Archive for August 9, 2009

Ántrax ó Carbunco

Revista Chilena de Infectología  2001


Prepararon este documento: Cecilia Perret P.1, Leonardo Maggi C., Carlos Pavletic B., Rodrigo Vergara F., Katia Abarca V., Jeannette Dabanch P., Cecilia González C., Roberto Olivares C.,Jaime Rodríguez T.

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August 9, 2009 at 6:48 pm Leave a comment

Infection with Panton-Valentine Leukocidin–Positive Methicillin-Resistant Staphylococcus aureus t034

Emerging Infectious Diseases Journal August 2008  V.14  N.8

Christina Welinder-Olsson,*  Kerstin Florén-Johansson,* Leif Larsson,* Sven Öberg,† Lisbeth Karlsson,‡ and Christina Åhrén*

*Sahlgrenska University Hospital, Göteborg, Sweden; †Uddevalla Hospital, Uddevalla, Sweden; and ‡Borås Hospital, Borås, Sweden


Panton-Valentine leukocidin (PVL)–positive methicillin-resistant Staphylococcus aureus (MRSA), sequence type 398 is believed to be of animal origin. We report 2 cases of infection due to PVL–positive MRSA, spa type t034, in patients in Sweden who had had no animal contact.

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August 9, 2009 at 6:47 pm Leave a comment

Increased Amoxicillin–Clavulanic Acid Resistance in Escherichia coli Blood Isolates, Spain

Emerging Infectious Diseases Journal August 2008  V.14  N.8

Jesús Oteo,* José Campos,*†  Edurne Lázaro,‡ Óscar Cuevas,* Silvia García-Cobos,* María Pérez-Vázquez,* F.J. de Abajo,‡ and Spanish Members of EARSS1

*Instituto de Salud Carlos III, Madrid, Spain; †Consejo Superior de Investigaciones Científicas, Madrid; and ‡Agencia Española del Medicamento y Productus Sanitarios, Madrid


To determine the evolution and trends of amoxicillin–clavulanic acid resistance among Escherichia coli isolates in Spain, we tested 9,090 blood isolates from 42 Spanish hospitals and compared resistance with trends in outpatient consumption. These isolates were collected by Spanish hospitals that participated in the European Antimicrobial Resistance Surveillance System network from April 2003 through December 2006.

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August 9, 2009 at 6:45 pm Leave a comment

Plasmodium ovale: Parasite and Disease

Clinical Microbiology Reviews  1 July 2005  V.18  N.3  p.570-581

William E. Collins1* and Geoffrey M. Jeffery2

Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Parasitic Diseases, Malaria Branch, Chamblee, Georgia 30341,1 U.S. Public Health Service, Atlanta, Georgia2

Humans are infected by four recognized species of malaria parasites. The last of these to be recognized and described is Plasmodium ovale. Like the other malaria parasites of primates, this parasite is only transmitted via the bites of infected Anopheles mosquitoes. The prepatent period in the human ranges from 12 to 20 days. Some forms in the liver have delayed development, and relapse may occur after periods of up to 4 years after infection. The developmental cycle in the blood lasts approximately 49 h. An examination of records from induced infections indicated that there were an average of 10.3 fever episodes of 101°F and 4.5 fever episodes of 104°F. Mean maximum parasite levels were 6,944/µl for sporozoite-induced infections and 7,310/µl for trophozoite-induced infections. Exoerythrocytic stages have been demonstrated in the liver of humans, chimpanzees, and Saimiri monkeys following injection of sporozoites. Many different Anopheles species have been shown to be susceptible to infection with P. ovale, including A. gambiae, A. atroparvus, A. dirus, A. freeborni, A. albimanus, A. quadrimaculatus, A. stephensi, A. maculatus, A. subpictus, and A. farauti. An enzyme-linked immunosorbent assay has been developed to detect mosquitoes infected with P. ovale using a monoclonal antibody directed against the circumsporozoite protein. Plasmodium ovale is primarily distributed throughout sub-Saharan Africa. It has also been reported from numerous islands in the western Pacific. In more recent years, there have been reports of its distribution on the Asian mainland. Whether or not it will become a major public health problem there remains to be seen. The diagnosis of P. ovale is based primarily on the characteristics of the blood stages and its differentiation from P. vivax. The sometimes elliptical shape of the infected erythrocyte is often diagnostic when combined with other, subtler differences in morphology. The advent of molecular techniques, primarily PCR, has made diagnostic confirmation possible. The development of techniques for the long-term frozen preservation of malaria parasites has allowed the development diagnostic reference standards for P. ovale. Infections in chimpanzees are used to provide reference and diagnostic material for serologic and molecular studies because this parasite has not been shown to develop in other nonhuman primates, nor has it adapted to in vitro culture. There is no evidence to suggest that P. ovale is closely related phylogenetically to any other of the primate malaria parasites that have been examined.



August 9, 2009 at 6:43 pm Leave a comment

Respiratory Syncytial Virus Infection in Adults

Clinical Microbiology Reviews  July 2000  V.13  N.3  p.371-384

Ann R. Falsey* and Edward E. Walsh

Rochester General Hospital and University of Rochester School of Medicine and Dentistry, Rochester, New York

Respiratory syncytial virus (RSV) is now recognized as a significant problem in certain adult populations. These include the elderly, persons with cardiopulmonary diseases, and immunocompromised hosts. Epidemiological evidence indicates that the impact of RSV in older adults may be similar to that of nonpandemic influenza. In addition, RSV has been found to cause 2 to 5% of adult community-acquired pneumonias. Attack rates in nursing homes are approximately 5 to 10% per year, with significant rates of pneumonia (10 to 20%) and death (2 to 5%). Clinical features may be difficult to distinguish from those of influenza but include nasal congestion, cough, wheezing, and low-grade fever. Bone marrow transplant patients prior to marrow engraftment are at highest risk for pneumonia and death. Diagnosis of RSV infection in adults is difficult because viral culture and antigen detection are insensitive, presumably due to low viral titers in nasal secretions, but early bronchoscopy is valuable in immunosuppressed patients. Treatment of RSV in the elderly is largely supportive, whereas early therapy with ribavirin and intravenous gamma globulin is associated with improved survival in immunocompromised persons. An effective RSV vaccine has not yet been developed, and thus prevention of RSV infection is limited to standard infection control practices such as hand washing and the use of gowns and gloves.



August 9, 2009 at 6:41 pm Leave a comment

Enterotoxigenic Escherichia coli in Developing Countries: Epidemiology, Microbiology, Clinical Features, Treatment, and Prevention

Clinical Microbiology Reviews  1 July 2005  V.18  N.3  p.465-483

Firdausi Qadri,1 Ann-Mari Svennerholm,2 A. S. G. Faruque,1 and R. Bradley Sack3*

International Centre for Diarrhoeal Disease Research, Bangladesh, and Centre for Health and Population Research, Mohakhali, Dhaka 1212, Bangladesh,1 Department of Medical Microbiology and Immunology, Göteborg University, 40530 Göteborg, Sweden ,2 Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland3

ETEC is an underrecognized but extremely important cause of diarrhea in the developing world where there is inadequate clean water and poor sanitation. It is the most frequent bacterial cause of diarrhea in children and adults living in these areas and also the most common cause of traveler’s diarrhea. ETEC diarrhea is most frequently seen in children, suggesting that a protective immune response occurs with age. The pathogenesis of ETEC-induced diarrhea is similar to that of cholera and includes the production of enterotoxins and colonization factors. The clinical symptoms of ETEC infection can range from mild diarrhea to a severe cholera-like syndrome. The effective treatment of ETEC diarrhea by rehydration is similar to treatment for cholera, but antibiotics are not used routinely for treatment except in traveler’s diarrhea. The frequency and characterization of ETEC on a worldwide scale are inadequate because of the difficulty in recognizing the organisms; no simple diagnostic tests are presently available. Protection strategies, as for other enteric infections, include improvements in hygiene and development of effective vaccines. Increases in antimicrobial resistance will dictate the drugs used for the treatment of traveler’s diarrhea. Efforts need to be made to improve our understanding of the worldwide importance of ETEC.



August 9, 2009 at 6:39 pm Leave a comment

Diagnostic Accuracy of a Rapid Real-Time Polymerase Chain Reaction Assay for Universal Intrapartum Group B Streptococcus Screening

Clinical Infectious Diseases  Aug.1, 2009  V.49  N.3  p.417–423

Najoua El Helali,1 Jean-Claude Nguyen,1 Aïcha Ly,1 Yves Giovangrandi,2 and Ludovic Trinquart3,4,5

Services de 1Microbiologie and 2Gynécologie-Obstétrique, Groupe Hospitalier Paris Saint-Joseph, 3Université Paris Descartes, 4Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, and 5Centre d’Investigation Épidémiologique 4, INSERM, Paris, France

Background. Intrapartum antibiotic prophylaxis is currently given to mothers who test positive for group B streptococcus (GBS) by antenatal culture-based screening, with a risk-based approach for cases with an unknown GBS status. A rapid real-time polymerase chain reaction (PCR) assay for the detection of GBS became available recently, making intrapartum screening possible. We aimed to assess its diagnostic accuracy and to compare it with antenatal screening.

Methods. We conducted a prospective study in a French hospital. All pregnant women giving birth at the maternity ward were considered for inclusion, except those with planned cesarean delivery, with delivery at <35 weeks gestation, and who received antibiotic therapy before admission. We performed GBS culture (the reference standard) and a molecular GBS test (Xpert GBS; Cepheid) on intrapartum specimens. Decisions about intrapartum antibiotic prophylaxis were based on the current GBS screening by culture at 35–37 weeks gestation.

Results. We prospectively enrolled 968 pregnant women from April 2007 through March 2008. The overall molecular GBS test yield was 89.2%. Among the 863 women with available results, the molecular GBS test had a sensitivity of 98.5%, specificity of 99.6%, positive predictive value of 97.8%, and negative predictive value of 99.7%. The positive predictive value of antenatal culture for identifying colonization status at delivery was low (58.3%), whereas the negative predictive value was imperfect (92.1%).

Conclusions. This real-time PCR assay is a highly accurate test to identify intrapartum GBS carriers at point of care. This new tool could enhance the exact identification of candidates for intrapartum antibiotic prophylaxis, including women with preterm rupture of membranes or preterm labor.


August 9, 2009 at 6:38 pm Leave a comment

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