Rhinovirus – From bench to bedside

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Quantitative and qualitative analysis of antibody response after dose sparing intradermal 2009 H1N1 vaccination

Letter to the editorpostprin

Educational Usage of Mobile Devices: Differences Between Postgraduate and Undergraduate Students

The rapid increase of smartphone usage in recent years has provided students the opportunity to participate in mobile learning (m-learning) anywhere, anytime. Academic institutions are also following this trend to launch many m-learning services. This article investigates the differences of the user needs between undergraduate (UG) and postgraduate (PG) students though an online survey with 140 Library Information Systems (LIS) subjects in a Japanese university in order to provide solid foundations for future m-learning studies. We find that UG and PG students do not show significant differences in adopting m-learning by smartphones despite the fact that they have different learning patterns. The m-learning frequencies of smartphones generally range from weekly to monthly, where using search engines is the most frequent, and reading academic resources is the least frequent. They tend to use these services for handling their daily routines (such as search engine, social networks) rather than their academic activities (such as using online databases to search for academic materials). Further, the results also show that content displaying issues (e.g., small display screen, text unable to enlarge) are barriers for most subjects in using these m-learning services.postprin

Efficacy of combined influenza and 23-valent pneumococcal polysaccharide vaccines in patients with chronic illness

Parallel Session 4: Infectious Diseases: abstract no. S13 (Project No. HK-09-01-16)published_or_final_versio

Middle East respiratory syndrome coronavirus: another zoonotic betacoronavirus causing SARS-like disease

The source of the severe acute respiratory syndrome (SARS) epidemic was traced to wildlife market civets and ultimately to bats. Subsequent hunting for novel coronaviruses (CoVs) led to the discovery of two additional human and over 40 animal CoVs, including the prototype lineage C betacoronaviruses, Tylonycteris bat CoV HKU4 and Pipistrellus bat CoV HKU5; these are phylogenetically closely related to the Middle East respiratory syndrome (MERS) CoV, which has affected more than 1,000 patients with over 35% fatality since its emergence in 2012. All primary cases of MERS are epidemiologically linked to the Middle East. Some of these patients had contacted camels which shed virus and/or had positive serology. Most secondary cases are related to health care-associated clusters. The disease is especially severe in elderly men with comorbidities. Clinical severity may be related to MERS-CoV's ability to infect a broad range of cells with DPP4 expression, evade the host innate immune response, and induce cytokine dysregulation. Reverse transcription-PCR on respiratory and/or extrapulmonary specimens rapidly establishes diagnosis. Supportive treatment with extracorporeal membrane oxygenation and dialysis is often required in patients with organ failure. Antivirals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid, and lopinavir. They should be evaluated in suitable animal models before clinical trials. Developing an effective camel MERS-CoV vaccine and implementing appropriate infection control measures may control the continuing epidemic. © 2015, American Society for Microbiology. All Rights Reserved.postprin

Severe macrolide-resistant Mycoplasma pneumoniae pneumonia associated with macrolide failure

We investigated differences in outcomes between 68 children hospitalized with macrolide-sensitive Mycoplasma pneumoniae pneumonia (MSMP group) and 25 children hospitalized with macrolide-resistant M. pneumoniae pneumonia (MRMP group). In the MRMP group, 19 children received macrolides and clinical failure occurred in six of which five had pneumonia progression during therapy.published_or_final_versio

Clinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity

Objectives: This study assessed the impact of discordant empirical antibiotic therapy on the outcome of bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. Methods: The clinical features and outcomes of a cohort of patients hospitalized with ESBL E. coli bacteremia between 2007 and 2008 were retrospectively reviewed. The effect of different antimicrobial regimens on patient outcomes was analyzed. Results: ESBL E. coli accounted for 24.2% (207/857) of E. coli bacteremia cases. The urinary tract (43.6%) was the most common source of infection, followed by the hepatobiliary tract (23.0%). Discordant empirical antibiotic therapy was given to 52.0% patients. Admission to the intensive care unit was associated with the use of a carbapenem as empirical antibiotic therapy (p<. 0.001). Univariate analysis revealed no significant differences in 30-day mortality rates between patients receiving concordant and discordant empirical antibiotic therapy (23.5% vs. 19.8%, p=. 0.526), carbapenem and non-carbapenem empirical antibiotic therapy (29.8% vs. 19.1%, p=. 0.118), beta-lactam/beta-lactam inhibitor combinations (BLBLIs) and non-BLBLIs empirical antibiotic therapy (20.3% vs. 22.3%, p=. 0.734), cephalosporin and non-cephalosporin empirical antibiotic therapy (19.7% vs. 22.6%, p=. 0.639), and fluoroquinolone and non-fluoroquinolone empirical antibiotic therapy (8.3% vs. 22.4%, p=. 0.251). The findings were confirmed by multivariate analysis. Conclusions: Despite a high proportion of discordant empirical antibiotic therapy, ESBL production had little effect on 30-day mortality. Whether the observation can be applied to different ESBL types is unknown and warrants further study. © 2012 International Society for Infectious Diseases.postprin

Infection after fracture osteosynthesis – Part I: Pathogenesis, diagnosis and classification

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Infection after fracture osteosynthesis – Part II: Treatment

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Successful control of vancomycin-resistant Enterococcus faecium outbreak in a neurosurgical unit at non-endemic region

Vancomycin-resistant enterococci (VRE) have emerged in many parts of the world, but have only been reported sporadically in Hong Kong. We report an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in a neurosurgical unit at a tertiary teaching hospital between 3 March and 3 April 2009 in Hong Kong. During the outbreak investigation, clinical samples from 193 (91.5%) of 211 patients who had stayed in the neurosurgical unit and 506 environmental samples were screened for VREfm. Besides the index case, another 3 (1.6%) out of 192 patients were found to be positive for VREfm. Two (0.4%) out of 506 environmental samples were positive for VREfm. All four clinical and two environmental isolates were found to be clonally related by pulse-field gel electrophoresis. The risk factors for nosocomial acquisition of VREfm included advanced age (P¼0.047), presence of nasogastric tubing (P¼0.002) and tracheostomy (Po0.001), and the use of b-lactam antibiotics (Po0.001) and vancomycin (P¼0.001). Contrary to other VRE outbreaks in which the spread was rapid, the neurosurgical patients’ immobilization because of coma and mechanical ventilation dependency, and the vigilant practice of hand hygiene by health-care workers successfully limited the number of secondary cases despite the delayed recognition of the index case. All patients with VREfm were labeled in the hospital network information system so that stringent infection control measures with contact precautions would be carried out once these patients were readmitted to prevent its spread in our locality.published_or_final_versio