recipients and Hematologic Malignancy Patients]]> https://www.researchpad.co/article/N3614cf21-117e-448d-b3f8-6c900f935532 ]]> <![CDATA[Laboratory-Confirmed Human Coronavirus Infections Among Children: Does Type Matter?]]> https://www.researchpad.co/article/Ncfc5b759-d35e-489e-8ecd-7be09b7a93a2 ]]> <![CDATA[Hematologic and Biochemical Changes in Hospitalized Patients With Middle East Respiratory Syndrome-Coronavirus]]> https://www.researchpad.co/article/N5810e15b-1451-483a-84d6-3255599e920f ]]> <![CDATA[1122Increase in Influenza-Like Illness in the Spring of 2014 Associated with Human Metapneumovirus]]> https://www.researchpad.co/article/N122d09fe-0787-4944-8e5f-38c1939eca5f ]]> <![CDATA[Comparative Evaluation of Diatherix Target Enriched Multiplex Polymerase Chain Reaction and BioFire FilmArray in the Detection of Viral and Bacterial Respiratory Pathogens]]> https://www.researchpad.co/article/N8008dd3f-ea58-4550-ae24-ffe9e56e86ea ]]> <![CDATA[2448. Clinical Presentation and Outcomes of Long-Term Care Residents with Coronavirus Respiratory Infection: A Retrospective Cohort Study]]> https://www.researchpad.co/article/N825d33c0-6b41-4783-bb6b-79c029dd0739

Abstract

Background

Human coronaviruses (CoVs) are a major cause of respiratory infection and institutional outbreaks, yet the epidemiology and clinical outcomes of these viruses is poorly described among the elderly residing in long-term care facilities (LTCFs).

Methods

We performed a retrospective cohort study of LTCF residents with positive nasopharyngeal or mid-turbinate swabs for CoVs (OC43, 229E, NL63 and HKU1) between January 2013 and December 2018. Demographic and clinical data were obtained from resident charts including clinical presentation, treatment, outcome, and transmission to other residents. Variables were compared using univariate analysis.

Results

3268 residents met inclusion criteria (median age 93 years, 90% male) comprising 7.5% (246/3268) of all positive respiratory virus specimens detected during the study period. 97(39%) of cases were associated with a respiratory outbreak while 149(61%) were sporadic cases that did not result in transmission. OC43 (52%) was the most commonly identified CoV and was more commonly associated with outbreak cases (76% vs. 37%; P < 0.001). In total, 87% of all cases had two or more of runny nose/congestion, cough, sore throat/hoarse voice or fever. The most common symptoms among residents were cough (85%), runny nose/congestion (79%), and sore throat/hoarse voice (59%) and only 17% of residents had a measured temperature of ≥ 37.8C. Only 6% of residents received antibiotic treatment for suspected secondary bacterial pneumonia. The 30-day mortality rate was 3.7% with 67% of deaths attributable to the CoV infection. There was no statistically significant difference in symptoms, treatment or outcomes associated with outbreaks or seasonality.

Conclusion

CoVs make up an important proportion of respiratory viral infections among LTCF residents and may result in frequent outbreaks. Most residents remain afebrile and have self-limited illness while only a small minority develop secondary bacterial pneumonia and death. Given these findings the benefits of control measures should be weighed against the impact on resident quality of life.

Disclosures

All authors: No reported disclosures.

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<![CDATA[739. Middle East Respiratory Syndrome Coronavirus Infection Profile in Qatar: A 7-Year Retrospective Study]]> https://www.researchpad.co/article/5c15e80fd5eed0c4842aab3e

Abstract

Background

A deadly zoonotic Middle East respiratory syndrome coronavirus (MERS-CoV) had emerged over the last 7 years in the Arabian Peninsula. As of February 28, 2018, 2,182 cases of MERS-CoV infection (with 779 deaths) in 27 countries were reported to WHO worldwide. The objectives of this study were to identify the clinical and epidemiological characteristics of MERS-CoV infection as well as determine its clinical outcome.

Methods

This was a retrospective-observational study of all laboratory confirmed cases of MERS-CoV infection conducted at the main seven hospitals in the State of Qatar from January, 2012 to April 2018. We used the Fast Track diagnostics real-time reverse-transcription polymerase chain reaction (rRT-PCR), targeting the upE and ORF1a genes respectively. Demographics, clinical information, potential contacts and probable risk factors were collected and analyzed by standard statistical methods.

Results

The mean annual incidence was 1.7 per 100,0000 person-years. Among the 24 confirmed cases of of MERS-CoV, males constituted the vast majority of cases (23 males) with a median age of 52 years (range 22–74). Fifty percent of the cases were Qatari and 42% reside in the same region. 67% of the cases had contact with camels, and 21% had contact with MERS-CoV-infected patient. Thirty-eight had travel history within 2 weeks of symptoms onset to the Kingdom of Saudi Arabia. Fifty percent were smokers and 42% had comorbidities.

The median symptoms duration was 4.5 days. Most of the patient presented with flu-like symptoms, were fever was the most common presentation, followed by cough, SOB, diarrhea, abdominal pain and headache, 96%, 83%, 33%, 8%, 8% and 4%, respectively. All patients were admitted to a tertiary hospital with a median hospital stay 41 days (8–97). Forty-five percent patients developed severe sepsis with multi-organ failure and needed ICU admission. Fifty percent patients developed acute kidney injury, 29% patients were on hemodialysis and 16% needed extra-corporeal membrane oxygenation. Thirty-three percent patients died. The rest of patients had recovered from the infection and discharged home. Among those who died all had one or more comorbidities.

Conclusion

MERS-CoV infection is a rare infection in the State of Qatar, seen in both Qataris and expatriates with and without travel history. The infection in patients with comorbidities carries high mortality.

Disclosures

All authors: No reported disclosures.

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<![CDATA[1583. The Utility of the Immunodeficiency Scoring Index (ISI) to Predict Outcomes of Coronavirus (HCoV) Infections in Hematopietic Cell Transplant (HCT) Recipients]]> https://www.researchpad.co/article/5c15de64d5eed0c48429b815

Abstract

Background

Respiratory viral infections in HCT recipients are associated with high morbidity and mortality, especially after progression from upper respiratory tract infection (URI) to lower respiratory tract infections (LRI). Data on risk factors (RF) for LRI and mortality is lacking for HCoV infections after HCT. We aimed to validate our ISI in HCoV infections.

Methods

All adult HCT recipients with HCoV infection from 2015 to 2017 were evaluated. An ISI based on RF was used to classify patients as low (0–2), moderate (3–6), or high (7 or higher) risk for progression to LRI or death. We defined LRI as HCoV detected in nasal wash and/or bronchoalveolar lavage and new lung infiltrates on diagnostic imaging. Clinical parameters were collected and ISI were calculated for comparison.

Results

A total of 144 adult HCT recipients with 166 episodes of HCoV infections were analyzed. The most common HCoV serotype for LRI and URI was 229E (42.4%) and OC43 (37.6%), respectively, and most patients were infected between November and March each year (Figures 1 and 2). When compared with URI, patients with LRI were more likely in the pre-engraftment period, had multiple respiratory viruses infections, had nosocomially acquired HCoV, required hospitalization, ICU transfer, and mechanical ventilation (all, P < 0.05). Overall mortality rate was 4% at Day 30 from diagnosis and all patients who died had LRI with an 18% mortality. Among those who died, 33% had nosocomial infection, 67% were co-infected with another respiratory virus and 67% required mechanical ventilation. Using an ISI cut off of <4, the negative predictive value (NPV) for progression to LRI was 86% with a specificity of 76%.

Figure 1.

The seasonal distribution of HCT recipients by month of diagnosis and human coronavirus serotypes for upper respiratory infections (URIs).

Figure 2.

The seasonal distribution of HCT recipients by month of diagnosis and human coronavirus serotypes for lower respiratory infections (LRI).

Conclusion

HCT recipients with HCoV LRI were more likely to have a fatal outcome. The NPV of the ISI for progression to LRI was high and could be used as a prognostic tool for future studies and for therapeutic clinical trials.

Disclosures

All authors: No reported disclosures.

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<![CDATA[634. Transcriptional Stimulation of Antiviral Response Components by the Structural and Accessory Human coronavirus OC43 Proteins]]> https://www.researchpad.co/article/5c15e2c4d5eed0c4842a2094

Abstract

Background

In Kuwait, human coronavirus OC43 (HCoV-OC43) causes 25–30% of common cold, and 8.8% of respiratory infections in hospitalised patients. It is also associated with severe respiratory symptoms in infants, elderly, and immunocompromised patients. Our previous results showed that the expression of antiviral genes in human embryonic kidney (HEK) 293 cells is downregulated in the presence of HCoV-OC43 proteins. To understand the role of HCoV-OC43 proteins in antagonizing antiviral responses of the host, we investigated the effect of HCoV-OC43 structural and accessory proteins on the transcriptional activation of interferon-stimulated response element (ISRE), interferon-β (IFN-β) promoter, and nuclear factor kappa B response element (NF-kappaB-RE).

Methods

HCoV-OC43 ns2a, ns5a, membrane (M), and nucleocapsid (N) mRNA were amplified and cloned into the pAcGFP1-N expression vector, followed by transfection in HEK-293 cells. Two days post-transfection, the cells were co-transfected with a reporter vector containing firefly luciferase under the control of ISRE, IFN-β promoter, or NF-kappaB-RE. Renilla luciferase vector was used as an internal control for transfection efficiency. Following 24 hours of incubation, the cells were treated with either IFN or tumour necrosis factor (TNF) for 6 hours. Thereafter, promoter activity was assayed using the dual-luciferase reporter assay system. Influenza NS1 protein was used as positive control for antagonism.

Results

The transcriptional activity of ISRE, IFN-β promoter, and NF-kappaB-RE was downregulated in the presence of ns2a, ns5a, M, or N protein as there was a sharp fall in firefly luciferase levels. Overall, HCoV-OC43 proteins reduced firefly luciferase levels for ISRE and IFN-β promoter by at least ten fold, whereas for NF-kappaB-RE the firefly luciferase levels were reduced by at least fivefold.

Conclusion

HCoV-OC43 has the ability to block the activation of different antiviral signaling pathways.

Disclosures

All authors: No reported disclosures.

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<![CDATA[2491. Post-Exposure Prophylaxis With Ribavirin Plus Lopinavir/Ritonavir for Middle East Respiratory Syndrome in Healthcare Workers]]> https://www.researchpad.co/article/5c15ea09d5eed0c4842ae07e

Abstract

Background

In 2015, an outbreak of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection occurred in South Korea involving 186 patients, 39 of whom were healthcare workers (HCWs) exposed to the infection. An effective post-exposure prophylaxis (PEP) strategy may limit the spread of infection; however, there is no consensus regarding PEP for MERS-CoV infection. In this study, we assessed (1) the efficacy of oral ribavirin and lopinavir/ritonavir as PEP for HCWs exposed to patients with severe MERS-CoV pre-isolation pneumonia, and (2) safety of the PEP regimen.

Methods

We retrospectively enrolled 43 HCWs with high-risk exposure to MERS-CoV from 5 hospitals affected during this outbreak in South Korea. The rate of MERS-CoV infection was compared between 22 workers at 1 hospital who received PEP consisting of oral ribavirin and lopinavir/ritonavir after exposure to patients with severe MERS-CoV pre-isolation pneumonia and 21 workers at other hospitals who did not receive PEP.

Results

Six workers (14%) developed MERS-CoV infection; all of these subjects belonged to the non-PEP group. The attack rate was lower in the PEP group compared with the non-PEP group (0% vs. 28.6%; Odds ratio = 0.405, 95% confidence interval = 0.274–0.599; P = 0.009). The most commonly reported side effects of PEP therapy were nausea and diarrhea, but there were no severe adverse effects associated with PEP therapy.

Conclusion

PEP with a combination of oral ribavirin and lopinavir/ritonavir appears to be effective and generally safe for preventing MERS-CoV infection after high-risk exposure in healthcare workers.

Disclosures

All authors: No reported disclosures.

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<![CDATA[139Descriptive study of patterns of urine testing and antibiotic use in an inpatient physical medicine and rehabilitation population]]> https://www.researchpad.co/article/5b4b6ba5463d7e75da240380 ]]> <![CDATA[1687Comparision of Xpert MTB/RIF assay and the conventional sputum analysis in detecting M. tuberculosis at Maharaj Nakorn Chiang Mai hospital]]> https://www.researchpad.co/article/5b4b6c39463d7e75da240382 ]]> <![CDATA[766Clinical Features and Outcome of Patients with Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) Infection]]> https://www.researchpad.co/article/5bf91363d5eed0c4841e5a8a ]]> <![CDATA[810Antibiotic Treatment Patterns and Outcomes Following Outpatient Treatment of Community-Acquired Bacterial Pneumonia: A US Cohort Study]]> https://www.researchpad.co/article/5b4b6b13463d7e75da24037e ]]> <![CDATA[1616Long Term Outcomes of a Cohort of HIV-Infected Children in Mexico City, 1998-2013]]> https://www.researchpad.co/article/5b4b6aca463d7e75da24037d ]]> <![CDATA[815Diagnosis of Pulmonary Nocardiosis]]> https://www.researchpad.co/article/5b4b6c83463d7e75da240383 ]]> <![CDATA[1040Describing Antibiotic Utilization Patterns and Healthcare Costs for Ambulatory and Inpatient/ED Treatment of Complicated Urinary Tract Infection (cUTI)]]> https://www.researchpad.co/article/5b4b6fed463d7e75da24038f ]]>