Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is particularly life threatening in patients who are immunocompromised, including those with advanced chronic kidney disease (CKD) [1,2]. Despite the implementation of a third dose of a messenger RNA (mRNA) vaccine, the efficacy of SARS-CoV-2 vaccination on humoral and cellular immunities is reduced in the population with CKD, resulting in an increased incidence of severe infection and mortality, including in fully vaccinated patients [3]. In this context, several antiviral therapies or monoclonal antibodies are being investigated for treatment of COVID-19. These drugs prevent viral replication through various mechanisms, including neutralization, blocking SARS-CoV-2 entry, and inhibiting RNA polymerase or proteases activity [4,5]. However, patients with CKD are frequently excluded from clinical trials evaluating new drugs. Although sotrovimab and casirivimab/imdevimab have been shown to confer satisfactory protection against the COVID-19 Delta variant, they have limited neutralizing activity against the Omicron variant [4]. Remdesivir, nirmatrelvir/ritonavir, bebtelovimab, and molnupiravir seem to be effective against the Omicron variant [5]. U.S. Food and Drug Administration product labels do not recom
1 December 2018 in Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Pulmonary infections due to non-tuberculous mycobacteria (NTM) are an emerging issue in the cystic fibrosis (CF) population. Due to bacterial and fungal overgrowth, isolation of mycobacteria from the sputum samples of these patients remains challenging. RGM medium, a novel agar-based culture medium was evaluated for the isolation of NTM from sputum samples of CF patients. Sputum samples were inoculated onto RGM medium and conventional Mycobacterial Growth Indicator Tube (MGIT™, Becton Dickinson, USA). Agar plates were incubated at 35 °C and growth was recorded once a week during 42 days. We compared the yield of the two media. 217 samples were obtained from 124 CF patients. 20 samples (13 patients) had a positive culture for NTM. 79/217 (36.4%) MGIT had to be discontinued due to contamination compared to 18/217 (8.3%) for RGM. We reported equivalent NTM detection performances for RGM and MGIT (P = 0.579): these media enabled the isolation of 15 and 12 NTM strains respectively. RGM medium increases the proportion of interpretable results and the number of NTM cultured. Taking into account the non-inferiority compared to conventional methods and ease of use of RGM medium, we estimate that this test can replace current approaches for the screening of NTM among people with CF. Additionally, RGM provides semi-quantitative results (number of colonies) and information on the morphology of colonies, which may be clinically relevant information.
1 August 2021 in Diagnostic Microbiology and Infectious Disease