Archive for June 12, 2012

Achieving a cure for HIV infection: do we have reasons to be optimistic?

Journal of Antimicrobial Chemotherapy   May 2012 V.67  N.5  P.1063-1074

Valentin Le Douce1, Andrea Janossy1, Houda Hallay1, Sultan Ali1, Raphael Riclet1, Olivier Rohr1,2,3,† and Christian Schwartz1,2,*,†

1University of Strasbourg, EA4438, Institute of Parasitology, Strasbourg, France

2IUT de Schiltigheim, 1 Allée d’Athènes, 67300 Schiltigheim, France

3Institut Universitaire de France, 103 Bd Saint Michel, Paris, France

The introduction of highly active antiretroviral therapy (HAART) in 1996 has transformed a lethal disease to a chronic pathology with a dramatic decrease in mortality and morbidity of AIDS-related symptoms in infected patients. However, HAART has not allowed the cure of HIV infection, the main obstacle to HIV eradication being the existence of quiescent reservoirs. Several other problems have been encountered with HAART (such as side effects, adherence to medication, emergence of resistance and cost of treatment), and these motivate the search for new ways to treat these patients. Recent advances hold promise for the ultimate cure of HIV infection, which is the topic of this review. Besides these new strategies aiming to eliminate the virus, efforts must be made to improve current HAART. We believe that the cure of HIV infection will not be attained in the short term and that a strategy based on purging the reservoirs has to be associated with an aggressive HAART strategy.

PDF

http://jac.oxfordjournals.org/content/67/5/1063.full.pdf+html

June 12, 2012 at 10:03 pm

Specific IgA antibodies in the diagnosis of acute brucellosis.

J Infect Dev Ctries. 2012 Feb 13  V.6 N.2 P.192-200.

El-Mohammady H, Shaheen HI, Klena JD, Nakhla I, Weiner MA, Armstrong AW.

US Naval Medical Research Unit No. 3, Cairo, Egypt. hanan.elmohammady.eg@med.navy.mil

Abstract

An Egyptian female with night sweats, headache, and back pain was diagnosed with acute brucellosis one week after returning from a North African country. Humoral immune responses to specific immunogenic proteins were investigated before and after treatment. ELISA was performed to detect levels of specific antibody (Ab) titers. Immunoblot analysis of Ab recognizing specific Brucella antigenic bands was also performed. IgA was detected on the day of disease onset. Specific agglutination titer was 1:160; it doubled three days later and treatment was implemented. Blood culture yielded Gram-negative coccobacilli after one month, confirmed as B. melitensis by AMOS-PCR. Immunoblotting revealed IgM Abs against two protein bands of 112 and 130-kDa observed only during the acute stage. On the other hand, the intensity of IgG Abs against 21 and 21.5-kDa protein bands positively correlated with the time of convalescence. Based on our observations we conclude that specific IgA levels may be used as an early diagnostic marker for Brucella and high molecular weight protein bands may be useful in the differentiation between acute and chronic brucellosis.

PDF

http://www.jidc.org/index.php/journal/article/view/22337851/686

 

June 12, 2012 at 10:01 pm

Seroprevalence study of human brucellosis by conventional tests and indigenous indirect enzyme-linked immunosorbent assay.

ScientificWorld Journal.  Apr 1. 2012

Agasthya AS, Isloor S, Krishnamsetty P.

Department of Biotechnology, Lovely professional University, Punjab 144402, India.

Abstract

Brucellosis is one of the most important reemerging zoonoses in many countries. Brucellosis is caused by Gram-negative coccobacillus belonging to genus Brucella. Human brucellosis often makes the diagnosis difficult. The symptoms and clinical signs most commonly reported are fever, fatigue, malaise, chills, sweats headaches, myalgia, arthralgia, and weight loss. Some cases have been presented with only joint pain, lower backache, and involuntary limb movement, burning feet, or ischemic heart attacks. The focus of this work was to develop a highly sensitive and specific indirect ELISA by using smooth lipopolysaccharide antigen of Brucella abortus 99 to detect anti-Brucella antibodies at Project Directorate on Animal Disease Monitoring and Surveillance. Serum samples collected from 652 individuals in whom fever was not the major symptom but the complaint was of joint pain, headache, lower backache, and so forth, were screened by Rose Bengal plate agglutination test (RBPT) and standard tube agglutination test (STAT). Subsequent testing of sera by indigenous indirect ELISA detected 20 samples positive (3.6% seroprevalence), and indirect ELISA was found to be more sensitive than RBPT and STAT. The seroprevalence in South Karnataka was 2.14%, and inNorth Karnatakait was 0.92%.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329924/pdf/TSWJ2012-104239.pdf

June 12, 2012 at 9:59 pm

Back pain secondary to Brucella spondylitis in the lumbar region.

Ann Rehabil Med. 2012 Apr  V.36 N.2 P.282-6.

Lim KB, Kwak YG, Kim DY, Kim YS, Kim JA.

Department of Rehabilitation Medicine, Inje University College of Medicine, Ilsanpaik Hospital, Goyang 411-706, Korea.

Abstract

Brucellosis is a systemic, infectious disease caused by the bacterial genus Brucella and a common zoonosis that still remains a major health problem in certain parts of the world such as the Mediterranean region, the Middle East, andLatin America. It may involve multiple organs and tissues. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylitis is often difficult since the clinical presentation may be obscured by many other conditions. There are only a few reports on brucellar spondylitis inKorea. Here, we report a case of spondylitis due to brucella in an elderly male.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358688/pdf/arm-36-282.pdf

June 12, 2012 at 9:57 pm

Good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults in the UK: a consensus statement

Journal of Antimicrobial Chemotherapy   May 2012 V.67  N.5  P.1053-1062

Ann L. N. Chapman1,*, R. Andrew Seaton2, Mike A. Cooper3, Sara Hedderwick4, Vicky Goodall1, Corienne Reed5, Frances Sanderson6 and Dilip Nathwani7 on behalf of the BSAC/BIA OPAT Project Good Practice Recommendations Working Group†

1Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield S10 2JF, UK

2Brownlee Centre, Gartnavel General Hospital, Glasgow G12 0YN, UK

3Department of Microbiology, New Cross Hospital, Wolverhampton WV10 0QP, UK

4Royal Victoria Hospital, Belfast BT12 6BA, UK

5Salford Royal Foundation Trust, Salford M6 8HD, UK

6Clinical Infectious Diseases, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK

7Ninewells Hospital & Medical School, Dundee DD1 9SY, UK

These good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) are an update to a previous consensus statement on OPAT in theUKpublished in 1998. They are based on previous national and international guidelines, but have been further developed through an extensive consultation process, and are underpinned by evidence from published literature on OPAT. They provide pragmatic guidance on the development and delivery of OPAT services, looking at all aspects of service design, care delivery, outcome monitoring and quality assurance, with the aim of ensuring that OPAT services provide high-quality, low-risk care, whatever the healthcare setting. They will provide a useful resource for teams developing new services, as well as a practical set of quality indicators for existing services.

PDF

http://jac.oxfordjournals.org/content/67/5/1053.full.pdf+html

June 12, 2012 at 2:47 pm

The 2011 Garrod Lecture: From penicillin-binding proteins to molecular epidemiology

Journal of Antimicrobial Chemotherapy   July 2012 V.67  N.7  P.1578-1588

Brian G. Spratt*

Department of Infectious Disease Epidemiology, Imperial College London, St Mary’s Hospital Campus, Norfolk Place, London W2 1PG, UK

In this review, based on my Garrod Lecture to the British Society for Antimicrobial Chemotherapy, I have given a brief outline of my career over the past 40 years, starting with research in the 1970s into the properties and functions of penicillin-binding proteins (PBPs), leading to the identification of the high molecular mass PBPs as the physiological targets of penicillin, and subsequent studies showing the emergence of low-affinity PBPs in penicillin-resistant clinical isolates by inter-species recombination and the generation of mosaic PBP genes. The studies of clinical isolates of gonococci, meningococci and pneumococci with PBP-mediated resistance to penicillin led to new interests in molecular epidemiology and the population and evolutionary biology of bacterial pathogens. The development (with colleagues) of multilocus sequence typing provided a method for the unambiguous characterization of bacterial strains that has proved to be very widely used, but the recent remarkable (and ongoing) developments in DNA sequencing technologies have provided the prospect of being able routinely to use whole genome sequences to characterize pathogen isolates. These developments will soon have major implications for diagnostic microbiology, outbreak investigations and our ability to follow the spread of strains of community-acquired and nosocomial pathogens at local, national and international levels. However, there are major barriers to be overcome, particularly with respect to how the avalanche of genome sequence data will be stored so that its transformative potential for molecular epidemiology and international public health are fully realized.

PDF

http://jac.oxfordjournals.org/content/67/7/1578.full.pdf+html

 

June 12, 2012 at 2:44 pm


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