Supplemental material- The integration of Coxiella burnetii PCR testing in serum into the diagnostic algori

Supplemental materials for a study entitled:"The integration of Coxiella burnetii PCR testing in serum into the diagnostic algorithm of suspected acute Q fever in an endemic setting". accepted for publication in the Journal of Clinical Microbiology (JCM01703-23R2) </p

The accuracy of clinical prediction of prognosis for patients admitted with sepsis to internal medicine departments

<div><p></p><p><b>Introduction</b> Prognosis estimation offered by physicians for patients inflicted by sepsis on their admission to Internal Medicine (IM) departments is considered a challenge. Early prognosis estimation is critical and determines the intensity of treatment offered. The accuracy of prognosis estimation made by physicians has previously been investigated mainly among intensive care physicians and oncologists.</p><p><b>Objective</b> To ascertain the accuracy of prognosis prediction made by internists for septic patients on admission to IM departments.</p><p><b>Methods</b> Physicians were asked to estimate the prognosis of every patient identified to have sepsis on admission. Their intuitive assessment of prognosis was incorporated into the patients’ electronic medical record. Survival follow-up was recorded until death or for at least 2 years. Later we compared survival with physicians’ prognosis estimations.</p><p><b>Results</b> Prognosis estimation was recorded for 1,073 consecutive septic patients admitted throughout the years 2008–2009 to IM departments. The mean age of patients was 74.7 ± 16.1 years. A total of 42.4% were suspected to have pneumonia, and 65.4% died during a mean follow-up time of 661.1 ± 612.3 days. Almost half of the patients classified to have good prognosis survived compared to 14.9% and 4.9% of those with intermediate and bad prognosis estimation, respectively (P < 0.001).</p><p><b>Conclusion</b> Internists can discriminate well between septic patients with good, intermediate, and bad prognosis.</p><p></p><p>Key Messages</p><p></p><p>Many patients suffering from sepsis are treated at general medical departments.</p><p></p><p></p><p>Good estimation of the severity of disease upon admission is critical for decision-making regarding treatment.</p><p></p><p></p><p>Internists including junior staff could discriminate well between patients with different degrees of disease severity of sepsis.</p><p></p><p></p><p></p></div

Predictors of infectious foci on FDG PET/CT in Staphylococcus aureus bacteremia

Abstract We looked for predicting factors for the detection of infectious foci on 18F-fluorodeoxyglucose-positron emission tomography in combination with computed tomography (FDG PET/CT) among patients with Staphylococcus aureus bacteremia (SAB) who participated in an interventional study that was conducted at Rambam Health Care Campus, between July 1, 2015 and February 1, 2019. The primary outcome was an infectious focus detected by FDG PET/CT. Independent predictors for detection of focal infection were identified using univariate followed by a logistic regression multivariate analysis. We included 149 patients with 151 separate episodes of SAB who underwent FDG-PET/CT. Focal infections were detected in 107 patients (70.8%). Independent predictors for focal infection detection were community acquisition of bacteremia with odds ratio (OR) 3.03 [95% confidence interval (CI) 1.04–8.77], p-0.042 and C reactive protein (CRP) with OR 1.09 [95% CI 1.04–1.14], p < 0.001. Primary bacteremia was inversely associated with focal infection detection with OR 0.27 [0.10–0.69], p = 0.007, as were the pre-scan blood glucose levels OR 0.9 [0.98–0.99], p-0.004. The latter stayed significant in the subgroup of patients with diabetes mellitus. To conclude, patients with community-acquired bacteremia or high CRP levels should be carefully investigated for focal infection. Patients who present with primary bacteremia seem to be at low risk for focal infection

Insights from genomic analysis of a novel Coxiella burnetii strain isolated in Israel

The diagnosis of Q fever is challenging due to nonspecific symptoms and negative standard blood culture results. Serological testing through immunofluorescence assay (IFA) is the most commonly used method for diagnosing this disease. Polymerase chain reaction (PCR) tests can also be used to detect bacterial DNA if taken at an appropriate time. Once the presence of bacteria is confirmed in a sample, an enrichment step is required before characterizing it through sequencing. Cultivating C. burnetii is challenging as it can only be isolated by inoculation into cell culture, embryonated eggs, or animals. In this article, we describe the isolation of C. burnetii from a valve specimen in Vero cells. We conducted genome sequencing and taxonomy profiling of this isolate and were able to determine its taxonomic affiliation. Furthermore, Multispacer sequence typing (MST) analysis suggests that the infection originated from a local strain of C. burnetii found around northern Israel and Lebanon. This novel strain belongs to a previously described genotype MST6, harboring the QpRS plasmid, never reported in Israel

Risk factors for functional decline among survivors of Gram-negative bloodstream infection: A prospective cohort study

To identify risk factors for functional decline after hospitalization for Gram-negative bacteremia

Seven versus fourteen Days of Antibiotic Therapy for uncomplicated Gram-negative Bacteremia: a Non-inferiority Randomized Controlled Trial

Gram-negative bacteremia is a major cause of morbidity and mortality in hospitalized patients. Data to guide the duration of antibiotic therapy are limited