Archive for June, 2009

Acute Pericarditis

N Engl J of Medicine November 18, 2004  V.351  N.21  p.2195-2202

Clinical Practice

Richard A. Lange, M.D., and L. David Hillis, M.D.

Full Text

http://content.nejm.org/cgi/content/full/351/21/2195

PDF

http://content.nejm.org/cgi/reprint/351/21/2195.pdf

CORRECTION

Full Text

http://content.nejm.org/cgi/content/full/352/11/1163-a

PDF

http://content.nejm.org/cgi/reprint/352/11/1163-a.pdf

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June 24, 2009 at 11:48 am Leave a comment

Recomendaciones y Guías de la Sociedad Argentina de Infectología – SADI –

Actualización: 18/06/2009

Temas:

Guía para la Profilaxis Antibiótica Prequirúrgica

Guía intersociedades de Neumonía Adquirida en la Comunidad

Neumonía Nosocomial: Guía Clínica aplicable a Latinoamérica preparada en común por diferentes especialistas (2005)

Actualización Recomendaciones de Diagnóstico y Tratamiento de OI

Guía de Endocarditis Infecciosa (Intersociedades)

Autores

Editorial I

Editorial II

Diagnóstico y Evaluación

Tratamiento I

Tratamiento II

Tratamiento III

Profilaxis

Información para el paciente

CONSENSO ARGENTINO HIV – HCV 2005 (Intersociedades)

Recomendaciones en Tratamiento Antirretroviral y Profilaxis EO 2006  (anexo)

Primer Consenso Argentino de Terapia Antirretroviral 2006 (anexo)

Recomendaciones para el Diagnóstico y Tratamiento de Infecciones Urinarias

Consenso Diagnóstico y Tratamiento en Toxoplasmosis Congénita

Normas del Programa Nacional de Garantía de Calidad

Recomendaciones en Vacunación (parte I)

Manual de Diagnóstico y Tratamiento de la Enfermedad de Chagas-Mazza

Recomendaciones en el manejo de infecciones en pacientes con Cancer-Parte I-

Recomendaciones en el manejo de infecciones en pacientes con Cancer -Parte II-

Evaluación Infectológica para Donantes de Organo Sólido

Recomendaciones de Tratamiento Antirretroviral -2007

Recomendaciones en Tratamiento Antirretroviral y Profilaxis EO 2008

Actualizaciones en Vacunas (NUEVO!)

Consenso SADI – INE – SATI: Guía para el manejo racional de la antibióticoterapia en la Unidad de Terapia Intensiva (2008) Parte I  Parte II ( NUEVO!)

Historial

Guía para el Manejo de la Faringitis Aguda

Guía para el manejo de la exposición a Antrax

Recomendaciones sobre Tratamiento Antirretroviral (2003)

 

link

http://www.sadi.org.ar/mod-htmlpages-display-pid-11.html

 

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June 22, 2009 at 12:49 pm Leave a comment

Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990–2007

Clinical Infectious Diseases  July 1, 2009  V.49  N.1  p.85–92

Tami H. Skoff,1 Monica M. Farley,2,3 Susan Petit,4 Allen S. Craig,5 William Schaffner,6 Ken Gershman,7 Lee H. Harrison,8 Ruth Lynfield,9 Janet Mohle-Boetani,10 Shelley Zansky,11 Bernadette A. Albanese,12 Karen Stefonek,13 Elizabeth R. Zell,1 Delois Jackson,1 Terry Thompson,1 and

Stephanie J. Schrag1

1Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 2Emory University School of Medicine and 3Atlanta Veterans Affairs Medical Center, Atlanta, Georgia; 4Connecticut Department of Public Health, Hartford; 5Tennessee Department of Health and 6Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; 7Colorado Department of Public Health and Environment, Denver; 8Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 9Minnesota Department of Health, St. Paul; 10California Department of Health Services, Berkeley; 11New York State Department of Health, Albany; 12New Mexico Department of Health, Santa Fe; and 13Oregon Department of Human Services, Portland

Background. Group B Streptococcus (GBS), traditionally considered to be a neonatal pathogen, is an important cause of morbidity and mortality among older adults and among those with underlying medical conditions. We used population-based surveillance to examine trends in adult GBS disease during the period 1990–2007 and to describe the epidemiology of adult GBS disease to guide prevention efforts.

Methods. Active Bacterial Core surveillance was conducted in selected counties in 10 US states. A case was defined as isolation of GBS from a normally sterile site in a nonpregnant resident of a surveillance area who was 18 years of age. Rates were calculated using US Census data. Demographic and clinical information was abstracted from medical records. Serotyping and susceptibility testing were performed on isolates collected from a subset of case patients.

Results. A total of 19,512 GBS cases were identified in nonpregnant adults during 1990–2007 (median patient age, 63 years); the incidence of adult GBS disease doubled from 3.6 cases per 100,000 persons during 1990 to 7.3 cases per 100,000 persons during 2007 ( ). The mean difference in incidence between black and white persons was 4.6 cases per 100,000 persons (range, 3.1 cases per 100,000 persons during 1991 to 5.8 cases per 100,000 persons during 1999). Common clinical syndromes in 2007 included bacteremia without focus (39.3%), skin and/or soft-tissue infection (25.6%), and pneumonia (12.6%). Most (88.0%) GBS cases in adults had 1 underlying condition; diabetes was present in 44.4% of cases. Serotypes V, Ia, II, and III accounted for 80.8% of infections during 1998–1999 and 78.5% of infections during 2005–2006.

Conclusions. Invasive GBS disease in nonpregnant adults represents a substantial and increasing burden, particularly among older persons, black persons, and adults with diabetes. Prevention strategies are needed.

abstract

http://www.journals.uchicago.edu/doi/abs/10.1086/599369

June 21, 2009 at 8:26 pm Leave a comment

Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America

Clinical Infectious Diseases  July 1, 2009  V.49  N.1  p.1–45

IDSA GUIDELINES

Leonard A. Mermel,1 Michael Allon,2 Emilio Bouza,9 Donald E. Craven,3 Patricia Flynn,4 Naomi P. O’Grady,5 Issam I. Raad,6 Bart J. A. Rijnders,10 Robert J. Sherertz,7 and David K. Warren8

1Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island; 2University of Alabama-Birmingham Hospital, Birmingham, Alabama; 3Tufts University School of Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts; 4St. Jude Children’s Research Hospital, Children’s Infection Defense Center, Memphis, Tennessee; 5National Institutes of Health, Critical Care Medicine Department, Bethesda, Maryland; 6Section of Infectious Diseases, University of Texas-Cancer Center, Houston; 7Section of Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina; 8Division of Infectious Diseases, Washington University School of Medicine, St Louis, Missouri; 9Servicio de Microbiología Cliínica y E. Infecciosas Hospital General “Gregorio Marañón,” Madrid, Spain; and 10Internal Medicine and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands

These updated guidelines replace the previous management guidelines published in 2001. The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them.

abstract

http://www.journals.uchicago.edu/doi/abs/10.1086/599376

PDF

http://www.journals.uchicago.edu/doi/pdf/10.1086/599376

June 21, 2009 at 8:24 pm Leave a comment

Methicillin-Resistant Staphylococcus aureus Colonization, Behavioral Risk Factors, and Skin and Soft-Tissue Infection at an Ambulatory Clinic Serving a Large Population of HIV-Infected Men Who Have Sex with Men

Clinical Infectious Diseases  July 1, 2009  V.49  N.1  p.118–121

BRIEF REPORT

John D. Szumowski,1 Kenneth M. Wener,3 Howard S. Gold,1 Michael Wong,1 Lata Venkataraman,1

Carrie A. Runde,4 Daniel E. Cohen,5 Kenneth H. Mayer,2,6,7 and Sharon B. Wright1

1Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, and 2Fenway Community Health, Boston, and 3Department of Infectious Diseases, Division of Medicine, Lahey Clinic, Burlington, Massachusetts; 4Bastyr University, Seattle, Washington; 5Abbott Laboratories, Abbott Park, Illinois and Departments of 6Medicine and 7Community Health, Brown University School of Medicine, Providence, Rhode Island

We conducted a prospective cohort study of 795 outpatients, many of whom were human immunodeficiency virus–infected men who have sex with men, to characterize risk of skin and soft-tissue infection (SSTI) associated with methicillin-resistant Staphylococcus aureus (MRSA) nares and perianal colonization. Multivariate analysis revealed that perianal colonization, drug use, and prior SSTIs were strongly associated with development of an SSTI. Of the patients who were colonized with MRSA at study entry, 36.7% developed an SSTI during the ensuing 12 months, compared with 8.1% of persons who were not colonized with MRSA.

abstract

http://www.journals.uchicago.edu/doi/abs/10.1086/599608

June 21, 2009 at 8:22 pm Leave a comment

Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990–2007

Clinical Infectious Diseases  July 1, 2009  V.49  N.1  p.85–92

Tami H. Skoff,1 Monica M. Farley,2,3 Susan Petit,4 Allen S. Craig,5 William Schaffner,6 Ken Gershman,7 Lee H. Harrison,8 Ruth Lynfield,9 Janet Mohle-Boetani,10 Shelley Zansky,11 Bernadette A. Albanese,12 Karen Stefonek,13 Elizabeth R. Zell,1 Delois Jackson,1 Terry Thompson,1 and

Stephanie J. Schrag1

1Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 2Emory University School of Medicine and 3Atlanta Veterans Affairs Medical Center, Atlanta, Georgia; 4Connecticut Department of Public Health, Hartford; 5Tennessee Department of Health and 6Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; 7Colorado Department of Public Health and Environment, Denver; 8Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 9Minnesota Department of Health, St. Paul; 10California Department of Health Services, Berkeley; 11New York State Department of Health, Albany; 12New Mexico Department of Health, Santa Fe; and 13Oregon Department of Human Services, Portland

Background. Group B Streptococcus (GBS), traditionally considered to be a neonatal pathogen, is an important cause of morbidity and mortality among older adults and among those with underlying medical conditions. We used population-based surveillance to examine trends in adult GBS disease during the period 1990–2007 and to describe the epidemiology of adult GBS disease to guide prevention efforts.

Methods. Active Bacterial Core surveillance was conducted in selected counties in 10 US states. A case was defined as isolation of GBS from a normally sterile site in a nonpregnant resident of a surveillance area who was 18 years of age. Rates were calculated using US Census data. Demographic and clinical information was abstracted from medical records. Serotyping and susceptibility testing were performed on isolates collected from a subset of case patients.

Results. A total of 19,512 GBS cases were identified in nonpregnant adults during 1990–2007 (median patient age, 63 years); the incidence of adult GBS disease doubled from 3.6 cases per 100,000 persons during 1990 to 7.3 cases per 100,000 persons during 2007 ( ). The mean difference in incidence between black and white persons was 4.6 cases per 100,000 persons (range, 3.1 cases per 100,000 persons during 1991 to 5.8 cases per 100,000 persons during 1999). Common clinical syndromes in 2007 included bacteremia without focus (39.3%), skin and/or soft-tissue infection (25.6%), and pneumonia (12.6%). Most (88.0%) GBS cases in adults had 1 underlying condition; diabetes was present in 44.4% of cases. Serotypes V, Ia, II, and III accounted for 80.8% of infections during 1998–1999 and 78.5% of infections during 2005–2006.

Conclusions. Invasive GBS disease in nonpregnant adults represents a substantial and increasing burden, particularly among older persons, black persons, and adults with diabetes. Prevention strategies are needed.

abstract

http://www.journals.uchicago.edu/doi/abs/10.1086/599369

June 21, 2009 at 8:18 pm Leave a comment

Seven-Year Surveillance of North American Pediatric Group A Streptococcal Pharyngitis Isolates

Clinical Infectious Diseases  July 1, 2009  V.49  N.1  p.78–84

Stanford T. Shulman,1,3 Robert R Tanz,2,3 James B. Dale,4,5 Bernard Beall,6 William Kabat,1

Kathleen Kabat,1 Emily Cederlund,1 Devendra Patel,1 Jason Rippe,1 Zhongya Li,6 Varja Sakota,6 and the North American Streptococcal Pharyngitis Surveillance Groupa

Divisions of 1Infectious Diseases and 2General Academic Pediatrics, Children’s Memorial Hospital, and 3Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Departments of 4Medicine and 5Molecular Sciences, University of Tennessee Health Science Center and VA Medical Center, Memphis; and 6Centers for Disease Control and Prevention, Respiratory Diseases Branch, Atlanta, Georgia

Background. Pharyngeal group A streptococcal (GAS) emm type surveillance enhances understanding of the epidemiology of pharyngitis and invasive GAS disease and formulation of multivalent type-specific vaccines. In addition, such surveillance provides pre-GAS vaccine baseline data. We assessed geographic and temporal trends in GAS emm-type distribution among pediatric pharyngeal isolates collected systematically in the United States and Canada from 2000 to 2007.

Methods. We collected 100 acute GAS pharyngitis isolates from each of 13 widely scattered sites (10 in the United States and 3 in Canada) annually for 7 seasons (2000–2007) from 3- to 18-year-old children. We assessed emm type and subtype by DNA sequencing and analyzed temporal and geographic trends.

Results. A total of 7040 US and 1434 Canadian GAS isolates were studied. The 6 most prevalent emm types (in descending order) were 1, 12, 28, 4, 3, and 2 in the United States and 12, 1, 28, 4, 3, 2, and 77 in Canada, constituting 70%–71% of isolates in each country; 10 emm types constituted 87%–89% total. Fifty-six emm types were identified in the United States, including 8 new types, and 33 types in Canada. Although a few types predominated nationally, marked variability among individual sites and at individual sites from year to year was observed. US-Canadian differences in type distribution were apparent. Twenty percent of isolates represented emm subtypes that differed slightly from reference types; 110 new subtypes were identified. An experimental 26-valent M protein vaccine covers 85% of pharyngitis isolates.

Conclusions. Although overall US and Canadian emm type distribution was consistent and relatively few types dominated nationally, striking intersite and temporal variations within individual sites in prevalent emm types of GAS occurred. These results have important implications for the development and formulation of type-specific GAS vaccines.

abstract

http://www.journals.uchicago.edu/doi/abs/10.1086/599344

June 21, 2009 at 8:15 pm Leave a comment

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