Archive for July 27, 2012

Cytomegalovirus infection in non-immunosuppressed critically ill patients.

J Infect Dev Ctries. 2011 Aug 12  V.5 N.8 P.571-9.

Jain M, Duggal S, Chugh TD.

Department of Microbiology, G. B. Pant Hospital, Delhi, India. manisha_jain29@yahoo.com

Abstract

Cytomegalovirus (CMV) is an important and common cause of mortality and morbidity in immunocompromised patients such as those with HIV/AIDS, transplant recipients on immunosuppressive therapy, and malignant hematological disease. After primary infection with CMV the virus becomes latent in multiple organs and can later be reactivated during severe dysregulation of the immune system. A large population carry dormant virus and are thus at risk for reactivation. However, reactivation of CMV has been reported in “non-immunosuppressed patients” such as severe trauma, sepsis, shock, burns, cirrhosis and other critically ill patients lying in the intensive care units. Therefore, the intensivists are increasingly facing a dilemma of identifying such patients to treat and there is a debate if there is a scientific justification for prophylaxis in such immunocompetent patients.

PDF

http://www.jidc.org/index.php/journal/article/view/21841300/587

http://www.jidc.org/index.php/journal/article/view/21841300

July 27, 2012 at 2:37 pm

Macrolide-resistant Bordetella pertussis infection in newborn girl, France.

Emerg Infect Dis. 2012 Jun V.18 N.6  P.966-8.

Guillot S, Descours G, Gillet Y, Etienne J, Floret D, Guiso N.

Institut Pasteur, Paris, France

Abstract

A macrolide antimicrobial drug was administered to a newborn with cough. On day 23 of hospitalization, macrolide-resistant Bordetella pertussis was isolated from nasopharyngeal aspirates. DNA sequencing and PCR-restriction fragment length polymorphism showed a 2047 A-to-G mutation in the 3 copies of the 23S rRNA gene. Monitoring for macrolide resistance is essential in infants <6 months of age.

PDF

http://wwwnc.cdc.gov/eid/article/18/6/pdfs/12-0091.pdf

July 27, 2012 at 2:33 pm

Clinical management of HIV drug resistance.

Viruses. 2011 Apr V.3 N.4 P.347-78.

Cortez KJ, Maldarelli F.

HIV Drug Resistance Program, NCI, NIH, Bethesda, MD 20892, USA. karoll.cortez@fda.hhs.gov

Abstract

Combination antiretroviral therapy for HIV-1 infection has resulted in profound reductions in viremia and is associated with marked improvements in morbidity and mortality. Therapy is not curative, however, and prolonged therapy is complicated by drug toxicity and the emergence of drug resistance. Management of clinical drug resistance requires in depth evaluation, and includes extensive history, physical examination and laboratory studies. Appropriate use of resistance testing provides valuable information useful in constructing regimens for treatment-experienced individuals with viremia during therapy. This review outlines the emergence of drug resistance in vivo, and describes clinical evaluation and therapeutic options of the individual with rebound viremia during therapy.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185705/pdf/viruses-03-00347.pdf

July 27, 2012 at 2:32 pm


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