Archive for February, 2020

2020/03 EDITORIAL – Challenges of coronavirus disease 2019 LANCET ID

Yet again, the world is experiencing a global viral epidemic of zoonotic origin. As of Feb 12, 45204 confirmed cases of coronavirus disease 2019 (COVID-19) and 1116 deaths had been reported in 25 countries. The majority of cases and, at the time of writing, all but one death have been in China, despite efforts in the country to halt transmission through shutting down transport, quarantining entire cities, and enforcing the use of face masks. International flights have been cancelled and affected cruise ships quarantined. At this stage, it is unclear whether the severe acute respiratory syndrome coronavirus (SARS-CoV)-2 outbreak will run its course, as SARS-CoV did in 2003, or will become an endemic cause of viral pneumonia….



February 27, 2020 at 8:37 am

2020/02/19 [Correspondence] Asymptomatic cases in a family cluster with SARS-CoV-2 infection LANCET ID

Since December, 2019, an outbreak of pneumonia caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a serious epidemic in China and other countries, resulting in worldwide concern.1 Family clusters of infected individuals have been reported, and this phenomenon could present a serious threat to public health if not strictly controlled. In a previously reported family cluster, most infected individuals had clinical symptoms, decreased lymphocyte counts, and abnormal chest CT images, and were positive for the virus on quantitative RT-PCR (qRT-PCR) analysis….


February 25, 2020 at 8:29 pm

2020/02/24 Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study LANCET ID


A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course.


Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups.


81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4).


COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1–3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia.




February 25, 2020 at 8:25 pm

Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020

MMWR Early Release  February 25, 2020 / 69

What is already known about this topic?

An outbreak of coronavirus disease 2019 (COVID-19) has spread throughout China and to 31 other countries and territories, including the United States.

What is added by this report?

Fourteen cases have been diagnosed in the United States, in addition to 39 cases among repatriated persons from high-risk settings, for a current total of 53 cases within the United States. The U.S. government and public health partners are implementing aggressive measures to slow and contain transmission of COVID-19 in the United States.

What are the implications for public health practice?

Interim guidance is available at As more is learned about this virus and the outbreak, CDC will rapidly incorporate new knowledge into guidance for action.



February 25, 2020 at 7:55 pm

Commentary – A Unified Numbering Scheme for Class C β-Lactamases

Antimicrob. Agents Chemother. March 2020 V.64 N.3

A standard numbering scheme has been proposed for class C β-lactamases. This will significantly enhance comparison of biochemical and biophysical studies performed on different members of this class of enzymes and facilitate communication in the field.




February 25, 2020 at 10:44 am

A Standard Numbering Scheme for Class C β-Lactamases

Antimicrob. Agents Chemother. March 2020 V.64 N.3

Unlike for classes A and B, a standardized amino acid numbering scheme has not been proposed for the class C (AmpC) β-lactamases, which complicates communication in the field. Here, we propose a scheme developed through a collaborative approach that considers both sequence and structure, preserves traditional numbering of catalytically important residues (Ser64, Lys67, Tyr150, and Lys315), is adaptable to new variants or enzymes yet to be discovered and includes a variation for genetic and epidemiological applications.




February 25, 2020 at 10:43 am

Emergence of Ceftriaxone Resistance during a Case of Pneumococcal Meningitis with Fatal Evolution

Antimicrob. Agents Chemother. March 2020 V.64 N.3

We report a case of a 62-year-old man treated for Streptococcus pneumoniae meningitis by ceftriaxone and dexamethasone. After neurological improvement, neurological degradation by vasculitis occurred, despite effective concentrations of ceftriaxone in the serum and cerebrospinal fluid (CSF). S. pneumoniae with increased MICs to third-generation-cephalosporins (3GC) was isolated from the ventricular fluid 10 days after the isolation of the first strain. Isolate analysis showed that a mutation in the penicillin-binding protein 2X (PBP2X) has occurred under treatment.

This Journal section presents a real, challenging case involving a multidrug-resistant organism. The case authors present the rationale for their therapeutic strategy and discuss the impact of mechanisms of resistance on clinical outcome. An expert clinician then provides a commentary on the case.





Antimicrob. Agents Chemother. March 2020 V.64 N.3

Case Commentary: Delayed Cerebral Vasculitis Associated with the Development of Ceftriaxone-Resistant Pneumococcal Meningitis

Mizrahi and colleagues present a well-described case of the emergence of drug resistance in Streptococcus pneumoniae meningitis during therapy with ceftriaxone monotherapy with a low bactericidal concentration in the cerebrospinal fluid. Adherence to international guidelines could possibly have prevented the emergence of this resistant isolate and the adverse outcome.




February 25, 2020 at 10:41 am

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