Dengue among immunocompromised patients: a systematic review and meta-analysis.

Background: Although there is a rising trend in both dengue cases and immunocompromised conditions, there is limited research on how common severe dengue is in immunocompromised individuals. This data is key for those advising the ever-increasing numbers of immunocompromised travellers.

Methods: We conducted a systematic review and meta-analysis of studies reporting dengue frequency or outcomes in immunocompromised populations.

Aztreonam-avibactam for the treatment of serious infections caused by metallo-β-lactamase-producing Gram-negative pathogens: a Phase 3 randomized trial (ASSEMBLE).

Background: The Phase 3 ASSEMBLE study investigated aztreonam-avibactam versus best available therapy (BAT) for treatment of complicated intra-abdominal infection (cIAI), complicated urinary tract infection (cUTI), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) or bloodstream infection (BSI) caused by confirmed MBL-producing multidrug-resistant pathogens.

Methods: This prospective, multicentre, randomized, open-label, central assessor-blinded study randomized hospitalized adults 2:1 to aztreonam-avibactam [+ metronidazole (cIAI)] or BAT for 5-14 (cIAI, cUTI and BSI) or 7-14 (HAP/VAP) days. Primary endpoint was clinical cure at test-of-cure (TOC) visit on Day 28  ±  3 [microbiological ITT (micro-ITT) analysis set].

Behavior Changes of Patients With Type 2 Diabetes During the National Lockdown Due to the COVID-19 Pandemic.

Background: We previously reported that the national lockdown led to worsening glucose control and increased systolic blood pressure in patients with type 2 diabetes (T2D). This study aimed to investigate the impact of the national lockdown on changes in diet and physical activity among these patients.

Methods: A questionnaire-based survey (N=100) was conducted to assess changes in dietary habits, physical activity, and medication adherence during the lockdown in a subset of patients from the Siriraj Diabetes Registry who attended a follow-up visit after the lockdown.

Real-world effectiveness and economic analysis of nirmatrelvir/ritonavir, remdesivir, and molnupiravir for treatment of COVID-19 among ambulatory patients in Thailand.

Background: Nirmatrelvir/ritonavir, remdesivir, and molnupiravir are recommended antiviral therapies for non-severe COVID-19 patients at high risk of disease progression. This study evaluated the real-world effectiveness and economic impact of these three antiviral regimens in Thailand.

Methods: This retrospective observational study was conducted at Siriraj Hospital, Thailand.

Association between the big five personalities and academic performance among grade 12 students at international high school in Thailand.

The well-known Big Five personalities represent five personality characteristics including conscientiousness, extraversion, agreeableness, neuroticism, and openness. Previous literature confirmed that academic performance is associated with conscientiousness personality but there were some uncertainties in other personalities across study populations. The questionnaire-based study was conducted among Grade-12 students at an international high school in Thailand.

Unveiling the complexity of vaccine hesitancy: A narrative review focusing on dengue vaccination.

Dengue vaccines face significant challenges, including safety concerns, which contribute to vaccine hesitancy. Addressing this complex issue requires targeted strategies to overcome existing barriers. Through an extensive review of current evidence, we identified key factors contributing to vaccine hesitancy and explored strategies to enhance global vaccine uptake.

A case report of discordant Chikungunya manifestations in a married couple: From acute undifferentiated fever to fatal sepsis with purpura fulminans.

Chikungunya virus, an alphavirus transmitted by mosquitoes, causes chikungunya fever, a non-fatal febrile illness characterized by severe arthralgia and rash. We are reporting on two Chikungunya cases who recently returned from the Thailand-Cambodia border. The first case involved a man who presented with atypical manifestations, including purpura fulminans and multi-organ failure, ultimately leading to death.

Evaluating Antibiotic Misuse and Cost Analysis Among Hospitalized Dengue Virus-Infected Adults: Insights From a Retrospective Cohort Study.

Background: Dengue is a prevalent cause of acute febrile illness, predominantly in Asia, where it necessitates supportive care without the need for antibiotics. This study aimed to evaluate antibiotic usage and analyze hospitalization costs among adults infected with the dengue virus.

Methods: This retrospective cohort study was conducted at the Hospital for Tropical Diseases, Thailand, in 2022.

Epidemiology of ventilator-associated tracheobronchitis and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria at a tertiary care hospital in Thailand.

Objectives: To investigate the epidemiology of MDR Gram-negative bacilli ventilator-associated tracheobronchitis (MDR GNB-VAT) and MDR GNB ventilator-associated pneumonia (MDR GNB-VAP) among mechanically ventilated patients.

Methods: We conducted a retrospective observational study among hospitalized patients who underwent continuous mechanical ventilation for ≥48 h at Siriraj Hospital, Thailand.

Results: During the 18 month study period, 1824 unique patients underwent continuous mechanical ventilation (12 216 ventilator-days).

Rat bite fever caused by mimicking pyogenic polyarthritis: A case report.

We report the world's sixth case of rat bite fever caused by that mimicked pyogenic polyarthritis and required surgical debridement in combination with prolonged antibiotic therapy. This case report highlights the higher severity of rat bite fever caused by compared to

A cost-effectiveness analysis of the 13-valent pneumococcal conjugated vaccine and the 23-valent pneumococcal polysaccharide vaccine among Thai older adult.

Introduction: This study aims to assess the economic impact of introducing the 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) to Thai older adult aged ≥ 65  years who are healthy or with chronic health conditions and immunocompromised conditions from a societal perspective in order to introduce the vaccine to Thailand's National Immunization Program for the older adult.

Methods: A Markov model was adopted to simulate the natural history and economic outcomes of invasive pneumococcal diseases using updated published sources and Thai databases. We reported analyses as incremental cost-effectiveness ratios (ICER) in USD per quality-adjusted life year (QALY) gained.

Pneumococcal carriage among high-risk adults in a country with nonmandatory pneumococcal vaccination during the coronavirus disease 2019 pandemic.

Background: Streptococcus pneumoniae carriage is a prerequisite for clinical infections and is used to make public health decisions on vaccine licensure. Pneumococcal carriage data among high-risk Thai adults are needed before national vaccine program introduction. The association between coronavirus disease 2019 (COVID-19) and pneumococcal carriage were also investigated.

Development and Implementation of a Mobile Application for Choosing Empirical Antimicrobial Therapy for Bacteremia, Pneumonia, Urinary Tract Infection, and Skin and Soft Tissue Infection among Hospitalized Patients.

Clinical practice guidelines (CPGs) and computerized clinical decision support programs are effective antimicrobial stewardship strategies. The DigitalAMS™, a mobile-based application for choosing empirical antimicrobial therapy under the hospital’s CPGs, was implemented at Siriraj Hospital and evaluated. From January to June 2018, a cross-sectional study was conducted among 401 hospitalized adults who received ≥1 dose of antimicrobials and had ≥1 documented site-specific infection.

Comparison of the mathematical equation and trapezoidal approach for 24 h area under the plasma concentration-time curve calculation in patients who received intravenous vancomycin in an acute care setting.

The current recommendation for therapeutic monitoring of vancomycin has recently suggested AUC-guided dosing in patients with serious methicillin-resistant Staphylococcus aureus infections. The study objective was to evaluate mathematical equations and trapezoidal methods for calculating the 24 h area under the plasma vancomycin concentration-time curve (AUC24). The analysis of plasma vancomycin concentrations was performed in 20 adult patients treated with intravenous vancomycin.

A Risk Prediction Model and Risk Score of SARS-CoV-2 Infection Following Healthcare-Related Exposure.

Hospital workers are at high risk of contact with COVID-19 patients. Currently, there is no evidence-based, comprehensive risk assessment tool for healthcare-related exposure; so, we aimed to identify independent factors related to COVID-19 infection in hospital workers following workplace exposure(s) and construct a risk prediction model. We analyzed the COVID-19 contact tracing dataset from 15 July to 31 December 2021 using multiple logistic regression analysis, considering exposure details, demographics, and vaccination history.

Antimicrobial Stewardship in Tropical Infectious Diseases: Focusing on Dengue and Malaria.

Acute undifferentiated febrile illness (AUFI) is the presenting symptom of various tropical and infectious diseases. Viral infection is generally the most common cause of AUFI, accounting for 8-11.8% of cases; thus, antibiotics might be unnecessary.

JMM Profile: Fosfomycin: a potential antibiotic for multi- and extensively resistant bacteria.

Fosfomycin (FOF) is the first antimicrobial of the epoxide class. It is commercially available in oral and parenteral formulations. Oral FOF is widely used to treat uncomplicated cystitis in women, while parenteral FOF is extensively utilized for upper urinary tract infections.

Implementation of Clinical Practice Guidelines for Empirical Antibiotic Therapy of Bacteremia, Urinary Tract Infection, and Pneumonia: A Multi-Center Quasi-Experimental Study.

A quasi-experimental study was conducted on the implementation of locally developed clinical practice guidelines (CPGs) for empirical antibiotic (ATB) therapy of common infections (bacteremia, urinary tract infection (UTI), pneumonia) in the hospitals from January 2019 to December 2020. The CPGs were developed using data from patients with these infections at individual hospitals. Relevant CPG data pre- and post-implementation were collected and compared.

Real-World Effectiveness and Optimal Dosage of Favipiravir for Treatment of COVID-19: Results from a Multicenter Observational Study in Thailand.

Favipiravir is a broad-spectrum oral antiviral agent that shows in vitro activity against SARS-CoV-2. Presently, data on the real-world effectiveness and optimal dosage of favipiravir for treating COVID-19 are limited. We conducted a retrospective observational study of hospitalized adult patients with COVID-19 at five tertiary care hospitals in Thailand.

Safety and Efficacy of Ivermectin for the Prevention and Treatment of COVID-19: A Double-Blinded Randomized Placebo-Controlled Study.

The safety and efficacy of ivermectin for the prevention and treatment of COVID-19 are still controversial topics. From August to November 2021, we conducted a double-blinded, randomized controlled trial at Siriraj Hospital, Thailand. Eligible participants were adults ≥ 18 years with suspected COVID-19 who underwent a SARS-CoV-2 RT-PCR test.

Economic Impact of Home-Use versus Office-Use Diphenylcyclopropenone in Extensive Alopecia Areata.

Introduction: Diphenylcyclopropenone (DPCP) is the medication of choice for the treatment of severe alopecia areata (AA) according to AA treatment guidelines. Precise initiation and application are important factors for successful treatment. However, it is difficult for patients who live far away to visit their doctor weekly.

Cumulative incidence of and risk factors for herpes zoster among patients with diabetes mellitus: Results from a 10-year nested case-control study.

Background: Diabetes mellitus (DM) is a well-known risk factor for herpes zoster (HZ). Data specific to the incidence of and risk factors for HZ among Thai DM patients are scarce.

Methods: This nested case-control study evaluated a 10-year cohort of DM patients (N = 1428) treated at Siriraj Hospital (Bangkok, Thailand).

Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study.

Implementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand. Customised pre-authorisation of selected restricted antibiotics and post-authorisation of selected controlled antibiotics were undertaken and implemented at each hospital by the local AMS team with guidance from the AMS team at the university hospital.