Archive for September, 2007

A Systematic Review of Population-Based Studies of Infective Endocarditis*

Chest 2007;Vol.132  N.3  p.1025-1035

Imad M. Tleyjeh, MD, MSc; Ahmed Abdel-Latif, MD; Hazim Rahbi, MBChB; Christopher G. Scott, MSc; Kent R. Bailey, PhD; James M. Steckelberg, MD; Walter R. Wilson, MD and Larry M. Baddour, MD

* From the Divisions of Infectious Diseases (Drs. Tleyjeh, Steckelberg, Wilson, and Baddour) and Biostatistics (Mr. Scott and Dr. Bailey), Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN; Department of Medicine (Dr. Abdel-Latif), Division of Cardiology, University of Louisville, Louisville, KY; and Leicester Medical School (Dr. Rahbi), University of Leicester, Leicester, UK.

Correspondence to: Imad M. Tleyjeh, MD, MSc, Department of Medicine, King Fahd Medical City, Riyadh, Saudi Arabia, Main Hospital, PO Box 59046, Riyadh, 11525, KSA; e-mail: tleyjeh.imad@mayo.edu

abstract
http://www.chestjournal.org/cgi/content/abstract/132/3/1025?etoc

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September 29, 2007 at 12:12 am Leave a comment

Insights into Severe Sepsis in Older Patients: From Epidemiology to Evidence-Based Management

Clinical Infectious Diseases 1 Mar 2005 Vol.40  N.5  p.719-727

Timothy D. Girard,1 Steven M. Opal,3 and E. Wesley Ely1,2

1Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, and 2Veterans Affairs Tennessee Valley Geriatric Research, Education, and Clinical Center, Nashville, Tennessee; and 3Infectious Disease Division, Brown University School of Medicine, Providence, Rhode Island

FREE Full Text  (CLIC en Download PDF)
http://www.journals.uchicago.edu/CID/journal/issues/v40n5/34226/34226.html

September 29, 2007 at 12:11 am Leave a comment

Antimicrobials for right-sided endocarditis in intravenous drug users: a systematic review

Journal of Antimicrobial Chemotherapy  19 Sept 2007  Vol.60  N.3 
 
Systematic review 
  
Derek Yung1, Dan Kottachchi1, Binod Neupane2, Shariq Haider1 and Mark Loeb2,*
 
1 Department of Medicine, McMaster University, Hamilton, Ontario, Canada 2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
 
Background: Right-sided endocarditis (RSE) is a serious complication of intravenous drug use. We sought to systematically review the evidence for obtaining clinical cure with antimicrobials in intravenous drug users (IVDUs) with isolated native valve RSE.
 
Search strategy: We applied broad search strategies in the following databases: MEDLINE (1966–2006), EMBASE (1980–2006) and Cochrane CENTRAL Register (2006, Issue 3). Hand searching was performed on selected peer-reviewed journals and relevant citation lists were screened. No restrictions were set on language and type of publication.
 
Selection criteria: We included randomized controlled trials that evaluated clinical and microbiological cure using single or combination antibiotic regimens for the treatment of isolated native valve bacterial RSE. Clinical and microbiological cure and failure outcomes were evaluated between 2 weeks and 6 months after completion of therapy. Quality assessment of relevant studies was performed using an objective scoring scale.
 
Results: We identified seven randomized controlled trials, one comparing single antimicrobial therapies, four comparing combination with single therapy and two studies comparing combination therapies. Short-course therapy was present in at least one arm in three studies, but only one study compared short- and long-course therapy. No statistically significant benefit was demonstrated between any antimicrobial therapy and all studies were scored as having a moderate to severe risk of bias.
 
Conclusions: Randomized trial evidence does not support one antimicrobial regimen over another in the treatment of RSE in IVDUs.
 
abstract
http://jac.oxfordjournals.org/cgi/content/abstract/dkm324v1
 

September 29, 2007 at 12:09 am Leave a comment

Risk Factors For Hematogenous Complications of Intravascular CatheterAssociated Staphylococcus aureus Bacteremia

Clinical Infectious Diseases 1 Mar 2005 Vol.40  N.5  p.695-703

Vance G. Fowler, Jr.,1,3 Anita Justice,4 Catrin Moore,4 Daniel K. Benjamin, Jr.,2,3 Christopher W. Woods,1 Steven Campbell,1 L. Barth Reller,1 G. Ralph Corey,1 Nicholas P. J. Day,4 and Sharon J. Peacock4

Departments of 1Medicine and 2Pediatrics and 3Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina; and 4Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom

FREE Full Text  (CLIC en Download PDF)
http://www.journals.uchicago.edu/CID/journal/issues/v40n5/34862/34862.html

September 29, 2007 at 12:07 am Leave a comment

Postexposure prophylaxis after sexual exposure to HIV. HIV infection and AIDS.

CURRENT OPINION IN INFECTIOUS DISEASE  Feb 2007  Vol.20  N.1  p.39-46.

Roland, Michelle E

Abstract

Purpose of review: HIV postexposure prophylaxis is often recommended following potential sexual exposure to HIV. Recent data address the effectiveness of postexposure prophylaxis and prevention counseling, cost-effectiveness, antiretroviral options, challenges with nonoccupational postexposure prophylaxis among adolescents and children and following sexual assault in high HIV prevalence areas, and a successful program in Amsterdam.

Recent findings: Postexposure prophylaxis is not completely protective. Seroconversion may result from antiretroviral failure or from ongoing exposures. Postexposure prophylaxis associated risk reduction counseling results in reductions in subsequent risk behavior. Programs that target outreach and limit prescriptions to those with exposure sources who are at risk of being HIV infected are cost-effective. Less restrictive guidelines result in more prescriptions for low-risk exposures; this practice is not cost-effective. The ideal antiretrovirals for postexposure prophylaxis use have not been established. Tenofovir has several attractive properties. Developing systems to support the effective delivery of postexposure prophylaxis among children and adolescents and following sexual assault in high HIV prevalence, resource limited settings is challenging.

Summary: Numerous national and international guidelines recommend postexposure prophylaxis following potential sexual exposure to HIV. Maximizing adherence and minimizing subsequent HIV exposures will be critical to enhancing the effectiveness of this HIV prevention intervention.

abstract
http://www.co-infectiousdiseases.com/pt/re/coinfdis/abstract.00001432-200702000-00008.htm;jsessionid=G5Kd45JQ1JCNLQnyCJJD86JpkRDxYdxhcf2bNwMnn5hx1vPTJ12R!-2030958118!181195628!8091!-1

September 27, 2007 at 3:29 pm Leave a comment

MRSA Infections Rise

JAMA 26 Sept 2007  Vol.298  N.12  p.1389

MRSA Infections Rise

Bridget M. Kuehn

Despite efforts to prevent the spread of antibiotic-resistant bacteria, the number of hospital stays for patients infected with methicillin-resistant Staphylococcus aureus nearly tripled between 2000 and 2005, from 128 500 to 368 800, according to a report from the Agency for Healthcare Research and Quality (AHRQ).

The AHRQ’s report, Infections With Methicillin-Resistant Staphylococcus Aureus (MRSA) in US Hospitals, 1993-2005, draws on a national database of hospital inpatient stays that includes 90% of all hospital discharges in the United States (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb35.pdf).

The number of hospital stays associated with MRSA infections has risen steadily since 1995, when the AHRQ reported 38 100 cases. The report did not distinguish between hospital-acquired and community-acquired MRSA infections, so it is not clear whether the growth in infections suggests a failure of preventive measures at hospitals or growth in community-acquired infections.

NO abstract
http://jama.ama-assn.org/cgi/content/extract/298/12/1389

September 27, 2007 at 3:27 pm Leave a comment

Cytomegalovirus Infection of the Heart Is Common in Patients with Fatal Myocarditis

Clinical Infectious Diseases 1 Mar 2005 Vol.40  N.5  p.683-688

Ville Kytö,1 Tytti Vuorinen,2 Pekka Saukko,3 Irmeli Lautenschlager,4 Eberhard Lignitz,6 Antti Saraste,1 and Liisa-Maria Voipio-Pulkki5

Departments of 1Anatomy, 2Virology, and 3Forensic Medicine, University of Turku, Turku, and 4Department of Virology, University of Helsinki and Helsinki University Central Hospital, and 5Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland; and 6Department of Forensic Medicine, University of Greifswald, Greifswald, Germany

FREE Full Text  (CLIC en Download PDF)
http://www.journals.uchicago.edu/CID/journal/issues/v40n5/34709/34709.html

September 27, 2007 at 3:25 pm Leave a comment

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