Publications by authors named "Tun-Chieh Chen"

Mixed bloodstream infections (BSIs) involving and other bacterial pathogens present significant diagnostic and therapeutic challenges. The incidence of these co-infections has been increasing. However, the limited literature on this topic necessitates a deeper understanding of its epidemiological and clinical characteristics.

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Background: People living with HIV (PLWH) are at increased risk for metabolic disorders, including diabetes and prediabetes. While hemoglobin A1c (HbA1c) is widely used for glycemic assessment, its reliability in PLWH is questioned due to altered red blood cell turnover. Glycated albumin (GA) has been proposed as an alternative, but its diagnostic utility remains unclear in PLWH.

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Background: By June 2024, Taiwan reported 381 Mpox virus (MPXV) cases and one death. This study aims to analyze the characteristics and clinical presentations during the first outbreak of Mpox in Taiwan.

Methods: The study was conducted across 16 hospitals and included patients aged 20 and older diagnosed with Mpox between May 2022 and March 2024.

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: To evaluate the effectiveness of local antibiotic prophylaxis (e.g., powder, bone cement, intraosseous injection) in reducing periprosthetic joint infections (PJI) and deep wound infections in adults undergoing primary joint replacement surgery.

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Acute pharyngotonsillitis is a common reason to visit primary care providers. Group A Streptococcal (GAS) pharyngitis is the most common bacterial infection which needs antibiotic treatment. GAS accounts for only 10-15% of adult acute pharyngitis cases.

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Healthcare-associated infections (HAIs) significantly increase morbidity, mortality, length of hospital stays, and costs, particularly among ICU patients. Despite standard interventions, catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) remain major HAI contributors. This study evaluated the efficacy of daily 2% chlorhexidine gluconate (CHG) bathing in reducing HAI incidence, specifically CAUTI, CLABSI, and multidrug-resistant organisms (MDROs), in a 20-bed ICU at a regional hospital.

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Background: Leptospirosis (LS) and hantavirus (HV) are rodent-borne diseases and share similar clinical manifestations, posing diagnostic challenges.

Methods: This retrospective study compared clinical characteristics, laboratory data, complications and outcomes of 33 LS and nine HV cases in Kaohsiung, Taiwan, from 2006 to 2021.

Results: Both LS and HV diseases had high rates of acute kidney injury (84.

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Article Synopsis
  • Vancomycin-variable enterococci (VVE) are a type of Enterococcus faecium that carry the vanA gene but appear susceptible to vancomycin, making them difficult to detect and potentially dangerous for treatment and infection control.
  • This study, conducted in southern Taiwan from 2017 to 2021, analyzed patients with vancomycin-susceptible E. faecium bacteremia to find the prevalence of VVE and identify clinical risk factors.
  • Out of 142 patients, 21 had VVE, with higher resistance rates to certain antibiotics; malignancy and central venous catheter use were identified as significant risk factors, while VVE presence did not correlate with increased mortality, though one case of
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Rationale: Primary myelofibrosis is a subtype of myeloproliferative neoplasm that leads to bone marrow fibrosis. Historically, the only curative option for primary myelofibrosis was allogeneic hematopoietic stem cell transplant. Ruxolitinib, a Janus kinase inhibitor, is now used for the treatment of primary myelofibrosis and polycythemia vera.

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Objectives: The trailing effect of Candida species is a phenomenon characterized by reduced but persistent growth at antifungal concentrations above the MIC. We assessed the impact of trailing growth on the persistence of Candida albicans candidemia in patients receiving fluconazole (FLC) therapy.

Methods: We retrospectively investigated candidemia isolates at three hospitals in southern Taiwan between 2013 and 2020.

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Background: Late cART initiation (CD4 count ≤200 cells/μL or AIDS-defining opportunistic illnesses [AOIs] at cART initiation) impedes CD4 count recovery and virologic suppression after cART initiation. However, studies to evaluate trends of and modifiable factors for optimal immunological response (IR) and virological response (VR) in people living with HIV (PLWH) with late cART initiation with the current HIV treatment strategies are limited.

Methods: We retrospectively identified 475 PLWH with late cART initiation in 2009-2020.

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Background: Integrase strand transfer inhibitor (INSTIs)-based combination antiretroviral treatment in people living with HIV (PLWH) has been reportedly correlated with several adverse effects, such as weight gain, fetal defects or psychiatric disorders.

Methods: To comprehensively understand the adverse effect of INSTIs, our study utilized Caenorhabditis Elegans (C. elegans) as a model to investigate how dolutegravir (DTG) affected its life cycle, growth, reproduction and lifespan.

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Background: Real-world experience with combinations of short-course rifapentine-based regimens and integrase strand-transfer inhibitor-containing antiretroviral therapy (ART) in management of latent tuberculous infection (LTBI) is limited among people with human immunodeficiency virus (PWH).

Methods: From August 2019 to October 2022, PWH receiving 3 months of weekly rifapentine plus isoniazid (3HP) or 1 month of daily rifapentine plus isoniazid (1HP) in combination with ART were included. The primary outcome was virologic response within 12 months after LTBI treatment; secondary outcomes included treatment completion rate and safety of LTBI regimens.

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Background: People living with HIV (PLWH) are susceptible to non-AIDS-related events, particularly those with immunological nonresponses (INRs) to highly active antiretroviral therapy (HAART). This study assessed the association of INRs with incident non-AIDS-related events among PLWH.

Methods: This multicenter retrospective cohort study enrolled PLWH who had newly diagnosed stage 3 HIV and received HAART between January 1, 2008, and December 31, 2019.

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Using 3-stage pooled-plasma hepatitis C virus (HCV) RNA testing performed quarterly among at-risk people with human immunodeficiency virus (PWH), we found that if testing had been performed every 6 or 12 months, 58.6%-91.7% of PWH who recently acquired HCV would be delayed for diagnosis and might contribute to onward HCV transmission with longer durations.

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Article Synopsis
  • Vaccination against COVID-19 is critical for controlling the pandemic, but the serological response in Taiwanese patients with different comorbidities is not well understood.
  • A study enrolled 824 uninfected subjects who received various COVID-19 vaccines and measured their antibody levels post-vaccination, finding common vaccination patterns among participants.
  • Results showed that factors like age, sex, vaccination type, and comorbidity scores significantly affected antibody levels, indicating that higher comorbidity scores are linked to lower neutralizing antibody responses.
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Article Synopsis
  • The study investigates the effects of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) on kidney function in patients who are coinfected with HIV and hepatitis C virus (HCV), focusing on changes in estimated glomerular filtration rate (eGFR) at various stages of treatment.
  • The research involved tracking eGFR values in 445 patients over multiple time points to identify any declines and the factors contributing to acute kidney disease (AKD), particularly in relation to different antiretroviral therapies (ART) and modes of HIV transmission.
  • The main finding indicates that aging is the only independent risk factor linked to a decline in kidney function among these patients during and after DAA treatment, particularly
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Linoleic acid (LA, omega-6), an essential polyunsaturated fatty acid, is supplied by vegetable oils such as corn, sunflower and soybean. Supplementary LA in infants and children is required for normal growth and brain development, but has also been reported to induce brain inflammation and neurodegenerative diseases. This controversial role of LA development requires further investigation.

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Fomite transmission is a possible route by which different pathogens spread within facilities. In hospital settings, elevator buttons are widely observed to be covered with various types of plastic wraps; however, limited information is available concerning the impact of different plastic materials on cleaning. Our study aimed to identify which plastic material is suitable for the coverage of elevator buttons and the optimal intervals for their cleaning.

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In 2019, the CLSI lowered the susceptible levofloxacin breakpoints for Enterobacterales from a MIC of ≤2 μg/mL to ≤0.5 μg/mL. The study evaluated the correlation between the susceptibility profiles obtained by the Vitek 2 and agar dilution (AD) methods in levofloxacin MIC ≤2 μg/mL isolates and its clinical impacts.

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Testing and treatment of tuberculosis infection (TBI) are recommended for people living with HIV (PLWH). We aimed to evaluate the care cascade of TBI treatment among PLWH in the era of antiretroviral therapy (ART) scale-up. This retrospective study included adult PLWH undergoing interferon-gamma release assay (IGRA)-based TBI screening during 2019-2021.

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Coronavirus 3C-like protease (3CLpro) is found in SARS-CoV-2 virus, which causes COVID-19. 3CLpro controls virus replication and is a major target for target-based antiviral discovery. As reported by Pfizer, Nirmatrelvir (PF-07321332) is a competitive protein inhibitor and a clinical candidate for orally delivered medication.

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Autoimmune encephalitis is a rare disease, which should be differentiated from aseptic encephalitis. Possessing anti-N-methyl-D-aspartate (NMDA) receptor autoantibody is the leading cause of autoimmune encephalitis. However, it may pose a diagnostic challenge to clinicians, especially to nonpsychiatric or non-neurologic specialist, resulting in a delayed initiation of treatment.

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Background: Hepatitis C virus (HCV) genotype 6 (HCV-6) infection is prevalent predominantly in Southeast Asia, and the data on the virologic response of HCV-6 to direct-acting antivirals (DAAs) are sparse in people living with human immunodeficiency virus (HIV) (PLWH).

Aim: To assess the virologic response of HCV-6 to DAAs in PLWH.

Methods: From September 2016 to July 2019, PLWH coinfected with HCV-6 initiating DAAs were included.

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