An outbreak of HBV and HCV infection in a paediatric oncology ward: Epidemiological investigations and prevention of further spread
Hospital-acquired hepatitis B (HBV) and C virus (HCV) infections continue to occur despite increased awareness of this problem among the medical community. One hundred six patients were infected in a haematology oncology ward for children, over the time period 1996 to 2000. Serum samples from 45 such patients and 3 from infected medical personnel were used for nucleic acid amplification. HBV core, as well as HCV core and hypervariable region 1 (HVR1) nucleotide sequences, were analysed by phylogenetic tree analysis, in order to characterise the epidemiological pattern of viral transmission on the ward. Samples from 32 patients were positive for HBV-DNA or HCV-RNA by PCR. Ten patients were p…
Towards a European strategy to address the COVID-19 pandemic
Novel activities of safe-in-human broad-spectrum antiviral agents
According to the WHO, there is an urgent need for better control of viral diseases. Re-positioning existing safe-in-human antiviral agents from one viral disease to another could play a pivotal role in this process. Here, we reviewed all approved, investigational and experimental antiviral agents, which are safe in man, and identified 59 compounds that target at least three viral diseases. We tested 55 of these compounds against eight different RNA and DNA viruses. We found novel activities for dalbavancin against echovirus 1, ezetimibe against human immunodeficiency virus 1 and Zika virus, as well as azacitidine, cyclosporine, minocycline, oritavancin and ritonavir against Rift valley feve…
First Report on the Latvian SARS-CoV-2 Isolate Genetic Diversity
Remaining a major healthcare concern with nearly 29 million confirmed cases worldwide at the time of writing, novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused more than 920 thousand deaths since its outbreak in China, December 2019. First case of a person testing positive for SARS-CoV-2 infection within the territory of the Republic of Latvia was registered on 2nd of March 2020, 9 days prior to the pandemic declaration by WHO. Since then, more than 277,000 tests were carried out confirming a total of 1,464 cases of coronavirus disease 2019 (COVID-19) in the country as of 12th of September 2020. Rapidly reacting to the spread of the infection, an ongoing sequenci…
Hepatitis B and C virus variants in long-term immunosuppressed renal transplant patients in Latvia.
The incidence of genome variants of hepatitis B and hepatitis C viruses among 38 long-term (2–15 years) immunosuppressed patients after renal transplantation and 10 patients undergoing dialysis was investigated. Twelve patients had only HBV infection, 9 had only HCV infection and 14 were co-infected. Regions corresponding to the HBV X/EnII/BCP, preC/C, preS/S and to the HCV core were sequenced for molecular characterization of the HBV and HCV genomes. Fifty-seven percent of HBV DNA isolates belonged to genotype D and 42% to genotype A, whereas 77% of HCV RNA isolates belonged to genotype 1b and only 17% to genotype 3a. One sample (6%) was of genotype 2c. Detailed analysis of the above-menti…
Dissemination of a Carbapenem-Resistant Acinetobacter baumannii Strain Belonging to International Clone II/Sequence Type 2 and Harboring a Novel AbaR4-Like Resistance Island in Latvia
ABSTRACT An outbreak of hospital-acquired Acinetobacter baumannii infections, caused by a bla OXA-23 -positive carbapenem-resistant strain belonging to international clone II/ST2, was detected in Latvia. The strain was partially equipped with the armA gene and the intI1-aacA4-catB8-aadA1-qacE Δ 1 class 1 integron. In addition, the strain carried AbaR25, a novel AbaR4-like resistance island of ∼46,500 bp containing structures similar to the previously described AbaR22 and Tn 6167 islands. AbaR25 was characterized by the occurrence of a second copy of Tn 6022a interrupted by Tn 2006 carrying the bla OXA-23 gene.
Outbreak of CTX-M-15-producing Klebsiella pneumoniae of sequence type 199 in a Latvian teaching hospital
Dumpis U, Iversen A, Balode A, Saule M, Miklasevics E, Giske CG. Outbreak of CTX-M-15-producing Klebsiella pneumoniae of sequence type 199 in a Latvian teaching hospital. APMIS 2010; 118: 713–6. Previous studies on the epidemiology of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in Latvia are lacking. ESBL-producing Klebsiella pneumoniae (n = 32) were subjected to pulsed-field gel electrophoresis (PFGE) and selected isolates to multi-locus sequence typing (MLST). Species identification and susceptibility testing were performed using VITEK2, and sequencing of blaCTX-M was performed in selected isolates. PFGE revealed one major clone (n = 23), with most of the isolates de…
Assessment of antibiotic prescribing in Latvian general practitioners.
Abstract Background Though general antibiotic consumption data is available, information on the actual patterns of prescribing antibiotics locally is difficult to obtain. An easy to use methodology was designed to assess ambulatory management of infections by Latvian general practitioners (GPs). Methods GPs were asked to record data in a patient data collection form for every patient that received antibiotics. Study period – (7 days) one week in November, 2008. Data recorded included the following details: an antibiotic, the prescribed dose, dosing interval, route of administration combined with the demographic factors of the patient and clinical diagnosis based on a pre-defined list. Resul…
A Simulation-Based Failure Mode Analysis of SARS-CoV-2 Infection Control and Prevention in Emergency Departments
Background Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19)] outbreak has been declared a global pandemic by the World Health Organization. The COVID-19 pandemic has highlighted problems of sustainable infection prevention and control measures worldwide, particularly the emerging issues with an insufficient supply of personal protective equipment. The aim of this study was to provide an action plan for mitigation of occupational hazards and nosocomial spread of SARS-CoV-2 through a failure mode analysis based on observations during in situ simulations. Methods A multicenter, cross-sectional, observational, simulation-bas…
A look into the future of the COVID-19 pandemic in Europe : an expert consultation
How will the coronavirus disease 2019 (COVID-19) pandemic develop in the coming months and years? Based on an expert survey, we examine key aspects that are likely to influence COVID-19 in Europe. The future challenges and developments will strongly depend on the progress of national and global vaccination programs, the emergence and spread of variants of concern, and public responses to nonpharmaceutical interventions (NPIs). In the short term, many people are still unvaccinated, VOCs continue to emerge and spread, and mobility and population mixing is expected to increase over the summer. Therefore, policies that lift restrictions too much and too early risk another damaging wave. This ch…
Repeated prevalence studies on antibiotic use in Latvia, 2003-2007.
Antibiotic resistance and nosocomial infections have recently been recognised as a growing threat in Latvian hospitals. We used a modified point prevalence study design to gain accurate information on the antibiotic prescription pattern and the prevalence of nosocomial infections in different hospital departments. A given department was observed on a given day in a given month (May) five years in a row. All antibiotic treatments, dose and route of administration were recorded, in addition to demographic data. The most commonly used antibiotic groups were first generation cephalosporins (35.6-38.9%), broad-spectrum penicillins (17.5-23.0%), fluoroquinolones (8.4-14.5%) and aminoglycosides (7…
Saliva as a testing sample for SARS-CoV-2 detection by RT-PCR in low prevalence community settings
AbstractObjectivesThe number of COVID-19 cases is increasing globally and there is an urgency for a simple non-invasive method for the detection of SARS-CoV-2. Our study aimed to demonstrate that saliva can be used as a specimen for SARS-CoV-2 detection notably for the screening of extensive population groups via pooling.MethodsTo demonstrate that saliva is an appropriate specimen for SARS-CoV-2 detection a field study including 3,660 participants was performed between September 29 and October 1, 2020. We collected paired nasopharyngeal/oropharyngeal swabs (NPS) and saliva specimens and processed them within 24 hours of collection. We performed 36 serial measurements of 8 SARS-CoV-2 positiv…