Different treatment costs pertaining to the population were applied according to the usage data (IQVIA Singapore National Sales Data) for different scenarios. Drug costs were obtained from public-sector hospitals. Exacerbation management costs were obtained from literature searches.

The analysis showed that increased access to FP/FORM as a result of switching from FP/SAL could help achieve drug (S$1,042,289) and exacerbation management (S$223,550) cost savings over 5 years. In the scenario where patients switched from BUD/FORM, greater drug (S$2,572,797) and exacerbation management (S$256,781) cost savings were observed over 5 years.

The analysis provides a perspective that the increased access to FP/FORM could help achieve drug and exacerbation cost savings for the treatment of moderate-to-severe asthma.

The analysis provides a perspective that the increased access to FP/FORM could help achieve drug and exacerbation cost savings for the treatment of moderate-to-severe asthma.

appears as the main pathogen in cystic fibrosis (CF) involved in recurrent pneumonia and pulmonary exacerbations. The type III secretion system (T3SS) is one of its main determinants of virulence and is associated with poor clinical progression and increased mortality. This study determined the relationship of clinical features of patients with CF and

T3SS virulotypes.

From January 2018 to March 2019,

were isolated from sputum and/or oropharyngeal swabs. T3SS markers (

and

) were detected by PCR. Clinical severity according to Shwachman-Kulckycki score and spirometry data were associated with T3SS virulotypes.

A total of 49 patients had positive cultures for

. T3SS virulence-related markers were detected as follows

97.9% (n=48),

63.2% (n=31),

95.9% (n=47) and

97.9% (n=48). The prevalence of

virulotype was higher than previously reported in CF settings, being detected in 61.2% of the evaluated isolates, present in 70% of intermittent infections and with a significantly higher . Finally, the presented data highlight the relevance of T3SS virulence markers in the clinical progression and disease severity in CF patients.

Hypervirulent

(hvKP) is responsible for various invasive diseases and associated with high mortality. However, the clinical and microbiological factors of hvKP infection that influence prognosis have not been well studied. The purpose of this study was to evaluate the prognostic factors for in-hospital mortality of patients with hvKP infections, mainly focusing on clinical and microbiological characteristics.

A retrospective study was conducted in hvKP strains which positive for

and string test. According to the clinical outcomes during hospitalization, hvKP-infected patients were divided into non-survivor and survivor groups. The clinical characteristics, capsule types, multi-locus sequence types (MLST), virulence genes and antimicrobial susceptibility were compared between those of the two groups.

A total of 135 patients were demonstrated to be with hvKP infections, with a prevalence rate of 22% among all the

infected cases. Sixteen of these patients died during hospitalization, with an in-hoindependent prognostic factors for the in-hospital mortality of patients with hvKP infections.

With the onset of any novel condition, it is the „first” case identified that brings attention and sets into motion the machinery to respond – so it began with a first novel pneumonia case of unknown origin in Wuhan, China. Currently, the World Health Organization has declared SARS-CoV-2 (more commonly known as COVID-19) a public health emergency of international concern. It is projected that the path of COVID-19 could kill 50-80 million people and impacts the world’s economy in its devastating global sweep. The surge is increasing on global and national levels, causing rapid loss of life, joblessness, deterioration of the healthcare systems, and both national and global economies. In Ethiopia, the first COVID-19 case was reported in March. Since then, the government has been taking different measures to prevent its spread. Locking down all schools, declared social distancing and hand hygiene, and restricting large gatherings were some of the Ethiopian government’s actions.

To determine knowledge, attitud when leaving home, and practiced preventive measures given by local health authorities. Knowledge score was statistically significantly associated with gender, age, and educational status of the study participants, whereas attitude and practices were significantly associated with educational status and knowledge of participants.The renin-angiotensin system (RAS) is the most important regulatory system of electrolyte homeostasis and blood pressure and acts through angiotensin-converting enzyme (ACE)/angiotensin II (Ang II)/Ang II type 1 (AT1) receptor axis and angiotensin-converting enzyme 2 (ACE2)/angiotensin (1-7)/MAS receptor axis. RAS dysfunction is related to the occurrence and development of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) and causes a serious prognosis and even death. ALI/ARDS can be induced by various ways, one of which is viral infections, such as SARS-CoV, SARS-CoV-2, H5N1, H7N9, and EV71. This article reviews the specific mechanism on how RAS dysfunction affects ALI/ARDs caused by viral infections. SARS-CoV and SARS-CoV-2 enter the host cells by binding with ACE2. H5N1 and H7N9 avian influenza viruses reduce the ACE2 level in the body, and EV71 increases Ang II concentration. Treatment with angiotensin-converting enzyme inhibitor and angiotensin AT1 receptor blocker can alleviate ALI/ARDS symptoms. This review provides suggestions for the treatment of lung injury caused by viral infections.

We conducted a retrospective study to evaluate the performance of MeltPro assay for detecting ethambutol (EMB) susceptibility of

(MTB) isolates in sputum specimens in Beijing, China.

Smear-positive TB patients undergoing MeltPro assay in the Beijing Chest Hospital between January 2019 and December 2019 were included. Phenotypic drug susceptibility testing (DST) was used as the reference standard to calculate the diagnostic accuracy of MeltPro assay for EMB resistance. Sanger sequencing of

gene was conducted to resolve the discrepancies between MeltPro assay and phenotypic DST.

A total of 222 smear-positive patients were included in our analysis. The overall agreement rate between the two assays was 91.4%, with a kappa value of 0.78. Among 59 EMB-resistant TB cases diagnosed by DST, 49 were identified by MeltPro assay, demonstrating a sensitivity of 83.1%. In addition, 154 out of 163 EMB-susceptible patients diagnosed by DST were correctly detected with MeltPro assay, yielding a specificity of 93.9%. The probe frequency associated with the observed EMB-resistance was as follows A (45/58), B (7/58), and D (6/58), and no EMB-resistance was associated with probe C. The presence of amino acid substitution was observed among all 9 cases with potentially „false-negative” results, including 7 with Met306Ile, 1 with Met306Val, 1 with Gly406Asp, respectively.

MeltPro assay is a promising diagnostic tool for the detection of EMB resistance in China. The specific amino acid substitution in

gene is the major reason for discrepancies between MeltPro assay and phenotypic DST.

MeltPro assay is a promising diagnostic tool for the detection of EMB resistance in China. The specific amino acid substitution in embB gene is the major reason for discrepancies between MeltPro assay and phenotypic DST.

With the recommendation of World Health Organization (WHO) and as per the Ethiopian National Implementation Guideline, GeneXpert is used for rapid diagnosis of rifampicin (RIF)-resistant multidrug-resistant tuberculosis (MDR-TB) from the suspected TB patients; however, there were limited findings in Ethiopia particularly in the study area showing the magnitude of RIF-resistant MDR-TB and related factors among suspected TB cases. Hence, we aimed to assess resistance to RIF as a biomarker for the detection of MDR-TB cases from the suspected TB patients in selected hospitals, Western Oromia, Ethiopia.

We have conducted a cross-sectional review on 2300 registered GeneXpert data as clinically suspected TB cases in three governmental hospitals, Western Oromia, Ethiopia, between October 2015 and April 2016 to assess resistance to RIF as a biomarker for the detection of MDR-TB cases. Trained data collectors enumerated the data using pre-tested semi-structured questionnaires from the Gene Xpert records found in th more attention towards improving the treatment to minimize evolving of the MDR-TB cases.

The rifampicin-resistant TB is prevalent in all age groups. The strong association and high prevalence of RIF-resistant TB to failure after treatment in this study require more attention towards improving the treatment to minimize evolving of the MDR-TB cases.Eggerthella lenta is part of the normal bacterial flora of the intestinal tract, but may cause life-threatening infections. E. lenta has been isolated from blood, abscesses, wounds, skin ulcers, and intra-abdominal infections. However, due to historical difficulties with laboratory identification by conventional biochemical methods, some cases of E. lenta infection have previously gone undiagnosed, especially in China where E. lenta infections are very rare. Recently, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), a new type of technology, has made it possible to identify E. lenta. We report a case of postoperative infection caused by E. lenta which was treated successfully using meropenem.To date, more than 35 million people worldwide have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent of coronavirus disease 2019 (COVID-19), and more than one million have died in the COVID-19 pandemic. International economies are stalled and social isolation based on palpable fear of death remains the order of the day. The United States and other countries are moving toward resuming work activities and social interaction to boost economic recovery. While this makes financial sense, from a medical perspective our population has already suffered and will continue to suffer severe losses in the absence of a viable aggressive prophylaxis strategy for SARS-CoV-2. Herein, we present a plan to address this problem.This study analyzed the barriers of patient access to affordable MDR-TB medication in China and the reasons behind, and proposed strategies towards removing the barriers based on literature review and key informant interviews. Reasons behind the high financial burden of MDR-TB patients in China are the lack of a coordinated and multi-sourced financing model to secure patients’ access to the expensive novel medicines, and the absence of the safety-net for the patients with low ability to pay the costs. Appropriate health insurance benefit packages and provider payment mechanisms, supportive legal framework, coordinated policies as well as incentives for off-label use of evidence-based repurposed medicines are missing. The observations identified key intervention areas including continued efforts to make the novel effective medicines affordable and to strengthen the legislative protection for off-label use of evidence-based medicines; increase incentives for pharmaceutical companies to expand indications of established medicines based on the evidence; implement public initiatives to support the use of repurposed medicines for diseases with major public health significance, and scale up good practices from local pilots to create a coordinated multi-sourced financing model.