Archive for July, 2011

Frequency of Panton-Valentine Leukocidin-Producing Methicillin-Sensitive Staphylococcus Strains in Patients with Complicated Skin and Soft Tissue Infection in Bronx, New York

J Clin Microbiol 1 Aug 2011 V.49 N.8 P.2992-2995


Anna Kaltsas1,, Alice Guh1,, José R. Mediavilla2, Avanish K. Varshney3,4, Natalie Robiou5, Philip Gialanellia1,6, Michael Henry7, Michael H. Levi1,6 and Bettina C. Fries1,3,4*

Infectious Disease Division, Montefiore Medical Center, Bronx, New York,1

Public Health Research Institute, University of Medicine and Dentistry of New Jersey, International Center for Public Health, Newark, New Jersey,2

Departments of Medicine,3

Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York,4

Fordham University, Bronx, New York,5

Department of Clinical Microbiology, Montefiore Medical Center, Bronx, New York,6

Infectious Disease Division, Bronx Lebanon Hospital, Bronx, New York7

lukF-PV was present in 36% of skin and soft tissue infection (SSTI)-derived methicillin-susceptible Staphylococcus aureus (MSSA) strains and comprised six distinct clones, which contained fewer enterotoxin genes than strains without lukF-PV. Clinical presentations and outcomes of lukF-PV+ methicillin-resistant S. aureus (MRSA) and MSSA SSTIs were comparable. In multivariable analysis, the presence of lukF-PV remained a significant predictor for incision and drainage among MSSA strains.


July 30, 2011 at 5:29 pm Leave a comment

Emerging Severe and Fatal Infections Due to Klebsiella pneumoniae in Two University Hospitals in France

J Clin Microbiol 1 Aug 2011 V.49 N.8 P.3012-3014


Dominique Decré1*, Charlotte Verdet2, Aurélie Emirian1, Thibault Le Gourrierec3, Jean-Claude Petit1, Georges Offenstadt4, Eric Maury4, Sylvain Brisse5 and Guillaume Arlet2

Laboratoire de Microbiologie, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France,1

Laboratoire de Bactériologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France,2

Service d’Accueil des Urgences, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France,3

Service de Réanimation Médicale, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France,4

Institut Pasteur, Genotypage des Pathogènes et Santé Publique, Paris, France5

Severe infections caused by hypermucoviscous Klebsiella pneumoniae have been reported in Southeast Asian countries over the past several decades. This report shows their emergence inFrance, with 12 cases observed during a 2-year period in two university hospitals. Two clones (sequence type 86 [ST86] and ST380) of serotypeK2caused five rapidly fatal bacteremia cases, three of which were associated with pneumonia, whereas seven liver abscess cases were caused by K1 strains of ST23.


July 30, 2011 at 5:27 pm Leave a comment

Clinical and Microbiological Characteristics of Community-Acquired Staphylococcus lugdunensis Infections in Southern Taiwan

J Clin Microbiol 1 Aug 2011 V.49 N.8 P.3015-3018


An-Bang Wu1,, Ming-Cheng Wang1,2,, Chin-Chung Tseng1, Wei-Hung Lin3, Ching-Hao Teng4, Ay-Huey Huang5, Kuei-Hsiang Hung6, Chuan Chiang-Ni6 and Jiunn-Jong Wu6,7*

Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan,1

Institute of Clinical Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan,2

Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan,3

Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan,4

Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan,5

Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan,6

Infectious Disease and Signaling Research Center, National Cheng Kung University, Tainan, Taiwan7

Most Staphylococcus lugdunensis strains (49/59, 83%) were related to clinical infections, were susceptible to most antimicrobial agents with an overall oxacillin-resistant rate of 5% (3/58), and carried relatively great genetic diversity. Community-acquired infections (41/49, 84%) were dominant, often developed in patients with comorbidity, and had rather benign clinical courses without mortality.


July 30, 2011 at 5:25 pm Leave a comment

Aging and HIV infection.

Ageing Res Rev. 2011 Jan V.10 N.1 P.163-72..

Avelino-Silva VI, Ho YL, Avelino-Silva TJ, Santos Sde S.

Infectious and Parasitic Diseases Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo – Avenida Dr. Eneas de Carvalho Aguiar 255, 4° Andar do Instituto Central, Sala 4028 – 05403-000-Sao Paulo, SP, Brazil.



Population aging has become a global phenomenon, and HIV infection among older individuals is also increasing. Because age can affect the progression of HIV infection, we aimed to evaluate the present knowledge on HIV infection in older patients.


Literature review of the last 20 years.


Older HIV-infected patients have lower CD4(+) T cell counts, higher viral load and are more frequently symptomatic at diagnosis. The infection progresses more rapidly, with higher morbidity and lethality rates. However, older patients are more compliant to antiretroviral treatment; they experience a better virologic response, and treatment represents a positive clinical impact. Aging affects the complex interaction between HIV infection and the immune system. Both conditions contribute to the dysfunction of immune cells, including a decrease in the phagocytes’ microbicidal capability, natural killer cells’ cytolytic function, expression of toll-like receptors and production of interleukin-12. Chronic immune activation responsible for the depletion of CD4(+) and CD8(+) T cells in HIV infection appears to worsen with senescence. Older patients also exhibit a less robust humoral response, with the production of less avid and specific antibodies.


Both HIV and aging contribute to immune dysfunction, morbidity and mortality. However, highly active antiretroviral therapy (HAART) is beneficial for older patients, and treatment of older patients should not be discouraged.



July 23, 2011 at 6:29 pm Leave a comment

Growing Old with HIV

Curr Infect Dis Rep. 2011 Feb;13(1):75-82.

Patel D, Crane LR.

Department of Medicine, Division of Infectious Diseases, Wayne State University School of Medicine, c/o Harper University Hospital, 3990 John R Street, Room 5929 Hudson, Detroit, MI, 48201, USA,


The intersection of chronic HIV infection, its treatment, and lifestyle with aging has become a topic of considerable fascination during this, the third decade of the AIDS epidemic. An understanding of the pathophysiology of this intersection may provide valuable insights into our general understanding of human aging. This review summarizes the results of recent publications that may have considerable impact on screening and management strategies in the aging HIV-infected population.


July 23, 2011 at 6:25 pm Leave a comment

HIV infection, inflammation, immunosenescence, and aging.

Annu Rev Med. 2011 Feb 18;62:141-55.

Deeks SG.

Department of Medicine, San Francisco General Hospital, University of California San Francisco, CA, USA.


Although antiretroviral therapy for HIV infection prevents AIDS-related complications and prolongs life, it does not fully restore health. Long-term treated patients remain at higher than expected risk for a number of complications typically associated with aging, including cardiovascular disease, cancer, osteoporosis, and other end-organ diseases. The potential effect of HIV on health is perhaps most clearly exhibited by a number of immunologic abnormalities that persist despite effective suppression of HIV replication. These changes are consistent with some of the changes to the adaptive immune system that are seen in the very old (“immunosenescence”) and that are likely related in part to persistent inflammation. HIV-associated inflammation and immunosenescence have been implicated as causally related to the premature onset of other end-organ diseases. Novel therapeutic strategies aimed at preventing or reversing these immunologic defects may be necessary if HIV-infected patients are to achieve normal life span.




July 23, 2011 at 6:22 pm Leave a comment

Febrile Urinary Tract Infections in Children

N Engl J of Med  July 21, 2011 V.365 P.239-250


Medical Progress

Giovanni Montini, M.D., Kjell Tullus, M.D., Ph.D., and Ian Hewitt, M.B., B.S.

Acute pyelonephritis is the most common serious bacterial infection in childhood; many affected children, particularly infants, have severe symptoms. Most cases are readily treated, provided diagnosis is prompt, though in some children fever may take several days to abate.

Approximately 7 to 8% of girls and 2% of boys have a urinary tract infection during the first 8 years of life. Febrile urinary tract infections have the highest incidence during the first year of life in both sexes, whereas nonfebrile urinary tract infections occur predominantly in girls older than 3 years. After infancy, urinary tract infections confined to the bladder are generally accompanied by localized symptoms and are easily treated. In contrast, the presence of fever increases the probability of kidney involvement (sensitivity, 53 to 84%; specificity, 44 to 92%) and is associated with an increased likelihood of underlying nephrourologic abnormalities and a greater risk of consequent renal scarring….



July 21, 2011 at 5:07 pm Leave a comment

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