Epidemiological Effectiveness and Cost of a Fungal Meningitis Outbreak Response in New River Valley, Virginia: Local Health Department and Clinical Perspectives

Dorratoltaj, Nargesalsadat; O'Dell, Margaret L.; Bordwine, Paige; Kerkering, Thomas M.; Redican, Kerry J.; Abbas, Kaja

doi:10.1017/dmp.2017.32

Cited by 3 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Steroids themselves may be associated with adverse events, to the point that the use of epidural steroids in and of itself is coming under question because of the rare but potential risk for stroke, vision loss, paralysis, and fatality [ 11 ]. The literature has also reported cases of compounded corticosteroids contaminated with fungal meningitis [ 4 , 12 ]. Infarction with epidural injections might occur when particulate steroids are injected, a vessel is dissected, trauma to an artery occurs, or an arterial muscle spasm happens [ 4 ].…”

Section: Reviewmentioning

confidence: 99%

Iatrogenic Side Effects of Pain Therapies

Gharibo,

Drewes,

Breve

et al. 2023

Cureus

View full text Add to dashboard Cite

Pain regimens, particularly for chronic cancer and noncancer pain, must balance the important analgesic benefits against potential risks. Many effective and frequently used pain control regimens are associated with iatrogenic adverse events. Interventional procedures can be associated with nerve injuries, vascular injuries, trauma to the spinal cord, and epidural abscesses. Although rare, these adverse events are potentially catastrophic. Pharmacologic remedies for pain must also consider potential side effects that can occur even at therapeutic doses of over-the-counter remedies such as paracetamol (acetaminophen) or nonsteroidal anti-inflammatory drugs. Opioids are effective pain relievers but are associated with many side effects, some of which can be treatment limiting. A prevalent and distressing side effect of opioid therapy is constipation. Opioid-induced constipation is caused by binding to opioid receptors in the gastrointestinal system, making conventional laxatives ineffective. Peripherally acting mu-opioid receptor antagonists are a new drug class that offers the benefits of preserving opioid analgesia without side effects in the gastrointestinal system. An important safety concern, particularly among geriatric patients is the increasingly prevalent condition of polypharmacy. Many senior patients take five or more medications, including some that may be contraindicated in geriatric patients, duplicative of other drugs, have potential pharmacokinetic drug-drug interactions, or may not be the optimal choice for the patient’s age and condition. Careful assessment of medications in the elderly, including possibly deprescribing with tapering of certain drugs, may be warranted but should be done systematically and under clinical supervision.

show abstract

Section: Reviewmentioning

confidence: 99%

Iatrogenic Side Effects of Pain Therapies

Gharibo,

Drewes,

Breve

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Bacterial meningitis is an infectious disease characterized by inflammation of the meninges [1,2]. Bacterial meningitis remains a global health problem with high morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal carriage of potential meningitis-causing bacteria in a Ghanaian prison

Amewu

Adu-Asiamah²,

Baba-Adam³

et al. 2023

Microbes and Infectious Diseases

View full text Add to dashboard Cite

Background: Bacterial meningitis continues to be a global health problem even after introducing of meningococcal and pneumococcal vaccines. Surveillance of high-risk populations such as prisoners is necessary for timely identification of outbreaks and prophylaxis. This study assessed pharyngeal colonisation of prisoners and officers in a Ghanaian prison with meningitis-causing bacteria. Methods: A cross-sectional study was conducted from January to April 2018. Oropharyngeal swabs were collected, and microbiological and antimicrobial susceptibility analyses were performed. Results: There were 205 participants. Carriage of meningitiscausing bacterial was 102 (49.7%), 8 (3.9%) and 1(0.48%) for Neisseria species (spp.), Staphylococcus aureus (S. aureus) and Streptococcus pneumoniae (S. pneumoniae), respectively and with a total carriage of 52.2% (107/ 205). Four individuals (1.9%) carried both Neisseria spp. and S. aureus. The S. aureus isolates were resistant to ampicillin (87.5%), chloramphenicol (87.5%), and penicillin (87.5%) and sensitive to cefoxitin (100%) cotrimoxazole (87.5%), clindamycin (87.5%), ciprofloxacin (75.0%), oxacillin (75.0%), and erythromycin (62.5%). None of the S. aureus isolated was methicillin resistant. The S. pneumoniae isolated was resistant to cotrimoxazole, tetracycline, and penicillin and sensitive to chloramphenicol, erythromycin, and clindamycin. Education (OR = 1.910, 95% CI 1.029 -3.545, p = 0.040) and years of incarceration (OR = 3.808, 95% CI 1.350 -10.739, p = 0.011) were associated with carriage of meningitis-causing bacteria. Conclusion:This study showed carriage of potential meningitis-causing bacteria in a Ghanaian prison. Multivalent meningococcal conjugate vaccine is key to controlling meningococcal disease outbreaks.

show abstract

Recognition of fungal priority pathogens: What next?

Rodrigues

Nosanchuk

2023

PLoS Negl Trop Dis

View full text Add to dashboard Cite

Fungal diseases kill more than 1.5 million people per year, mostly in regions where neglected populations live [1]. This alarming number of deaths is part of a highly complex problem, since mortality alone does not give a complete picture of the fungal burden in different populations [2]. Indeed, several fungal diseases are associated with low mortality but directly linked to social exclusion and hospitalization. For instance, patients suffering from chromoblastomycosis manifest chronic and progressive cutaneous and subcutaneous lesions that can persist for decades [3]. Affected individuals may have significant mental health issues associated with this rare and chronic condition [4]. Fungal infections are the most diagnosed skin disease in Africa, especially in 1-to 5-years-old children [5], and these cutaneous mycoses are associated with social disapproval and psychological trauma, negatively affecting their performance in class [6]. These and other examples demonstrate that the burden of fungal infections is not restricted to mortality. Another way of measuring the impact of fungi on public health is to determine their overall burden of disease using the disability-adjusted life year (DALY). One DALY represents the loss of the equivalent of 1 year of full health [2]. However, with a few exceptions [5,7-10], DALY estimates are not available for most of the fungal diseases.Although fungal diseases are directly associated with neglected populations, they clearly also cause important public health problems in developed countries. For example, in the United States, individuals with diseases such as coccidioidomycosis experience 3 or more months of diminished mental and emotional health [11]. The economic impact of fungal diseases is remarkable. For example, in 2019, the US spent approximately USD 11.5 billion on serious fungal diseases, distributed into direct medical costs, productivity loss due to absenteeism, and premature deaths [12]. To give this number tangible dimensions, USD 11.5 billion represent 25% of the annual budget of the US National Institutes of Health (NIH) [13]. Even diseases such as onychomycosis cost over USD 2,000 per person affected in antifungal drug expenses alone [14]. In large part due to the complexity of fungi, including that they are eukaryotic organisms, the pace of generation of knowledge in the area of fighting fungal diseases is clearly slower than other areas [15]. There are no human licensed antifungal vaccines, and much has been discussed about the problems of antifungal therapies, which include high costs, emergence of antifungal resistance, significant toxicity, and limited number of antifungal drug classes [16]. It is likely that this complex scenario is the consequence of reduced funding for research and insufficient recognition of the impact of fungal diseases on public health by science policymakers and health authorities [17]. This scenario contrasts with the ever-changing epidemiology of fungal infections, which includes the emergence of highly lethal and drugresistant pa...

show abstract

Epidemiological Effectiveness and Cost of a Fungal Meningitis Outbreak Response in New River Valley, Virginia: Local Health Department and Clinical Perspectives

Cited by 3 publications

References 19 publications

Iatrogenic Side Effects of Pain Therapies

Iatrogenic Side Effects of Pain Therapies

Oropharyngeal carriage of potential meningitis-causing bacteria in a Ghanaian prison

Recognition of fungal priority pathogens: What next?

Contact Info

Product

Resources

About