Archive for January 22, 2012
Integrase inhibitors in the treatment of HIV-1 infection
J of Antimicr Chemoth Dec 2010 V.65 N.12 P.2485-2488
William G. Powderly*
School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
*Tel: +353-1-7166609; Fax: +353-1-7166585; E-mail: bill.powderly@ucd.ie
Abstract
Agents active against HIV type 1 (HIV-1) that target the viral integrase by inhibiting the strand transfer step of integration have now entered the clinical arena. Raltegravir is the first in this new class. Clinical trials in treatment-experienced and in treatment-naive patients have shown that raltegravir-containing regimens have potent antiretroviral activity and are well tolerated. Drug resistance emerges relatively frequently in patients who fail therapy and is associated with mutations in the gene encoding the integrase enzyme. Although such mutations often confer cross-resistance to other integrase inhibitors, newer agents in development, such as S/GSK1349572, show promise as potential second-generation integrase inhibitors. Given their potency, safety and novel mechanism of action, integrase inhibitors represent an important advance in HIV-1 therapy.
abstract
http://jac.oxfordjournals.org/content/65/12/2485.abstract
http://jac.oxfordjournals.org/content/65/12/2485.full.pdf+html
Streptococcal toxic shock-like syndrome.
Intern Med. 2000 Mar V.39 N.3 P.195-6.
Shimizu Y.
Comment on
Intern Med. 2000 Mar;39(3):266-9.
The clinical importance of microbiological findings in the diagnosis and management of bloodstream infections.
Clin Infect Dis. 2009 May 15 V.48 Suppl 4:S238-45.
Seifert H.
Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany. harald.seifert@uni-koeln.de
Abstract
Bloodstream infections are associated with high morbidity and mortality. Accurate identification of blood isolates to the species level and identification of the source of infection and/or the portal of entry are crucial for optimal management of these infections. These investigations-in addition to clinical findings and laboratory and imaging studies-are central to informing and directing efficient and effective diagnostic examinations and to choosing the optimal antimicrobial regimen. Four case studies that demonstrate the importance of identifying the causative agents and the source of infection are discussed to illustrate the central importance of microbiological findings in the diagnosis of bacteremia and bloodstream infections associated with infections at other sites.
abstract
http://cid.oxfordjournals.org/content/48/Supplement_4/S238.long
http://cid.oxfordjournals.org/content/48/Supplement_4/S238.full.pdf+html
Streptococcus intermedius causing infective endocarditis and abscesses: a report of three cases and review of the literature.
BMC Infect Dis. 2008 Nov 10 V.8 P.154.
Tran MP, Caldwell-McMillan M, Khalife W, Young VB.
Department of Medicine, Infectious Diseases Division, Michigan State University, East Lansing, Michigan, USA. maryann.tran@hc.msu.edu
Abstract
BACKGROUND:
Streptococcus intermedius is a member of the Streptococcus anginosus group. Clinical disease with S. intermedius is characterized by abscess formation and rarely endocarditis. Identification of Streptococcus intermedius is difficult, leading to the development of molecular methods to more accurately identify and characterize this organism.
CASE PRESENTATION:
Over a period of 6 months we encountered three cases of invasive Streptococcus intermedius infection presenting as hepatic abscesses, brain abscess, and endocarditis. We confirmed our microbiologic diagnosis through 16S sequencing and found a common virulence gene in each case.
CONCLUSION:
Our report illustrates three different clinical manifestations due to Streptococcus intermedius infection that can be encountered in healthy individuals in a community hospital setting. To our knowledge, this is the first case of Streptococcus intermedius endocarditis confirmed by 16S sequencing analysis. The use of molecular methods may allow a better understanding of the epidemiology and pathogenesis of this organism.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600825/pdf/1471-2334-8-154.pdf
Purulent pericarditis caused by the Streptococcus milleri group: a case report and review of the literature.
Intern Med. 2009 V.48 N.12 P1073-8.
Tokuyasu H, Saitoh Y, Harada T, Touge H, Kawasaki Y, Maeda R, Isowa N, Shimizu E.
Division of Respiratory Medicine, Matsue Red Cross Hospital. tokuun3200@yahoo.co.jp
Abstract
A 69-year-old woman with a history of diabetes mellitus presented at our emergency room with chest pain and dyspnea. A chest computed tomography revealed a pericardial effusion. Pericardiocentesis was performed; strains of the Streptococcus milleri group were detected on culture of the fluid thus obtained. Therefore, purulent pericarditis was diagnosed. Despite treatment with panipenem/betamipron, the pericarditis worsened leading to the development of cardiac tamponade. Emergency pericardial drainage was performed, after which the condition resolved without any complications. We report an extremely rare case of purulent pericarditis caused by a strain of the Streptococcus milleri group. In addition, we review 5 previously reported cases of purulent pericarditis caused by strains.
abstract
http://www.jstage.jst.go.jp/article/internalmedicine/48/12/48_1073/_article
http://www.jstage.jst.go.jp/article/internalmedicine/48/12/1073/_pdf
