Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 ... more Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks (‘pre-pandemic’) to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. Methods We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January–March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Results Of 343 HCP, the proportion of participants reporting ‘always’ using PPE rose from 66% during the pre-pandemic period...
<p>(a) Correlation of collection year and divergence from the maximum likelihood tree. The ... more <p>(a) Correlation of collection year and divergence from the maximum likelihood tree. The R2 (coefficient of determination) of 0.79 was estimated using TempEst (shown at the top left). Red dots indicate sequences obtained in the present study. (b) Bayesian maximum clade credibility (MCC) phylogenetic tree estimated using BEAST v1.8.4. The terminal branch color indicates different geographical locations according to the legend at the bottom left corner of the figure. The mean time of the most recent common ancestor (tMRCA) and 95% highest probability density (HPD) (in calendar year and tenths of year) are indicated with a black arrow, and posterior probability values are indicated adjacent to the node of interest. The name of each taxon is presented formatted as accession number, country, and year of collection. Sequences obtained in the present study are labeled in red. (c) Demographic history of DENV-2 genotype Asian-I was inferred by a Gaussian Markov random field (GMRF) Skyride plot using Tracer 1.7.</p
<p>The amino acid substitutions in the open reading frames of the 3 lineages of DENV-2 geno... more <p>The amino acid substitutions in the open reading frames of the 3 lineages of DENV-2 genotype Cosmopolitan (in the right panel) are shown corresponding to the lineages. The occurrences of indicated amino acid variations are shown with arrows. Sequences obtained in the present study are labeled in red.</p
Southeast Asian Journal of Tropical Medicine and Public Health, 2020
Medical services have been affected worldwide since the outbreak of COVID-19 pandemic. A number o... more Medical services have been affected worldwide since the outbreak of COVID-19 pandemic. A number of patients with COVID-19 develop neurological manifestations, such as stroke, encephalopathy and seizures. In order to determine the relationship between COVID-19 and seizure disorders, a review of case series from 1 December 2019 to 7 July 2020 from seven hospitals in Thailand, which adequately detailed seizure occurrence or neurological manifestations, was carried out. Focus was placed on relationship of seizure/epilepsy and risk of COVID-19 infection, possible epileptogenic effects of the viral infection and management plans for control of seizures. Prevalence of acute symptomatic seizures among COVID-19 patients was 0.57%, indicating epilepsy patients in general were not more susceptible to COVID-19 infection. Issues on adverse interactions between antiepileptic drugs and antivirals, limited access to investigative diagnostic procedures, eg electroencephalography, CSF fluid and neuro...
BACKGROUND Completion of human immunodeficiency virus (HIV) occupational postexposure prophylaxis... more BACKGROUND Completion of human immunodeficiency virus (HIV) occupational postexposure prophylaxis (PEP) is important for successful prophylaxis. AIM To determine factors associated with failure to complete the four-week HIV PEP. METHODS A retrospective study was conducted among healthcare workers (HCWs) accidentally exposed to blood or body fluids of patients at the Bamrasnaradura Infectious Diseases Institute, Thailand, between March 1996 and June 2014. Logistic regression analysis was used to determine factors associated with failure to complete the four-week HIV PEP. FINDINGS In total, 225 exposure episodes were reported. The mean age of HCWs was 33.1 (standard deviation 9.9) years, and 189 (84%) were female. Nurses (43%) were exposed most frequently. The HIV status of the source was defined in 149 (66%) episodes, and 101 (68%) of these were positive. Of 225 exposures, PEP was prescribed in 155 (69%) cases, with intentional discontinuation in 26 cases. Ninety-one of 129 (71%) HCWs completed the four-week regimen. Multi-variate analysis showed that a regimen of two nucleotide reverse transcriptase inhibitors (NRTI) + efavirenz (EFV) was the only significant factor associated with non-completion of the four-week course (odds ratio 37.8, 95% confidence interval 4.2-342.3; P < 0.01). Other factors including age, sex, staff position, status of the source and other PEP regimens were not associated with non-completion of the four-week course (P > 0.05). None of the HCWs were documented to have HIV seroconversion. CONCLUSION A regimen of two NRTIs + EFV was significantly associated with premature discontinuation of occupational PEP. This regimen should not be used for HIV prophylaxis following occupational exposure.
<p>The maximum-likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using ... more <p>The maximum-likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using the TN+F+G4 with 500 bootstrap replications. Data included envelope-encoding sequences obtained in the present study (labeled in red) along with sequences obtained from Genbank (Asian-I, black; Cosmopolitan, blue). The viral genotypes are indicated to the right. Virus names are shown as accession number, country, and reported year of each sequence. Numbers on branches are bootstrap support values exceeding 75%.</p
<p>The maximum likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using ... more <p>The maximum likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using the TN+F+G4 with 500 bootstrap replications. Data included envelope-encoding sequences obtained in the present study (labeled in red) along with sequences obtained from Genbank (genotype II, black; genotype III, blue). The viral genotypes are indicated to the right. Virus names are shown as accession number, country, and reported year of each sequence. Numbers on branches are bootstrap support values exceeding 75%.</p
<p>The amino acid substitutions in the open reading frame among 3 lineages of DENV-3 genoty... more <p>The amino acid substitutions in the open reading frame among 3 lineages of DENV-3 genotype III (in the right panel) are shown corresponding to the lineages. The occurrences of the indicated amino acid variations are shown with arrows. Sequences obtained in this study are labeled in red.</p
<p>(a) Correlation of collection year and divergence from maximum likelihood tree. The R<... more <p>(a) Correlation of collection year and divergence from maximum likelihood tree. The R<sup>2</sup>, (coefficient of determination) of 0.82 was estimated using TempEst (shown at the top left). Red dots indicate sequences obtained in the present study. (b) Bayesian maximum clade credibility (MCC) phylogenetic tree estimated using BEAST v1.8.4. The terminal branch color indicates different geographical locations according to legend at the bottom left corner of the figure. The mean time of the most recent common ancestor (tMRCA) and 95% highest probability density (HPD) (in calendar year and tenths of year) are indicated with black arrows, and posterior probability values are indicated adjacent to the node of interest. The name of each taxon is presented formatted as accession number, country, and year of collection. Sequences obtained in the present study are labeled in red, while Thailand sequences obtained from GenBank are labeled in blue. Lineages A, B, and C are shown to the right. The KX621247 virus is indicated by a red asterisk. (c) Demographic history of DENV-2 genotype Cosmopolitan was inferred by a Gaussian Markov random field (GMRF) Skyride plot using Tracer 1.7.</p
<p>The maximum likelihood phylogenetic tree was constructed in the IQ-TREE program using th... more <p>The maximum likelihood phylogenetic tree was constructed in the IQ-TREE program using the general time reversible model with gamma distribution and invariant sites with 500 bootstrap replications. Data included envelope-encoding sequences obtained in the present study (labeled in red) along with sequences obtained from GenBank. The viral genotypes are indicated to the right. Virus names are shown as accession number, country, and reported year of each sequence. Numbers on branches are bootstrap support values exceeding 75%.</p
BACKGROUND We examined SARS-CoV-2 anti-spike 1 IgG antibody levels following COVID-19 vaccination... more BACKGROUND We examined SARS-CoV-2 anti-spike 1 IgG antibody levels following COVID-19 vaccination (AstraZeneca [AZ], Sinovac [SV], Pfizer-BioNTech [PZ]) among Thai healthcare providers. METHODS Blood specimens were tested using enzyme-linked immunosorbent assay. We analyzed seven vaccination regimens: (1) one dose of AZ or SV, (2) two doses of homologous (2AZ, 2SV) or heterologous (1AZ + 1PZ) vaccines, and (3) three doses of heterologous vaccines (2SV + 1AZ, 2SV + 1PZ). Differences in antibody levels were assessed using Kruskal-Wallis statistic, Mann-Whitney test, or Wilcoxon matched-pairs signed-rank test. Antibody kinetics were predicted using fractional polynomial regression. RESULTS The 563 participants had median age of 39 years; 92% were female; 74% reported no underlying medical condition. Antibody levels peaked at 22-23 days in both 1AZ and 2SV vaccinees and dropped below assay's cutoff for positive (35.2 binding antibody units/ml [BAU/ml]) in 55 days among 1AZ vaccinees compared with 117 days among 2SV vaccinees. 1AZ + 1PZ vaccination regimen was highly immunogenic (median 2279 BAU/ml) 1-4 weeks post vaccination. 2SV + 1PZ vaccinees had significantly higher antibody levels than 2SV + 1AZ vaccinees 4 weeks post vaccination (3423 vs. 2105 BAU/ml; p-value < 0.01), and during weeks 5-8 (3656 vs. 1072 BAU/ml; p-value < 0.01). Antibodies peaked at 12-15 days in both 2SV + 1PZ and 2SV + 1AZ vaccinees, but those of 2SV + 1AZ declined more rapidly and dropped below assay's cutoff in 228 days while those of 2SV + 1PZ remained detectable. CONCLUSIONS 1AZ + 1PZ, 2SV + 1AZ, and 2SV + 1PZ vaccinees had substantial IgG levels, suggesting that these individuals likely mounted sufficient anti-S1 IgG antibodies for possible protection against SARS-CoV-2 infection.
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus ... more Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread rapidly around the world. We reported the first two cases of COVID-19 pneumonia who had the chest computed tomography (CT) performed at the Bamrasnaradura Infectious Disease Institute (BIDI). The chest CT findings in the two patients with COVID-19 pneumonia showed bilateral lung involvement, multifocal involvement, peripheral distribution, ground glass opacity (GGO), consolidation and GGO with interlobular septal thickening (“crazy-paving” pattern). The chest CT findings in these patients are nonspecific and overlapped with other diseases.
Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 ... more Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks (‘pre-pandemic’) to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. Methods We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January–March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Results Of 343 HCP, the proportion of participants reporting ‘always’ using PPE rose from 66% during the pre-pandemic period...
<p>(a) Correlation of collection year and divergence from the maximum likelihood tree. The ... more <p>(a) Correlation of collection year and divergence from the maximum likelihood tree. The R2 (coefficient of determination) of 0.79 was estimated using TempEst (shown at the top left). Red dots indicate sequences obtained in the present study. (b) Bayesian maximum clade credibility (MCC) phylogenetic tree estimated using BEAST v1.8.4. The terminal branch color indicates different geographical locations according to the legend at the bottom left corner of the figure. The mean time of the most recent common ancestor (tMRCA) and 95% highest probability density (HPD) (in calendar year and tenths of year) are indicated with a black arrow, and posterior probability values are indicated adjacent to the node of interest. The name of each taxon is presented formatted as accession number, country, and year of collection. Sequences obtained in the present study are labeled in red. (c) Demographic history of DENV-2 genotype Asian-I was inferred by a Gaussian Markov random field (GMRF) Skyride plot using Tracer 1.7.</p
<p>The amino acid substitutions in the open reading frames of the 3 lineages of DENV-2 geno... more <p>The amino acid substitutions in the open reading frames of the 3 lineages of DENV-2 genotype Cosmopolitan (in the right panel) are shown corresponding to the lineages. The occurrences of indicated amino acid variations are shown with arrows. Sequences obtained in the present study are labeled in red.</p
Southeast Asian Journal of Tropical Medicine and Public Health, 2020
Medical services have been affected worldwide since the outbreak of COVID-19 pandemic. A number o... more Medical services have been affected worldwide since the outbreak of COVID-19 pandemic. A number of patients with COVID-19 develop neurological manifestations, such as stroke, encephalopathy and seizures. In order to determine the relationship between COVID-19 and seizure disorders, a review of case series from 1 December 2019 to 7 July 2020 from seven hospitals in Thailand, which adequately detailed seizure occurrence or neurological manifestations, was carried out. Focus was placed on relationship of seizure/epilepsy and risk of COVID-19 infection, possible epileptogenic effects of the viral infection and management plans for control of seizures. Prevalence of acute symptomatic seizures among COVID-19 patients was 0.57%, indicating epilepsy patients in general were not more susceptible to COVID-19 infection. Issues on adverse interactions between antiepileptic drugs and antivirals, limited access to investigative diagnostic procedures, eg electroencephalography, CSF fluid and neuro...
BACKGROUND Completion of human immunodeficiency virus (HIV) occupational postexposure prophylaxis... more BACKGROUND Completion of human immunodeficiency virus (HIV) occupational postexposure prophylaxis (PEP) is important for successful prophylaxis. AIM To determine factors associated with failure to complete the four-week HIV PEP. METHODS A retrospective study was conducted among healthcare workers (HCWs) accidentally exposed to blood or body fluids of patients at the Bamrasnaradura Infectious Diseases Institute, Thailand, between March 1996 and June 2014. Logistic regression analysis was used to determine factors associated with failure to complete the four-week HIV PEP. FINDINGS In total, 225 exposure episodes were reported. The mean age of HCWs was 33.1 (standard deviation 9.9) years, and 189 (84%) were female. Nurses (43%) were exposed most frequently. The HIV status of the source was defined in 149 (66%) episodes, and 101 (68%) of these were positive. Of 225 exposures, PEP was prescribed in 155 (69%) cases, with intentional discontinuation in 26 cases. Ninety-one of 129 (71%) HCWs completed the four-week regimen. Multi-variate analysis showed that a regimen of two nucleotide reverse transcriptase inhibitors (NRTI) + efavirenz (EFV) was the only significant factor associated with non-completion of the four-week course (odds ratio 37.8, 95% confidence interval 4.2-342.3; P < 0.01). Other factors including age, sex, staff position, status of the source and other PEP regimens were not associated with non-completion of the four-week course (P > 0.05). None of the HCWs were documented to have HIV seroconversion. CONCLUSION A regimen of two NRTIs + EFV was significantly associated with premature discontinuation of occupational PEP. This regimen should not be used for HIV prophylaxis following occupational exposure.
<p>The maximum-likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using ... more <p>The maximum-likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using the TN+F+G4 with 500 bootstrap replications. Data included envelope-encoding sequences obtained in the present study (labeled in red) along with sequences obtained from Genbank (Asian-I, black; Cosmopolitan, blue). The viral genotypes are indicated to the right. Virus names are shown as accession number, country, and reported year of each sequence. Numbers on branches are bootstrap support values exceeding 75%.</p
<p>The maximum likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using ... more <p>The maximum likelihood phylogenetic tree was constructed in IQ-TREE version 1.6.7 using the TN+F+G4 with 500 bootstrap replications. Data included envelope-encoding sequences obtained in the present study (labeled in red) along with sequences obtained from Genbank (genotype II, black; genotype III, blue). The viral genotypes are indicated to the right. Virus names are shown as accession number, country, and reported year of each sequence. Numbers on branches are bootstrap support values exceeding 75%.</p
<p>The amino acid substitutions in the open reading frame among 3 lineages of DENV-3 genoty... more <p>The amino acid substitutions in the open reading frame among 3 lineages of DENV-3 genotype III (in the right panel) are shown corresponding to the lineages. The occurrences of the indicated amino acid variations are shown with arrows. Sequences obtained in this study are labeled in red.</p
<p>(a) Correlation of collection year and divergence from maximum likelihood tree. The R<... more <p>(a) Correlation of collection year and divergence from maximum likelihood tree. The R<sup>2</sup>, (coefficient of determination) of 0.82 was estimated using TempEst (shown at the top left). Red dots indicate sequences obtained in the present study. (b) Bayesian maximum clade credibility (MCC) phylogenetic tree estimated using BEAST v1.8.4. The terminal branch color indicates different geographical locations according to legend at the bottom left corner of the figure. The mean time of the most recent common ancestor (tMRCA) and 95% highest probability density (HPD) (in calendar year and tenths of year) are indicated with black arrows, and posterior probability values are indicated adjacent to the node of interest. The name of each taxon is presented formatted as accession number, country, and year of collection. Sequences obtained in the present study are labeled in red, while Thailand sequences obtained from GenBank are labeled in blue. Lineages A, B, and C are shown to the right. The KX621247 virus is indicated by a red asterisk. (c) Demographic history of DENV-2 genotype Cosmopolitan was inferred by a Gaussian Markov random field (GMRF) Skyride plot using Tracer 1.7.</p
<p>The maximum likelihood phylogenetic tree was constructed in the IQ-TREE program using th... more <p>The maximum likelihood phylogenetic tree was constructed in the IQ-TREE program using the general time reversible model with gamma distribution and invariant sites with 500 bootstrap replications. Data included envelope-encoding sequences obtained in the present study (labeled in red) along with sequences obtained from GenBank. The viral genotypes are indicated to the right. Virus names are shown as accession number, country, and reported year of each sequence. Numbers on branches are bootstrap support values exceeding 75%.</p
BACKGROUND We examined SARS-CoV-2 anti-spike 1 IgG antibody levels following COVID-19 vaccination... more BACKGROUND We examined SARS-CoV-2 anti-spike 1 IgG antibody levels following COVID-19 vaccination (AstraZeneca [AZ], Sinovac [SV], Pfizer-BioNTech [PZ]) among Thai healthcare providers. METHODS Blood specimens were tested using enzyme-linked immunosorbent assay. We analyzed seven vaccination regimens: (1) one dose of AZ or SV, (2) two doses of homologous (2AZ, 2SV) or heterologous (1AZ + 1PZ) vaccines, and (3) three doses of heterologous vaccines (2SV + 1AZ, 2SV + 1PZ). Differences in antibody levels were assessed using Kruskal-Wallis statistic, Mann-Whitney test, or Wilcoxon matched-pairs signed-rank test. Antibody kinetics were predicted using fractional polynomial regression. RESULTS The 563 participants had median age of 39 years; 92% were female; 74% reported no underlying medical condition. Antibody levels peaked at 22-23 days in both 1AZ and 2SV vaccinees and dropped below assay's cutoff for positive (35.2 binding antibody units/ml [BAU/ml]) in 55 days among 1AZ vaccinees compared with 117 days among 2SV vaccinees. 1AZ + 1PZ vaccination regimen was highly immunogenic (median 2279 BAU/ml) 1-4 weeks post vaccination. 2SV + 1PZ vaccinees had significantly higher antibody levels than 2SV + 1AZ vaccinees 4 weeks post vaccination (3423 vs. 2105 BAU/ml; p-value < 0.01), and during weeks 5-8 (3656 vs. 1072 BAU/ml; p-value < 0.01). Antibodies peaked at 12-15 days in both 2SV + 1PZ and 2SV + 1AZ vaccinees, but those of 2SV + 1AZ declined more rapidly and dropped below assay's cutoff in 228 days while those of 2SV + 1PZ remained detectable. CONCLUSIONS 1AZ + 1PZ, 2SV + 1AZ, and 2SV + 1PZ vaccinees had substantial IgG levels, suggesting that these individuals likely mounted sufficient anti-S1 IgG antibodies for possible protection against SARS-CoV-2 infection.
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus ... more Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread rapidly around the world. We reported the first two cases of COVID-19 pneumonia who had the chest computed tomography (CT) performed at the Bamrasnaradura Infectious Disease Institute (BIDI). The chest CT findings in the two patients with COVID-19 pneumonia showed bilateral lung involvement, multifocal involvement, peripheral distribution, ground glass opacity (GGO), consolidation and GGO with interlobular septal thickening (“crazy-paving” pattern). The chest CT findings in these patients are nonspecific and overlapped with other diseases.
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