Publications by authors named "Ho Kwong Li"
Article Synopsis
- * Lineage M1 has emerged as the primary cause of these invasive infections, showing reduced genetic diversity and fewer mutations compared to earlier M1 strains that date back to 2008.
- * Despite being undetected before, M1 clades rapidly spread across the UK after the COVID-19 pandemic, suggesting that waning immunity and specific genetic traits enhance their ability to cause epidemics and survive population bottlenecks.
Article Synopsis
- * In a study analyzing RNAseq data from different strains, deletion of RofA in M1 strains affected expression levels of several genes, with distinct impacts on each lineage regarding non-pilus genes.
- * Changes in gene expression due to specific SNPs in the M1 lineage didn't significantly affect an M1 strain, but reversing those SNPs resulted in notable transcriptomic changes similar to those caused by RofA deletion, indicating a complex regulatory role that requires further exploration.
Article Synopsis
- Genotype 1, particularly the M1 sublineage, is a virulent strain linked to scarlet fever outbreaks in England during 2015/2016, marked by 27 specific SNPs in its genome.
- Comparative analyses revealed only seven differentially expressed genes in M1 compared to other strains, with key metabolic changes influencing pathogen behavior.
- The evolution of M1 is attributed to a stepwise accumulation of SNPs that enhance its fitness, allowing it to outcompete other related strains, despite having similar toxin production capabilities.
Increasing reports of invasive Streptococcus pyogenes infections mandate surveillance for toxigenic lineage M1. An allele-specific PCR was developed to distinguish M1 from other emm1 strains. The M1 lineage represented 91% of invasive emm1 isolates in England in 2020.
View Article and Find Full Text PDFBackground: There is a critical need for rapid viral infection diagnostics to enable prompt case identification in pandemic settings and support targeted antimicrobial prescribing.
Methods: Using untargeted high-resolution liquid chromatography coupled with mass spectrometry, we compared the admission serum metabolome of emergency department patients with viral infections (including COVID-19), bacterial infections, inflammatory conditions, and healthy controls. Sera from an independent cohort of emergency department patients admitted with viral or bacterial infections underwent profiling to validate findings.
Discovery and validation of a three-gene signature to distinguish COVID-19 and other viral infections in emergency infectious disease presentations: a case-control and observational cohort study.
Lancet Microbe
November 2021
Background: Emergency admissions for infection often lack initial diagnostic certainty. COVID-19 has highlighted a need for novel diagnostic approaches to indicate likelihood of viral infection in a pandemic setting. We aimed to derive and validate a blood transcriptional signature to detect viral infections, including COVID-19, among adults with suspected infection who presented to the emergency department.
View Article and Find Full Text PDFBone and joint infections are becoming increasingly common and are usually treated with surgery and a course of intravenous antibiotics. However, there is no evidence to support the superiority of intravenous therapy and there is a growing body of literature showing that oral therapy is effective in treating these infections.Given this lack of evidence the clinical trial 'Oral Versus Intravenous Antibiotics' (OVIVA) was designed to assess the clinical and cost-effectiveness of intravenous versus oral antibiotics for the treatment of bone and joint infections, using a non-inferiority design.
View Article and Find Full Text PDFBackground: Since 2014, England has seen increased scarlet fever activity unprecedented in modern times. In 2016, England's scarlet fever seasonal rise coincided with an unexpected elevation in invasive Streptococcus pyogenes infections. We describe the molecular epidemiological investigation of these events.
View Article and Find Full Text PDFBackground: Management of bone and joint infection commonly includes 4-6 weeks of intravenous (IV) antibiotics, but there is little evidence to suggest that oral (PO) therapy results in worse outcomes.
Objective: To determine whether or not PO antibiotics are non-inferior to IV antibiotics in treating bone and joint infection.
Design: Parallel-group, randomised (1 : 1), open-label, non-inferiority trial.
Background: The management of complex orthopedic infections usually includes a prolonged course of intravenous antibiotic agents. We investigated whether oral antibiotic therapy is noninferior to intravenous antibiotic therapy for this indication.
Methods: We enrolled adults who were being treated for bone or joint infection at 26 U.
The Not-So-Good Prognosis of Streptococcal Periprosthetic Joint Infection Managed by Implant Retention: The Results of a Large Multicenter Study.
Clin Infect Dis
June 2017
Article Synopsis
- Streptococci are a common cause of periprosthetic joint infections (PJI), and the standard treatment is debridement, antibiotics, and implant retention (DAIR), but the success rates are not well understood.
- A study conducted from 2003-2012 on 462 patients with streptococcal PJI revealed a failure rate of 42.1%, influenced by factors like rheumatoid arthritis, late infections, and bacteremia.
- Successful outcomes were associated with exchanging removable components, early rifampin use, and prolonged treatment (≥21 days) with β-lactams, highlighting the need for a more cautious prognosis than previously thought.
Background: Bone and joint infection in adults arises most commonly as a complication of joint replacement surgery, fracture fixation and diabetic foot infection. The associated morbidity can be devastating to patients and costs the National Health Service an estimated £20,000 to £40,000 per patient. Current standard of care in most UK centres includes a prolonged course (4-6 weeks) of intravenous antibiotics supported, if available, by an outpatient parenteral antibiotic therapy service.
View Article and Find Full Text PDFPhilip Bejon and colleagues reflect on the widespread belief in the superiority of intravenous antibiotics.
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