Among 777 patients transferred to 4 hospitals in Bangkok from southern Thailand after the tsunami of 26 December 2004, there were 515 with skin and soft-tissue infections. The most common organisms isolated were Aeromonas species (145 [22.6%] of 641 isolates from 305 patients). Most isolates were susceptible to aminoglycosides, third- and fourth-generation cephalosporins, quinolones, and imipenem but were resistant to amoxicillin-clavulanate and first-generation cephalosporins.

New evidence has emerged regarding when to commence antiretroviral therapy (ART), optimal treatment regimens, management of HIV co-infection with opportunistic infections, and management of ART failure. The 2014 guidelines were developed by the collaborations of the Department of Disease Control, Ministry of Public Health (MOPH) and the Thai AIDS Society (TAS). One of the major changes in the guidelines included recommending to initiating ART irrespective of CD4 cell count. However, it is with an emphasis that commencing HAART at CD4 cell count above 500 cell/mm3 is for public health, in term of preventing HIV transmission and personal benefit. In tuberculosis co-infected patients with CD4 cell counts ≤50 cells/mm3 or with CD4 cell counts >50 cells/mm3 who have severe clinical disease, ART should be initiated within 2 weeks of starting tuberculosis treatment. The preferred initial ART regimen in treatment naïve patients is efavirenz combined with tenofovir and emtricitabine or lamivudine. Plasma HIV viral load assessment should be done twice a year until achieving undetectable results; and will then be monitored once a year. CD4 cell count should be monitored every 6 months until CD4 cell count ≥350 cells/mm3 and with plasma HIV viral load <50 copies/mL; then it should be monitored once a year afterward. HIV drug resistance genotypic test is indicated when plasma HIV viral load >1,000 copies/mL while on ART. Ritonavir-boosted lopinavir or atazanavir in combination with optimized two nucleoside-analogue reverse transcriptase inhibitors is recommended after initial ART regimen failure. Long-term ART-related safety monitoring has also been included in the guidelines.Electronic supplementary materialThe online version of this article (doi:10.1186/s12981-015-0053-z) contains supplementary material, which is available to authorized users.

Recent studies have demonstrated a much higher incidence of venous thromboembolism (VTE) among Asian patients compared with previous studies. This study aims to determine dietary and behavioral factors that may have contributed to this increase. A case-control study was conducted. Cases were objectively confirmed VTE between 2006 and 2009 at King Chulalongkorn Memorial Hospital. Patients with underlying cancer, antiphospholipid syndrome and arterial thrombosis were excluded. Controls were age and sex-matched healthy volunteers. Food consumption was assessed using a food frequency questionnaire modified from the Thailand National Health Examination Survey III previously validated in the Thai population. There were 97 cases and 195 controls. The mean age was 54.6 years and 70% were women. VTE patients consumed significantly less vegetable, fish and spicy food compared with normal individuals with an odds ratio (OR) for venous thrombosis of 3.74 [95% confidence interval (CI) 2.24-6.26, P < 0.001], 2.05 (95% CI 1.24-3.41, P = 0.005) and 2.30 (95% CI 1.29-4.11, P = 0.01), respectively. Additionally, thrombosis was associated with overweight (OR 2.1, 95% CI 1.21-3.62, P = 0.002), obesity (OR 3.1, 95% CI 1.46-6.74, P = 0.001) and estrogen uses (OR 3.7, 95% CI 1.05-13.2, P = 0.02), but not with smoking or lack of exercise. A multivariate analysis showed that low vegetable consumption (OR 3.74, 95% CI 1.85-7.55, P < 0.001), female hormones (OR 5.80, 95% CI 1.51-22.22, P = 0.011) and body mass index (BMI, P = 0.048) were independently associated with VTE. Low vegetable intake, hormonal use and high BMI are the risk factors for noncancer-related VTE in Thai population.

Background COVID-19 seroprevalence data, particularly in less developed countries with a relatively low incidence, has been scant. We aimed to explore the seroprevalence of hospital staff in the area with zero confirmed COVID-19 case to shed light on the situation of COVID-19 infection in zero or low infection rate countries where mass screening was not readily available. Methods A locally developed rapid immunoglobulin M (IgM)/immunoglobulin G (IgG) test kit was used for hospital staff screening of Ranong hospital which is located in a province with zero COVID-19 prevalence in Thailand from 17th April to 17th May 2020. All staff was tested, 100 of which were randomly invited to have a repeating antibody test in one month. (Thai Clinical Trials Registry: TCTR20200426002) Results Of 844 hospital staff, 82 were tested twice one month apart (response rate for repeating antibody test 82%). Overall, 0.8% of the participants (7 of 844) had positive IgM, none had positive IgG. Female staff had 1.0% positive IgM (95% CI: 0.5–2.1%) while male had 0.5% positive IgM (95% CI: 0.1–2.6%). No participants with a history of travel to the high-risk area or close contact with PCR-confirmed COVID-19 case developed SARS-CoV-2 antibodies. Among 844 staff, 811 had no symptoms and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between SARS-CoV-2 IgM status and gender, history of travel to a high-risk area, close contact with PCR-confirmed or suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed SARS-CoV-2 IgG. Conclusions COVID-19 antibody test could detect a considerable number of hospital staff who could be potential silent spreaders in a province with zero COVID-19 cases. Accurate antibody testing is a valuable screening tool, particularly in asymptomatic healthcare workers. Trial registration: This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No.236/63) and the Institutional Review Board of Ranong Hospital. (Thai Clinical Trials Registry: TCTR20200426002).