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  • 1.
    Athlin, Simon
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Lidman, Christer
    Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Lundqvist, Anders
    Department of Infectious Diseases, Södra Älvsborgs Hospital, Borås, Sweden.
    Naucler, Pontus
    Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Nilsson, Anna C.
    Infectious Disease Research Unit, Department of Translational Medicine, Lund University, Malmö, Sweden.
    Spindler, Carl
    Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Strålin, Kristoffer
    Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Hedlund, Jonas
    Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Management of community-acquired pneumonia in immunocompetent adults: updated Swedish guidelines 20172018In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 50, no 4, p. 247-272Article, review/survey (Refereed)
    Abstract [en]

    Based on expert group work, Swedish recommendations for the management of community-acquired pneumonia in adults are here updated. The management of sepsis-induced hypotension is addressed in detail, including monitoring and parenteral therapy. The importance of respiratory support in cases of acute respiratory failure is emphasized. Treatment with high-flow oxygen and non-invasive ventilation is recommended. The use of statins or steroids in general therapy is not found to be fully supported by evidence. In the management of pleural infection, new data show favourable effects of tissue plasminogen activator and deoxyribonuclease installation. Detailed recommendations for the vaccination of risk groups are afforded.

  • 2.
    Lagging, Martin
    et al.
    Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wejstål, Rune
    Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Duberg, Ann-Sofi
    Örebro University, School of Medical Sciences. Department of Infectious Diseases.
    Aleman, Soo
    Department of Medicine, Division of Infectious Diseases, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Weiland, Ola
    Department of Medicine, Division of Infectious Diseases, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Westin, Johan
    Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Swedish Reference Group for Antiviral Therapy (RAV), Stockholm, Sweden.
    Treatment of hepatitis C virus infection for adults and children: updated Swedish consensus guidelines 20172018In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 50, no 8, p. 569-583Article, review/survey (Refereed)
    Abstract [en]

    Aim: Following the approval of two new therapeutic combinations within the European Union in 2017, the former Swedish recommendations for the treatment of hepatitis C virus (HCV) infection from 2016 were deemed in need of updating.

    Materials and methods: An expert meeting to this end was held in Stockholm, Sweden in October 2017.

    Results and conclusions: An interferon-free combination of direct-acting antiviral agents is now recommended for all patients with chronic HCV infection, regardless of liver fibrosis stage, in order to limit morbidity and spread of the disease. An extended discussion of treatment for people who inject drugs in order to diminish transmission is included.

  • 3.
    Magnusson, Charlotta
    et al.
    School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Stegger, Marc
    Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
    Hellmark, Bengt
    Örebro University, School of Health Sciences.
    Stenmark, Bianca
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Söderquist, Bo
    Örebro University, School of Medical Sciences.
    Staphylococcus aureus isolates from nares of orthopaedic patients in Sweden are mupirocin susceptible2019In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 51, no 6, p. 475-478Article in journal (Refereed)
  • 4.
    Westin, Johan
    et al.
    Deparment of Infectious Diseases, Institute of Biomedicine at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Aleman, Soo
    Deparment of Medicine, Division of Infectious Diseases, Karolinska Institutet and Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Castedal, Maria
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Duberg, Ann-Sofi
    Örebro University, School of Medical Sciences. Deparment of Infectious Diseases.
    Eilard, Anders
    Deparment of Infectious Diseases, Institute of Biomedicine at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Fischler, Björn
    Deparment of Pediatrics, CLINTEC, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Kampmann, Christian
    Deparment of Infectious Diseases, Skåne University Hospital Lund, Lund, Sweden.
    Lindahl, Karin
    Deparment of Medicine, Division of Infectious Diseases, Karolinska Institutet and Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Lindh, Magnus
    Deparment of Infectious Diseases, Institute of Biomedicine at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Norkrans, Gunnar
    Deparment of Infectious Diseases, Institute of Biomedicine at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Stenmark, Stephan
    Deparment of Clinical Microbiology and Infectious Diseases, Umeå University, Umeå, Sweden.
    Weiland, Ola
    Deparment of Medicine, Division of Infectious Diseases, Karolinska Institutet and Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Wejstål, Rune
    Deparment of Infectious Diseases, Institute of Biomedicine at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Management of hepatitis B virus infection, updated Swedish guidelines2020In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 52, no 1, p. 1-22Article in journal (Refereed)
    Abstract [en]

    Despite access to effective antiviral drugs and vaccines, hepatitis B virus (HBV) infection remains a major health issue worldwide. HBV is highly infectious and may cause chronic infection, progressive liver damage, hepatocellular cancer (HCC) and death. Early diagnosis, proper management and timing of treatment are crucial. The Swedish Reference group for Antiviral Treatment (RAV) here provides updated evidence-based guidelines for treatment and management of HBV infection which may be applicable also in other countries. Tenofovir alafenamide (TAF) has been introduced as a novel treatment option and new principles regarding indication and duration of treatment and characterization of hepatitis B have been gradually introduced which justifies an update of the previous guidelines from 2007. Updated guidelines on HCC surveillance in HBV-infected patients, treatment and prophylaxis for patients undergoing liver transplantation as well as management of pregnant women and children with HBV infection are also provided.

  • 5.
    Ziegler, Ingrid
    et al.
    Department of Infectious Diseases, Örebro University Hospital , Örebro, Sweden.
    Cajander, Sara
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Rasmussen, Gunlög
    Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ennefors, Theresa
    Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Mölling, Paula
    Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Strålin, Kristoffer
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
    High nuc DNA load in whole blood is associated with sepsis, mortality and immune dysregulation in Staphylococcus aureus bacteraemia2019In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 51, no 3, p. 216-226Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Staphylococcus aureus bacteraemia is a disease with varying presentation, ranging from uncomplicated to life-threatening infections. In S. aureus bacteraemia, a high load of bacterial DNA in blood has been linked to mortality. We hypothesized that a high DNA load would also be linked to the presence of sepsis, and to high C-reactive protein (CRP) and lymphopaenia, indicating inflammation and immunosuppression.

    METHODS: Twenty-seven patients with culture-proven S. aureus bacteraemia, 13 (48%) with sepsis and six (22%) non-survivors, were enrolled in a prospective study. Blood samples were collected on days 0, 1-2, 3-4, 6-8, 13-15 and 26-30, and subjected to droplet digital PCR targeting the nuc gene to determine the nuc DNA load.

    RESULTS: nuc DNA was detected on days 0-2 in 22 patients (81%), and on days 6-8 in three patients (all non-survivors). The nuc DNA load on days 1-2 was significantly elevated in patients with sepsis (median 2.69 versus 1.32 log10 copies/mL; p = .014) and in non-survivors (median 2.5 versus 1.0 log10 copies/mL; p = .033). Patients with a high nuc DNA load (>3.0 log10 copies/mL) on days 1-2 had significantly elevated CRP levels at all timepoints, and significantly decreased lymphocyte counts on days 0, 1-2, 13-15 and 26-30.

    CONCLUSIONS: Our results indicate that a high initial load of S. aureus DNA in blood is associated with sepsis, mortality and persistent immune dysregulation in S. aureus bacteraemia patients. Further studies are needed to define the role of bacterial DNA load monitoring in the management of S. aureus bacteraemia.

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