Archive for September, 2008

Serogroup A Neisseria meningitidis with Reduced Susceptibility to Ciprofloxacin

Emerging Infectious Diseases  October 2008  V.14  N.10

Letter

Jacob Strahilevitz, Amos Adler, Gillian Smollan, Violeta Temper, Nathan Keller, and Colin Block

Hadassah-Hebrew University Medical Center, Jerusalem, Israel (J. Strahilevitz, A. Adler, V. Temper, C. Block); and The Chaim Sheba Medical Center, Tel Hashomer, Israel (G. Smollan, N. Keller)

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September 29, 2008 at 5:47 pm Leave a comment

Confirmed Mycoplasma pneumoniae Endocarditis

Emerging Infectious Diseases  October 2008  V.14  N.10

Letter
Juan Pablo Scapini,  Luis Pedro Flynn, Silvia Sciacaluga, Lorena Morales, and María Estela Cadario

Facultad de Ciencias Médicas Universidad Nacional de Rosario, Santa Fe, Argentina (J.P. Scapini); Sanatorio de Niños Rosario, Santa Fe, (L.P. Flynn; S. Sciacaluga, L. Morales); and Instituto Nacional de Enfermedades Infecciosas ANLIS “Dr Carlos Malbrán,” Buenos Aires, Argentina (M.E. Cadario)

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September 29, 2008 at 5:46 pm Leave a comment

Prophylaxis after Exposure to Coxiella burnetii

Emerging Infectious Diseases  October 2008  V.14  N.10

Claire E. Moodie,  Herbert A. Thompson, Martin I. Meltzer, and David L. Swerdlow

Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Abstract
Coxiella burnetii is a category B bioterrorism agent. We numerically evaluated the risks and benefits from postexposure prophylaxis (PEP) after an intentional release of C. burnetii to the general population, pregnant women, and other high-risk populations. For each group, we constructed a decision tree to estimate illness and deaths averted by use of PEP/100,000 population. We calculated the threshold points at which the number of PEP-related adverse events was equal to the cases averted. PEP was defined as doxycycline (100 mg 2×/day for 5 days), except for pregnant women, where we assumed a PEP of trimethoprim-sulfamethoxazole (160 mg/800 mg 2×/day) for the duration of the pregnancy. PEP would begin 8–12 days postexposure. On the basis of upper-bound probability estimates of PEP-related adverse events for doxycycline, we concluded that the risk for Q fever illness outweighs the risk for antimicrobial drug–related adverse events when the probability of C. burnetii exposure is >7% (pregnant women using trimethoprim-sulfamethoxazole = 16%).

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September 29, 2008 at 5:44 pm Leave a comment

Invasive Group B Streptococcal Infections in Infants, France

Emerging Infectious Diseases  October 2008  V.14  N.10

Claire Poyart,  Hélène Réglier-Poupet, Asmaa Tazi, Annick Billoët, Nicolas Dmytruk, Philippe Bidet, Edouard Bingen, Josette Raymond, and Patrick Trieu-Cuot

Institut National de la Santé et de la Recherche Médicale U567 Unité Mixte de Recherche Centre National de la Recherche Scientifique 810, Paris, France (C. Poyart, H. Réglier-Poupet, A. Tazi); Centre National de Référence des Streptocoque, Paris (C. Poyart, H. Réglier-Poupet, A. Tazi, N. Dmytruk, P. Bidet, E. Bingen, J. Raymond, P. Trieu-Cuot); Groupe Hospitalier Cochin-Saint Vincent de Paul, Paris, (C. Poyart, H. Réglier-Poupet, A. Tazi, A. Billoët, J. Raymond); and Institut Pasteur, Paris (C. Poyart, P. Trieu-Cuot)

Abstract
Clinical features and molecular characterization of 109 group B streptococci causing neonatal invasive infections were determined over an 18-month period in France. Sixty-four percent of the strains were from late-onset infections, and 75% were capsular type III. The hypervirulent clone ST-17 was recovered in 80% of meningitis cases.

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September 28, 2008 at 1:18 pm Leave a comment

Ceftibuten Resistance and Treatment Failure of Neisseria gonorrhoeae Infection

Antimicrobial Agents and Chemotherapy  1 October 2008  V.52  N.10  p.3564-3567

Janice Y. C. Lo,1* K. M. Ho,2 Anna O. C. Leung,1 Felisa S. T. Tiu,1 Grand K. L. Tsang,1 Angus C. T. Lo,1 and John W. Tapsall3

Microbiology Division, Public Health Laboratory Services Branch,1 Social Hygiene Service, Public Health Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region,2 WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia3

Neisseria gonorrhoeae infections have been empirically treated in Hong Kong with a single oral 400-mg dose of ceftibuten since 1997. Following anecdotal reports of the treatment failure of gonorrhea with oral extended-spectrum cephalosporins, the current study was undertaken to determine the antimicrobial susceptibility pattern and molecular characteristics of isolates of N. gonorrhoeae among patients with putative treatment failure in a sexually transmitted disease clinic setting. Between October 2006 and August 2007, 44 isolates of N. gonorrhoeae were studied from patients identified clinically to have treatment failure with empirical ceftibuten. The ceftibuten MICs for three strains were found to have been 8 mg/liter. These strains were determined by N. gonorrhoeae multiantigen sequence typing to belong to sequence type 835 (ST835) or the closely related ST2469. The testing of an additional eight archived ST835 strains revealed similarly elevated ceftibuten MICs. The penA gene sequences of these 11 isolates all had the mosaic pattern previously described as pattern X. Of note is that the ceftriaxone susceptibility results of these strains all fell within the susceptible range. It is concluded that ceftibuten resistance may contribute to the empirical treatment failure of gonorrhea caused by strains harboring the mosaic penA gene, which confers reduced susceptibility to oral extended-spectrum cephalosporins. Screening for such resistance in the routine clinical laboratory may be undertaken by the disk diffusion test. The continued monitoring of antimicrobial resistance and molecular characteristics of N. gonorrhoeae isolates is important to ensure that control and prevention strategies remain effective.

abstract 
http://aac.asm.org/cgi/content/abstract/52/10/3564

September 28, 2008 at 1:16 pm Leave a comment

Rise and Persistence of Global M1T1 Clone of Streptococcus pyogenes

Emerging Infectious Diseases  October 2008  V.14  N.10

Ramy K. Aziz  and Malak Kotb

Cairo University, Cairo, Egypt (R.K. Aziz); VA Medical Center, Memphis, Tennessee, USA (R.K. Aziz, M. Kotb); University of Tennessee Health Science Center, Memphis (M. Kotb); and University of Cincinnati, Cincinnati, Ohio, USA (M. Kotb)

Abstract
The resurgence of severe invasive group A streptococcal infections in the 1980s is a typical example of the reemergence of an infectious disease. We found that this resurgence is a consequence of the diversification of particular strains of the bacteria. Among these strains is a highly virulent subclone of serotype M1T1 that has exhibited unusual epidemiologic features and virulence, unlike all other streptococcal strains. This clonal strain, commonly isolated from both noninvasive and invasive infection cases, is most frequently associated with severe invasive diseases. Because of its unusual prevalence, global spread, and increased virulence, we investigated the unique features that likely confer its unusual properties. In doing so, we found that the increased virulence of this clonal strain can be attributed to its diversification through phage mobilization and its ability to sense and adapt to different host environments; accordingly, the fittest members of this diverse bacterial community are selected to survive and invade host tissue.

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September 28, 2008 at 1:14 pm Leave a comment

Widespread Oseltamivir Resistance in Influenza A Viruses (H1N1), South Africa

Emerging Infectious Diseases  October 2008  V.14  N.10

Besselaar TG, Naidoo D, Buys A, Gregory V, McAnerney J, Manamela JM, et al.

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September 28, 2008 at 1:12 pm Leave a comment

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