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Article: [WHO'S AFRAID OF INFECTIOUS DISEASES - A DISCIPLINE WITH BROAD IMPACT].

Weinberger, Miriam

2019 Volume 158, Issue 5, Page(s) 282–284

Abstract: Introduction: The Infectious Diseases discipline is diverse, dynamic, vibrant, ever-changing, exciting and fascinating. The Infectious Diseases specialists have a major contribution both to the successful outcome of the individual patient with an ... ...

Abstract	Introduction: The Infectious Diseases discipline is diverse, dynamic, vibrant, ever-changing, exciting and fascinating. The Infectious Diseases specialists have a major contribution both to the successful outcome of the individual patient with an infectious episode and to public health on multiple levels. The involvement of infectious diseases specialist in complex infections has shown to reduce mortality by about 50%. On the background of the global antimicrobial resistance crisis, the infectious diseases specialists have assumed another important role: to guard antibiotics and fight resistance. As a response to the crisis, guidelines to balance between the need for high quality treatment for the individual patient and sensible use of antibiotics were issued. These were named antibiotic stewardship programs. The Israeli Society of Infectious Diseases, instituted in 1979, has risen to the challenge and undertaken leadership in promoting antibiotic stewardship programs in Israel. This edition of Harefuah, dedicated to the disciple of Infectious Diseases, includes several original articles and reviews representing a selection of the major activities of the Israeli Infectious Diseases specialists. The topic of antibiotic stewardship is emphasized in this edition; it is covered by two original articles, a review and an editorial. Other topics covered are antibiotic resistance, vaccine effects, travel medicine and international medicine. The field of infectious diseases is facing important challenges, among them responses to the global antibiotic crisis and the development of efficient vaccines to fight life-threatening endemic and emerging infections, as well as future epidemics. The Israeli Infectious Diseases specialists are also committed to these important tasks.
MeSH term(s)	Anti-Bacterial Agents ; Antimicrobial Stewardship ; Communicable Disease Control ; Communicable Diseases ; Drug Resistance, Microbial ; Humans ; Israel
Chemical Substances	Anti-Bacterial Agents
Language	Hebrew
Publishing date	2019-05-18
Publishing country	Israel
Document type	Journal Article
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article: [PRINCIPLES OF APPROPRIATE ANTIBIOTIC USAGE IN ISRAELBY THE ISRAELI SOCIETY FOR INFECTIOUS DISEASES: TO WHOM ARE THEY DIRECTED?]

Yinnon, Amos M / Weinberger, Miriam

Harefuah

2019 Volume 158, Issue 5, Page(s) 313–315

Abstract: Introduction: In this issue of Harefuah Nesher and Strahilevitz discuss the principles of appropriate antibiotic guidelines based on a position paper by the Israeli Society for Infectious Diseases (ISID). This editiorial discusses for whom this position ...

Abstract	Introduction: In this issue of Harefuah Nesher and Strahilevitz discuss the principles of appropriate antibiotic guidelines based on a position paper by the Israeli Society for Infectious Diseases (ISID). This editiorial discusses for whom this position paper was intended. The first and most obvious target would be the Infectious Disease (ID) physicians themselves. Since the setup of ID units in Israeli hospitals in the 1970s and 1980s, all have engaged in antibiotic control and infection control. Antibiotic control in Israel has always consisted of antibiotic restriction, development of guidelines for the most commonly encountered infections, and oversight of adherence to guidelines (including computer applications). In comparison, antibiotic control was not an ID priority in US hospitals until the concept of antibiotic stewardship emerged in the last decade. Second, the position paper could have been intended for hospital managements, in order to provide the resources necessary to make appropriate antibiotic use an attainable goal, in particular: allocation of highly skilled manpower (physicians, clinical microbiologists, pharmacists) and development of relevant computer applications. Third, the position paper could have been intended as a response to the initiatives by Ministry of Health National Center for Infection Control and Antibiotic Use. The latter was set up more than a decade ago to deal with emerging multi-drug resistant pathogens and to provide professional leadership. Unfortunately, a professional conflict has emerged between the ISID and the National Center, when the latter was trying to impose professional guidelines regarding antibiotic stewardship unilaterally. While Nesher and Strahilevitz outline the ISID view on antibiotic stewardship in Israeli hospitals, they also call for cooperation and joining forces to combat the huge problem of antibiotic resistance in Israel. Forth, the position paper was probably also intended for all physicians who prescribe antimicrobials, to engage them in the responsibility of guarding antibiotics for us and the next generations.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship ; Communicable Diseases ; Hospitals ; Humans ; Israel ; Practice Patterns, Physicians'
Chemical Substances	Anti-Bacterial Agents
Language	Hebrew
Publishing date	2019-05-18
Publishing country	Israel
Document type	Journal Article
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article ; Online: High Morbidity Due to Murine Typhus Upsurge in Urban Neighborhoods in Central Israel.

Rogozin, Evgeny / Lazarovitch, Tsilia / Weinberger, Miriam

The American journal of tropical medicine and hygiene

2019 Volume 100, Issue 4, Page(s) 952–956

Abstract: The incidence of murine typhus in Israel has decreased substantially since 1950 to a low of 0.04/100,000 population in 2010. We present the experience of a single university medical center in central Israel. Hospitalized patients serologically positive ... ...

Abstract	The incidence of murine typhus in Israel has decreased substantially since 1950 to a low of 0.04/100,000 population in 2010. We present the experience of a single university medical center in central Israel. Hospitalized patients serologically positive for
MeSH term(s)	Academic Medical Centers ; Adolescent ; Adult ; Aged ; Arabs ; Child ; Child, Preschool ; Cities/epidemiology ; Female ; Fever/epidemiology ; Fever/microbiology ; Fluorescent Antibody Technique, Indirect ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Infant ; Israel/epidemiology ; Jews ; Male ; Middle Aged ; Morbidity ; Retrospective Studies ; Rickettsia typhi ; Typhus, Endemic Flea-Borne/epidemiology ; Urban Population ; Young Adult
Language	English
Publishing date	2019-02-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.18-0076
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Article ; Online: Predictors of mortality in COVID-19 patients treated with convalescent plasma therapy.

Rahimi-Levene, Naomi / Shapira, Jonathan / Tzur, Irma / Shiloah, Eli / Peer, Victoria / Levin, Ella / Izak, Marina / Shinar, Eilat / Ziv-Baran, Tomer / Weinberger, Miriam / Zimhony, Oren / Chen, Jacob / Maor, Yasmin

PloS one

2022 Volume 17, Issue 7, Page(s) e0271036

Abstract: Several options to treat hospitalized severe COVID-19 patients have been suggested. The study aimed to describe survival in patients treated with convalescent COVID plasma (CCP) and to identify in-hospital mortality predictors. This prospective cohort ... ...

Abstract	Several options to treat hospitalized severe COVID-19 patients have been suggested. The study aimed to describe survival in patients treated with convalescent COVID plasma (CCP) and to identify in-hospital mortality predictors. This prospective cohort study examined data from 112 severe COVID-19 patients hospitalized in the Corona Departments in an acute care hospital who received two units of CCP (at least one of them high-titer). Demographic and medical data was retrieved from the patients' electronic health records (EHR). Possible predictors for in-hospital mortality were analyzed in a univariate analysis and those found to be clinically significant were further analyzed in a multivariable analysis. Median age was 67 years (IQR 55-74) and 66 (58.9%) of them were males. Of them, 20 (17.9%) died in hospital. On multivariable analysis diabetes mellitus (p = 0.004, OR 91.54), mechanical ventilation (p = 0.001, OR 59.07) and lower albumin levels at treatment (p = 0.027, OR 0.74) were significantly associated with increased in-hospital mortality. In our study, in-hospital mortality in patients receiving CCP is similar to that reported for the general population, however certain variables mentioned above were associated with increased in-hospital mortality. In the literature, these variables were also associated with a worse outcome in patients with COVID-19 who did not receive CCP. As evidence points toward a benefit from CCP treatment in immunocompromised patients, we believe the above risk factors can further define COVID-19 patients at increased risk for mortality, enabling the selection of candidates for early treatment in an outpatient setting if possible.
MeSH term(s)	Aged ; COVID-19/therapy ; Female ; Humans ; Immunization, Passive/adverse effects ; Male ; Prospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-07-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0271036
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Article ; Online: WGS-Based Prediction and Analysis of Antimicrobial Resistance in

Rokney, Assaf / Valinsky, Lea / Vranckx, Katleen / Feldman, Noa / Agmon, Vered / Moran-Gilad, Jacob / Weinberger, Miriam

Frontiers in cellular and infection microbiology

2020 Volume 10, Page(s) 365

Abstract: Rapid developments in the field of whole genome sequencing (WGS) ... ...

Abstract	Rapid developments in the field of whole genome sequencing (WGS) make
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Campylobacter Infections/epidemiology ; Campylobacter jejuni/genetics ; Drug Resistance, Bacterial/genetics ; Humans ; Israel/epidemiology ; Macrolides/pharmacology ; Microbial Sensitivity Tests ; Whole Genome Sequencing
Chemical Substances	Anti-Bacterial Agents ; Macrolides
Language	English
Publishing date	2020-08-13
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2020.00365
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Article: Genomic Epidemiology of

Rokney, Assaf / Valinsky, Lea / Moran-Gilad, Jacob / Vranckx, Katleen / Agmon, Vered / Weinberger, Miriam

Frontiers in microbiology

2018 Volume 9, Page(s) 2432

Abstract: Objectives: ...

Abstract	Objectives:
Language	English
Publishing date	2018-10-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2018.02432
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Article ; Online: Ambient temperature and age-related notified Campylobacter infection in Israel: A 12-year time series study.

Rosenberg, Alina / Weinberger, Miriam / Paz, Shlomit / Valinsky, Lea / Agmon, Vered / Peretz, Chava

Environmental research

2018 Volume 164, Page(s) 539–545

Abstract: Background: Campylobacter spp. are the leading cause of foodborne infection worldwide, with a seasonal disease peak that might be affected by temperature increase. We studied the relationship between ambient temperature and weekly notified Campylobacter ...

Abstract	Background: Campylobacter spp. are the leading cause of foodborne infection worldwide, with a seasonal disease peak that might be affected by temperature increase. We studied the relationship between ambient temperature and weekly notified Campylobacter spp.infections. Methods: Data on 29,762 laboratory-confirmed cases of Campylobacter infection for the period, January, 1999 to December, 2010 were retrieved from the Ministry of Health registry. To estimate the association between the number of weekly cases of Campylobacter infection and the national average temperature at lags 0-3 weeks, firstly, we used GAM models, and secondly two-segment piecewise linear Poisson regressions. The effect of temperature was adjusted for seasonality, long-term trends and holidays. Results: We found a J-shaped relationship between ambient temperature and notified Campylobacter spp. Cases: For C. jejuni in all ages, the curve below the threshold was constant and the percent increase in cases for 1 °C above a threshold of 27 °C was 15.4% (95%CI: 6.7-24.1%). For ages 3-10 yr and > =26 yr the curve was constant below the threshold and positive above it; the percent increase in cases for 1 °C was 17.7%(95%CI: 6.0-29.4%) and 23.7%(95%CI: 11.6-35.8%), respectively. For ages 0-2 yr the curve was linear with no threshold and the percent increase for 1 °C was 5.1%(95%CI: 2.1-8.1%). For ages 11-25 yr the curve was always constant. Results for C. coli were similar. Conclusion: Our findings indicate that higher temperatures throughout the year affect Campylobacter spp. morbidity, especially in younger children. This should be taken into consideration in public education and health system preparedness for temperature increases as a result of climate change.
MeSH term(s)	Adolescent ; Adult ; Campylobacter/isolation & purification ; Campylobacter Infections/epidemiology ; Child ; Child, Preschool ; Hot Temperature ; Humans ; Infant ; Infant, Newborn ; Israel ; Temperature ; Time Factors ; Young Adult
Language	English
Publishing date	2018-03-31
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	205699-9
ISSN	1096-0953 ; 0013-9351
ISSN (online)	1096-0953
ISSN	0013-9351
DOI	10.1016/j.envres.2018.03.017
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Article ; Online: Spotted Fever Group Rickettsioses in Israel, 2010-2019.

Cohen, Regev / Finn, Talya / Babushkin, Frida / Paran, Yael / Ben Ami, Ronen / Atamna, Alaa / Reisfeld, Sharon / Weber, Gabriel / Petersiel, Neta / Zayyad, Hiba / Leshem, Eyal / Weinberger, Miriam / Maor, Yasmin / Makhoul, Nicola / Nesher, Lior / Zaide, Galia / Klein, Dar / Beth-Din, Adi / Atiya-Nasagi, Yafit

Emerging infectious diseases

2022 Volume 27, Issue 8, Page(s) 2117–2126

Abstract: In a multicenter, nationwide, retrospective study of patients hospitalized with spotted fever group rickettsiosis in Israel during 2010-2019, we identified 42 cases, of which 36 were autochthonous. The most prevalent species was the Rickettsia conorii ... ...

Abstract	In a multicenter, nationwide, retrospective study of patients hospitalized with spotted fever group rickettsiosis in Israel during 2010-2019, we identified 42 cases, of which 36 were autochthonous. The most prevalent species was the Rickettsia conorii Israeli tick typhus strain (n = 33, 79%); infection with this species necessitated intensive care for 52% of patients and was associated with a 30% fatality rate. A history of tick bite was rare, found for only 5% of patients; eschar was found in 12%; and leukocytosis was more common than leukopenia. Most (72%) patients resided along the Mediterranean shoreline. For 3 patients, a new Rickettsia variant was identified and had been acquired in eastern, mountainous parts of Israel. One patient had prolonged fever before admission and clinical signs resembling tickborne lymphadenopathy. Our findings suggest that a broad range of Rickettsia species cause spotted fever group rickettsiosis in Israel.
MeSH term(s)	Humans ; Israel/epidemiology ; Retrospective Studies ; Rickettsia/genetics ; Rickettsia conorii ; Spotted Fever Group Rickettsiosis/diagnosis ; Spotted Fever Group Rickettsiosis/epidemiology
Language	English
Publishing date	2022-01-26
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2708.203661
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Article ; Online: Hospitalised patients with breakthrough COVID-19 following vaccination during two distinct waves in Israel, January to August 2021: a multicentre comparative cohort study.

Brosh-Nissimov, Tal / Maor, Yasmin / Elbaz, Meital / Lipman-Arens, Shelly / Wiener-Well, Yonit / Hussein, Khetam / Orenbuch-Harroch, Efrat / Cohen, Regev / Zimhony, Oren / Chazan, Bibiana / Nesher, Lior / Rahav, Galia / Zayyad, Hiba / Hershman-Sarafov, Mirit / Weinberger, Miriam / Najjar-Debbiny, Ronza / Chowers, Michal

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

2022 Volume 27, Issue 20

Abstract: BackgroundChanging patterns of vaccine breakthrough can clarify vaccine effectiveness.AimTo compare breakthrough infections during a SARS-CoV-2 Delta wave vs unvaccinated inpatients, and an earlier Alpha wave.MethodsIn an observational multicentre cohort ...

Abstract	BackgroundChanging patterns of vaccine breakthrough can clarify vaccine effectiveness.AimTo compare breakthrough infections during a SARS-CoV-2 Delta wave vs unvaccinated inpatients, and an earlier Alpha wave.MethodsIn an observational multicentre cohort study in Israel, hospitalised COVID-19 patients were divided into three cohorts: breakthrough infections in Comirnaty-vaccinated patients (VD; Jun-Aug 2021) and unvaccinated cases during the Delta wave (ND) and breakthrough infections during an earlier Alpha wave (VA; Jan-Apr 2021). Primary outcome was death or ventilation.ResultsWe included 343 VD, 162 ND and 172 VA patients. VD were more likely older (OR: 1.06; 95% CI: 1.05-1.08), men (OR: 1.6; 95% CI: 1.0-2.5) and immunosuppressed (OR: 2.5; 95% CI: 1.1-5.5) vs ND. Median time between second vaccine dose and admission was 179 days (IQR: 166-187) in VD vs 41 days (IQR: 28-57.5) in VA. VD patients were less likely to be men (OR: 0.6; 95% CI: 0.4-0.9), immunosuppressed (OR: 0.3; 95% CI: 0.2-0.5) or have congestive heart failure (OR: 0.6; 95% CI: 0.3-0.9) vs VA. The outcome was similar between all cohorts and affected by age and immunosuppression and not by vaccination, variant or time from vaccination.ConclusionsVaccination was protective during the Delta variant wave, as suggested by older age and greater immunosuppression in vaccinated breakthrough vs unvaccinated inpatients. Nevertheless, compared with an earlier post-vaccination period, breakthrough infections 6 months post-vaccination occurred in healthier patients. Thus, waning immunity increased vulnerability during the Delta wave, which suggests boosters as a countermeasure.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines ; Cohort Studies ; Female ; Humans ; Israel/epidemiology ; Male ; SARS-CoV-2 ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-05-03
Publishing country	Sweden
Document type	Journal Article ; Multicenter Study
ZDB-ID	1338803-4
ISSN	1560-7917 ; 1025-496X
ISSN (online)	1560-7917
ISSN	1025-496X
DOI	10.2807/1560-7917.ES.2022.27.20.2101026
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Zs.A 5066: Show issues

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Article: Healthcare-associated Pneumocystis jirovecii Pneumonia (PJP) Infection in HIV-negative Adults: a Multicenter Study.

Zalmanovich, Anat / Ben-Ami, Ronen / Rahav, Galia / Alon, Danny / Moses, Allon / Olshtain-Pops, Karen / Weinberger, Miriam / Shitrit, Pnina / Katzir, Michal / Gottesman, Bat-Sheva / Chowers, Michal

The Israel Medical Association journal : IMAJ

2021 Volume 23, Issue 5, Page(s) 312–317

Abstract: Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection in immunocompromised patients. Clusters of PJP, especially among organ transplant recipients in clinic settings were described. Data regarding nosocomial PJP infection ... ...

Abstract	Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection in immunocompromised patients. Clusters of PJP, especially among organ transplant recipients in clinic settings were described. Data regarding nosocomial PJP infection among inpatients are limited. Objectives: To assess the magnitude and characteristics of inpatient healthcare-associated PJP infection (HCA-PJP) in HIV-negative patients. Methods: A retrospective chart review of hospitalized PJP patients was performed to identify HCA-PJP. The study was performed at six medical centers in Israel from 2006 to 2016. HCA-PJP was defined as cases of hospital-onset or those with documented contact with a PJP patient. We reviewed and cross-matched temporal and spatial co-locations of patients. Clinical laboratory characteristics and outcomes were compared. Results: Seventy-six cases of PJP were identified. Median age was 63.7 years; 64% men; 44% hematological malignancies; 18% inflammatory diseases; and 61% steroid usage. Thirty-two patients (42%) were defined as HCA-PJP: 18/32 (23.6%) were hospitalized at onset and 14/32 (18.4%) had a previous encounter with a PJP patient. Time from onset of symptoms to diagnosis was shorter in HCA-PJP vs. community-PJP (3.25 vs. 11.23 days, P = 0.009). In multivariate analysis, dyspnea at presentation (odds ratio [OR] 16.79, 95% confidence interval [95%CI] 1.78-157.95) and a tendency toward higher rate of ventilator support (72% vs. 52%, P = 0.07, OR 5.18, 95%CI 0.7-30.3) were independently associated with HCA-PJP, implying abrupt disease progression in HCA-PJP. Conclusions: HCA-PJP was common. A high level of suspicion for PJP among selected patients with nosocomial respiratory infection is warranted. Isolation of PJP patients should be considered.
MeSH term(s)	Aged ; Cross Infection/diagnosis ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Disease Progression ; Dyspnea/etiology ; Female ; Hospitals ; Humans ; Israel ; Male ; Middle Aged ; Opportunistic Infections/diagnosis ; Opportunistic Infections/epidemiology ; Opportunistic Infections/microbiology ; Pneumocystis carinii/isolation & purification ; Pneumonia, Pneumocystis/diagnosis ; Pneumonia, Pneumocystis/epidemiology ; Pneumonia, Pneumocystis/microbiology ; Respiration, Artificial/statistics & numerical data ; Retrospective Studies ; Time Factors
Language	English
Publishing date	2021-05-23
Publishing country	Israel
Document type	Journal Article ; Multicenter Study
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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