Archive for March, 2013

Diagnosis and Management of Q Fever — United States, 2013

MMWR Recommendations and Reports March 29, 2013 V.62  N.RR-3  P.1-23

Recommendations from CDC and the Q Fever Working Group 

Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii. Transmission occurs primarily through inhalation of aerosols from contaminated soil or animal waste. No licensed vaccine is available in the United States.

This report provides the first national recommendations issued by CDC for Q fever recognition, clinical and laboratory diagnosis, treatment, management, and reporting for health-care personnel and public health professionals.

The guidelines address treatment of acute and chronic phases of Q fever illness in children, adults, and pregnant women, as well as management of occupational exposures.

PDF

http://www.cdc.gov/mmwr/pdf/rr/rr6203.pdf

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March 28, 2013 at 4:02 pm

Bacterial pneumonia and pandemic influenza planning.

Emerg Infect Dis. 2008 Aug;14(8):1187-92.

Gupta RK, George R, Nguyen-Van-Tam JS.

Source

Department of Infectious Diseases, John Radcliffe Hospital, Oxford, UK. rgupta2@nhs.net

Abstract

Pandemic influenza planning is well under way across the globe. Antiviral drugs and vaccines have dominated the therapeutic agenda. Far less work has been conducted on stockpiling and planning for deployment of antimicrobial drugs against secondary bacterial pneumonia, a cause of substantial illness and death in previous pandemics and epidemics. In the event of a pandemic, effective antimicrobial drug measures are expected to substantially benefit public health. We address issues regarding use of antimicrobial drugs as stocks of individual agents are diminished and the role of resistance surveillance in informing such policy. Furthermore, vaccination with polysaccharide and conjugate pneumococcal vaccines is considered as part of a pandemic strategy. Most illness and death from influenza are likely to occur in developing countries, where neuraminidase inhibitors and vaccines may be neither affordable nor available; thus, compared with industrialized countries, the benefits of treating bacterial complications in developing countries may be substantially greater.

PDF

http://wwwnc.cdc.gov/eid/article/14/8/pdfs/07-0751.pdf

March 27, 2013 at 2:24 pm

Methicillin-Resistant Staphylococcus aureus Colonization of the Groin and Risk for Clinical Infection among HIV-infected Adults

Emerging Infectious Diseases  April 2013 V.19  N.4 P.623-626

Philip J. Peters , John T. Brooks, Sigrid K. McAllister, Brandi Limbago, H. Ken Lowery, Gregory Fosheim, Jodie L. Guest, Rachel J. Gorwitz, Monique Bethea, Jeffrey Hageman, Rondeen Mindley, Linda K. McDougal, and David Rimland

Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.J. Peters, J.T. Brooks, S.K. McAllister, B. Limbago, G. Fosheim, R.J. Gorwitz, J. Hageman, L.K. McDougal); Veterans Affairs Medical Center, Atlanta (H.K. Lowery, J.L. Guest, M. Bethea, R. Mindley, D. Rimland); Emory University School of Medicine, Atlanta (D. Rimland)

Data on the interaction between methicillin-resistant Staphylococcus aureus (MRSA) colonization and clinical infection are limited. During 2007–2008, we enrolled HIV-infected adults in Atlanta, Georgia, USA, in a prospective cohort study. Nares and groin swab specimens were cultured for S. aureus at enrollment and after 6 and 12 months. MRSA colonization was detected in 13%–15% of HIV-infected participants (n = 600, 98% male) at baseline, 6 months, and 12 months. MRSA colonization was detected in the nares only (41%), groin only (21%), and at both sites (38%). Over a median of 2.1 years of follow-up, 29 MRSA clinical infections occurred in 25 participants. In multivariate analysis, MRSA clinical infection was significantly associated with MRSA colonization of the groin (adjusted risk ratio 4.8) and a history of MRSA infection (adjusted risk ratio 3.1). MRSA prevention strategies that can effectively prevent or eliminate groin colonization are likely necessary to reduce clinical infections in this population.

PDF

http://wwwnc.cdc.gov/eid/article/19/4/pdfs/12-1353.pdf

March 27, 2013 at 2:20 pm

NEUMONIA POR LEGIONELLA PNEUMOPHILA. EXPERIENCIA EN UN HOSPITAL UNIVERSITARIO DE BUENOS AIRES

MEDICINA (Buenos Aires) 2004; 64: 97-102

CARLOS M. LUNA1, JAVIER BREA FOLCO1, PATRICIA ARUJ1, KARINA REBORA1, CLAUDIA BALSEBRE1, RUBEN ABSI2, CARLOS VAY2, CARMEN DE MIER2, ANGELA FAMIGLIETTI2

1División Neumonología, Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina; y

2Secciones Inmunoserología y Bacteriología, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica,

Universidad de Buenos Aires

La enfermedad de los legionarios es una causa de neumonía adquirida en la comunidad (NAC) reconocida en todo el mundo. En Latinoamérica su incidencia es desconocida. En este estudio se analizó a 9 pacientes con NAC por Legionella pneumophila atendidos entre 1997 y 2001 en el Hospital de Clínicas José de San Martín de la Universidad de Buenos Aires. Se registraron datos de antecedentes, enfermedad actual, contactos, exposición laboral, examen físico, pruebas de laboratorio y uso previo de antibióticos, y se tomó en cuenta la presencia de criterios de gravedad. Nueve pacientes presentaron diagnóstico de NAC por Legionella, ninguno refirió antecedentes de viajes recientes; cuatro de ellos debieron ser internados en unidades de cuidado intensivo. Siete pacientes tenían antecedentes de tabaquismo, 4 tenían EPOC y un paciente linfoma no-Hodgkin. Nuestra casuística corrobora la baja especificidad de la clínica y estudios complementarios para predecir esta  etiología. El aislamiento de Legionella es dificultoso, la seroconversión permite el diagnóstico retrospectivo y requiere plazos prolongados y el antígeno urinario aporta un diagnóstico inmediato. Cuando la legionelosis aparece en casos aislados, como ocurriría en Argentina, si no se piensa en esta etiología no se llegará al diagnóstico. Legionella pneumophila es un patógeno de NAC en nuestro medio, debe buscarse mejor, particularmente en pacientes graves, inmunodeprimidos y en fumadores con enfermedad pulmonar obstructiva crónica (EPOC).

PDF

http://www.scielo.org.ar/pdf/medba/v64n2/v64n2a01.pdf

March 25, 2013 at 10:09 pm

Legionella pneumophila

Revista Chilena de Infectología  Junio 2008  V.25 N.3 P.208

Legionella es una bacteria ambiental. Su habitat es las aguas dulces de lagos y ríos. Se encuentra en bajas concentraciones en el plancton al interior de protozoos como Hart-mannella y Acanthamoeba, o formando parte de la biopelícula. A través de las redes de agua potable, accede a equipos tales como torres de refrigeración, sistemas centralizados de agua caliente, equipos de aerosol-terapia y sistemas de agua climatizada entre otros. A partir de estas instalaciones, Legionella puede infectar al hombre por inhalación de micro-aerosoles contaminados con la bacteria. Se reconocen dos formas clínico-epidemiológicas de la infección: “fiebre de Pontiac”, forma no neumónica, en general autolimitada, descrita como un “Flu like”; y legionelosis: neumonía con alteración del estado de conciencia.

PDF

http://www.scielo.cl/pdf/rci/v25n3/art13.pdf

March 25, 2013 at 10:07 pm

Pandemic Influenza and Pneumonia Due to Legionella pneumophila – A Frequently Underestimated Coinfection

Clinical Infectiosu Disesase 1July 2010  V.51 P.115

To the Editor—Secondary bacterial pneumonia is recognized as one of the most common causes of death in influenza cases. Coinfection has been found in ∼30% of all influenza cases in persons with seasonal influenza, and the pathogens most often involved are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenza …

PDF

http://cid.oxfordjournals.org/content/51/1/115.2.full.pdf

 

March 23, 2013 at 1:54 pm

Community-acquired pneumonia due to Legionella pneumophila, the utility of PCR, and a review of the antibiotics used.

Int J Gen Med. 2011 Jan 6;4:15-9.

Zarogoulidis P, Alexandropoulou I, Romanidou G, Konstasntinidis TG, Terzi E, Saridou S, Stefanis A, Zarogoulidis K, Constantinidis TC.

Source

Regional Laboratory of Public Health, East Macedonia-Thrace, Komotini, Greece. pzarog@hotmail.com

Abstract

INTRODUCTION:

There are at least 40 types of Legionella bacteria, half of which are capable of producing disease in humans. The Legionella pneumophila bacterium, the root cause of Legionnaires’ disease, causes 90% of legionellosis cases.

CASE PRESENTATION:

We describe the case of a 60-year-old woman with a history of diabetes mellitus and arterial hypertension who was admitted to our hospital with fever and symptoms of respiratory infection, diarrhea, and acute renal failure. We used real-time polymerase chain reaction (PCR) to detect L. pneumophila DNA in peripheral blood and serum samples and urine antigen from a patient with pneumonia. Legionella DNA was detected in all two sample species when first collected.

CONCLUSION:

Since Legionella is a cause of 2% to 15% of all community-acquired pneumonias that require hospitalization, legionellosis should be taken into account in an atypical pulmonary infection and not be forgotten. Moreover, real-time PCR should be considered a useful diagnostic method.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056326/pdf/ijgm-4-015.pdf

 

 

March 23, 2013 at 9:49 am

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