OBJECTIVE: We aimed to assess the association between carbapenem-resistant Enterobacterales (CRE) colonization pressure and carbapenem exposure and acquisition of carbapenemase-producing Enterobacterales (CPE) and non-carbapenemase-producing carbapenem-resistant Enterobacterales (non-CP-CRE).
METHODS: We conducted a parallel 1:2 matched case-control study at Rambam Health Care Campus, Israel, from January 2014 to June 2017. The cases included all adults who acquired CPE or non-CP-CRE in hospital. The controls were hospitalized patients who were negative for CRE on screening and matched by age, hospitalization division and the number of hospitalization days 90 days prior to CRE screening. The exposures of interest were high CRE colonization pressure, defined as a higher-than-median proportion of CRE carriers in the concurrent patient\'s department before acquisition, and carbapenem exposure, assessed as days of treatment. Conditional logistic regression was used for analyses of CPE and non-CP-CRE.
RESULTS: In total, 1058 patients were included: 278 CPE and 75 non-CP-CRE cases, matched to 556 and 149 controls, respectively. High CRE colonization pressure was associated with CPE acquisition (adjusted odds ratio [aOR], 2.6; 95% CI, 1.69-4.02); however, the duration of carbapenem treatment was not (aOR, 1.004; 95% CI, 0.98-1.03; 1-day increment). The duration of carbapenem treatment was significantly associated with non-CP-CRE acquisition (aOR per day, 1.07; 95% CI, 1.03-1.11). A source patient was identified significantly more frequently in epidemiological acquisition investigations of CPE than in those of non-CP-CRE (107/240, 44.6% vs. 18/64, 28.1%, respectively; p 0.017).
CONCLUSIONS: CPE acquisition was associated with horizontal transmission, whereas non-CP-CRE was associated with carbapenem exposure. Differences in the drivers of acquisition mandate tailored infection prevention efforts.

Theiler\'s disease (TD) is a (sub-)acute hepatitis in adult horses and one of the most common causes of acute hepatic failure. Recent findings indicate that equine parvovirus hepatitis (EqPV-H) likely causes TD and that its transmission occurs via iatrogenic and/or natural routes. Following the death of an EqPV-H positive mare with TD, close-contact mares and foals in the same paddock were monitored to evaluate if there was any evidence of EqPV-H. For this purpose, the serum of close contact horses was examined 6 and 42 days after the mare\'s death for the presence of EqPV-H DNA and changes in liver-associated serum biochemical parameters. The foals had higher EqPV-H viral loads than the mares. Apart from the mare that was euthanized, none of the horses included in this study showed signs of severe disease and nor did they have particularly elevated liver enzymes. Nucleotide sequence analysis revealed no major differences between the viral DNA detected in the serum of the dead mare and any of the in-contact horses. In conclusion, our data confirmed previous findings that horizontal transmission of EqPV-H may occur through close contact between horses.

This report describes a rare horizontal transmission of hepatitis B virus (HBV) from an unvaccinated 6-year-old boy to his father. The father had been diagnosed with acute hepatitis B 1 month earlier; therefore, when the child visited the clinic with fever, he was screened for HBV markers and diagnosed as an asymptomatic carrier. Neither the child nor his father was vaccinated against HBV, whereas the child\'s mother and sister, having received the HBV vaccination as they were medical staff and a nursing student, respectively, tested negative for the hepatitis B surface antigen (HBsAg) and positive for anti-HBs. We performed a phylogenetic analysis of HBV in the child and his father, and identified 100% homologous strains of identical genotype C. At diagnosis, the father tested positive for IgM anti-hepatitis B core with a high titer, whereas the child tested negative for this marker. These data strongly indicated a child-to-father transmission. In this case, the HBV infection route was speculated as close contact including saliva-based transmission between the child and father, mainly attributed to their daily food habits. When clinicians diagnose patients with acute or chronic HBV infection, the household members should have been examined for HBV markers immediately. If some household members are susceptible to HBV infection, all members should be vaccinated against HBV.

On March 11, 2020, the World Health Organization declared the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, and on February 28, Mexico reported its first case. Internationally, cases in newborns are few and the outcomes, in general, are good. There is no certainty of possible vertical transmission, and the presence of the virus in human milk is improbable. The gold standard for diagnosis is the reverse transcription-polymerase chain reaction (RT-PCR) test. We performed a literature review and presented a case of perinatal COVID-19.
We describe the case of a full-term male infant with a birth weight of 3450 g and history of rooming-in with another mother-baby pair, both positive for SARS-CoV-2. On the second day of life, the neonate developed pneumonia, with clinical, X-ray and ultrasound diagnostic confirmation. On the third day of life, RT-PCR was positive for SARS-CoV-2; the mother was also positive but remained asymptomatic. The patient required mechanical ventilation and was transferred to a tertiary level neonatal unit on day 5 of life, where congenital heart disease was ruled out. He evolved satisfactorily with a negative RT-PCR test for SARS-CoV-2 on day 8 and was extubated and discharged on day 21 of life. Telephone follow-up was performed without complications.
The present case was classified as horizontal transmission with a short incubation period of COVID-19.
El 11 de marzo de 2020 la Organización Mundial de la Salud declaró la pandemia por SARS-CoV-2 y el 28 de febrero México reportó su primer caso. En todo el mundo, los casos en recién nacidos son pocos y la evolución, en general, es buena. No hay certeza sobre la posible transmisión vertical, y la presencia del virus en la leche humana es altamente improbable. El método de referencia para el diagnóstico es la prueba de reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR). Se presenta un caso clínico de COVID-19 perinatal y se llevó a cabo una revisión de la literatura sobre el tema.
Recién nacido de sexo masculino, de término, con un peso al nacer de 3,450 g, con antecedente de alojamiento conjunto con otro binomio madre-hijo positivo para SARS-CoV-2. Al segundo día de vida desarrolló neumonía diagnosticada por clínica, rayos X y ultrasonido. Presentó prueba positiva para SARS-CoV-2 al día 3 de vida, al igual que la madre, quien permaneció asintomática. El paciente requirió ventilación mecánica y fue trasladado a una unidad neonatal de tercer nivel el día 5 de vida, donde se descartó cardiopatía congénita y evolucionó satisfactoriamente. La prueba de RT-PCR para SARS-CoV-2 fue negativa al día 8, por lo que se realizó extubación y egreso al día 21 de vida. Se realizó seguimiento telefónico, sin complicaciones.
El presente caso fue catalogado como transmisión horizontal con un periodo corto de incubación de COVID-19.